Chronic insomnia is a sleep disorder in which it is persistently difficult to fall or stay asleep, causing great distress to sufferers. Patients often feel tired, lack of energy and depressed mood, which affects their life and work. Even though patients may feel drowsy at times, the experience of not being able to fall asleep in bed can be very frustrating.
International clinical diagnostic criteria for chronic insomnia:
DSM-5：DSM-5 is a classification and diagnostic standard for mental illness. Insomnia is defined as “difficulty falling asleep, difficulty maintaining sleep, or early waking up.” It needs to last for more than 3 months, affects daytime functional performance, and excludes other possible causes.
ICSD-3：ICSD-3 is an international classification and diagnostic standard for sleep disorders, which defines insomnia as “problems such as difficulty falling asleep, maintaining sleep, waking up early, or poor sleep quality,” which need to last for more than 3 months and affect daytime function.
The impact of chronic insomnia on mental and mental health:
A systematic review and meta-analysis found that patients with chronic insomnia were more likely to experience anxiety and depressive symptoms than non-insomniac patients (Baglioni et al., 2011). Another large-scale survey study of adults aged 18-65 found that insomnia was significantly associated with the prevalence of depression and anxiety (Léger et al., 2019).
A meta-analysis study published in the journal Sleep found that compared with people without insomnia symptoms, people with insomnia symptoms had a 2-fold increased risk of suicide (relative risk = 2.10, 95% confidence interval 1.61-2.73 ). Another study, published in the journal Psychiatric Research, found a positive correlation between insomnia severity and suicide risk. The study showed that people with chronic insomnia had a 3-fold increased risk of suicide (relative risk = 3.00, 95% confidence interval 1.53-5.87).
The impact of chronic insomnia on physical health:
Chronic insomnia can also have adverse effects on physical health. People with insomnia often feel tired and weak, and are prone to symptoms such as headaches, muscle aches, and gastrointestinal discomfort.
Long-term insomnia can also increase the risk of cardiovascular disease, metabolic syndrome, diabetes and other diseases.
A meta-analysis study published in the journal Sleep found a significant association between insomnia and cardiovascular disease. Patients with insomnia had a 45% higher risk of cardiovascular disease than those without symptoms of insomnia (relative risk = 1.45, 95% confidence interval 1.28-1.65).
A study published in the journal Cardiology also supports this conclusion. The study tracked insomnia and cardiovascular disease status in more than 100,000 participants and found that those with insomnia had a 27% higher risk of cardiovascular disease than those without symptoms of insomnia (relative risk = 1.27, 95% confidence interval 1.22-1.33).
How chronic insomnia is treated :
The current treatment of chronic insomnia mainly includes behavior therapy, drug therapy and comprehensive treatment. Behavioral therapy includes cognitive behavioral therapy (CBT-I) for insomnia, hypnotherapy and relaxation therapy. Drug treatment mainly adopts hypnotic drugs and sedative drugs. Comprehensive treatment is a combination of behavioral therapy and drug treatment, personalized treatment.
CBT-I is the treatment of chronic insomnia
A meta-analysis of studies found that CBT-I is the treatment of choice for the treatment of chronic insomnia, and has a significant therapeutic effect. According to a 2018 article by Cuijpers et al., CBT-I had a longer-lasting effect than placebo and drug treatments without adverse effects.
CBT-I can significantly improve sleep quality and daytime function in patients with chronic insomnia. According to a clinical practice guideline published by Qaseem et al. in 2016, CBT-I can significantly improve patients’ time to fall asleep, sleep efficiency, and waking time, while also improving patients’ daytime attention and work efficiency.
Hypnotherapy:
Hypnotherapy is also widely used in the treatment of insomnia, but its long-term effects need further research. Although hypnotics and sedatives can quickly relieve insomnia symptoms, they are prone to dependence and side effects, so they should be used with caution.
A systematic review of medications for insomnia found that hypnotics and antidepressants were similarly effective in improving insomnia symptoms, but hypnotics may have a faster therapeutic effect (Huedo-Medina et al., 2012). Another study showed that behavioral therapy improved insomnia symptoms more sustainably than medication, without the side effects of medication (Smith et al., 2002).
Improvement measures to prevent insomnia:
- maintain a regular sleep schedule
- avoid using electronic devices in bed
- Avoid coffee and beverages before bed
- For patients with long-term insomnia, they should consult a professional doctor in time for personalized treatment.
Precautions:
Behavioral therapy is one of the safest and most effective treatments, and it can be used to relieve insomnia symptoms through cognitive behavioral therapy, hypnotherapy, and relaxation therapy. At the same time, it is also necessary to pay attention to the use of drug treatment, and not to easily abuse hypnotics and sedatives, so as to avoid dependence and side effects.
Dealing with chronic insomnia requires a multifaceted approach that addresses various aspects of your lifestyle and habits. By incorporating the strategies mentioned in this article, you can take proactive steps toward achieving restful nights and improved overall well-being.
