What Causes Chronic Insomnia?

There are many reasons why a person might develop insomnia.  These reasons usually fall into 3 categories:

Predisposing Factors

Some people are genetically at higher risk of chronic insomnia or have medical conditions that interfere with sleep.  For example, do your parents struggle with hypertension, obesity or sleep apnea?  Does anxiety or depression run in your family?  Does your partner tell you that you snore loudly or stop breathing in the middle of the night?  If so, you must take care to prevent chronic insomnia from becoming a problem.  Healthy practices like visiting your doctor and dentist regularly to monitor and treat underlying conditions are important to your wellbeing.  If you are being adequately treated for medical conditions and still experience chronic insomnia, you need specialized therapy like CBT-I to achieve healthy sleep.

Precipitating Factors

At some point in life, everyone will experience a major event that creates high levels of stress. Whether it is a joyful event (e.g., getting hired for a great new job) or a frightening event (e.g., being in a car accident) , it is normal to experience sleep disruption when something significant happens to you.  If you experience excessive exposure to distressing material (e.g., gruesome injuries, interpersonal violence, being threatened by serious danger or helplessness to stop a tragedy), you may be at additional risk of stress reactions such as repetitive traumatic nightmares or post traumatic stress disorder (PTSD). If you are haunted by traumatic memories for more than 1 month, you will likely need to get help from a therapist trained to treat PTSD (like Dr. Lin) in order to return to normal sleep. To learn more about PTSD and treatments for it, please click here.

Perpetuating Factors

Most people who experience stress may at first have disrupted sleep but eventually return to normal sleep.  However, some people continue to develop chronic insomnia. Why?  A close look at the daily routines of these individuals usually reveals a number of habits they picked up to compensate for inadequate sleep: napping during the day, drinking large amounts of caffeine or sugary sodas to stay alert, having a "nightcap" to get to sleep, staying in bed late whenever possible, etc. While these strategies may give some short term relief from sleeplessness, they sabotage healthy sleep in the long run and may lead to additional health problems.  In most cases, insomnia becomes chronic when a person does not break these habits.