Chronic Insomnia Affects 12% of Americans—Here’s How to Know If You Have It

Being unable to fall and stay asleep is a frustrating situation for anyone—but a new survey suggests 12% of Americans are struggling with chronic insomnia, or long-term, persistent sleep issues.

According to a new survey conducted by the American Academy of Sleep Medicine (AASM), 12% of Americans say they have been diagnosed with chronic insomnia. The survey of 2,006 adults was conducted online between May 16 and May 24, and was published on June 14.¹

The results of the survey showed that men were slightly more likely to have been diagnosed with chronic insomnia as compared to women. Diagnoses were also most prevalent in people ages 25 to 44.²

Chronic insomnia is a serious sleep issue—not only can this disorder lead to sleep deprivation, but it can also cause fatigue, low energy, and impact a person’s physical and emotional health. In fact, chronic insomnia has been linked to depression, anxiety, Alzheimer’s disease, and type 2 diabetes, among other health issues.¹

With chronic insomnia being a significant (and relatively common) health threat, how can you tell if you have this disorder, or you’re simply dealing with garden-variety sleeping troubles?

Here’s what experts had to say about how to identify chronic insomnia, why some people develop the disorder, and what it takes to get properly diagnosed and treated.

What Is Chronic Insomnia?

In general, insomnia is a condition in which a person has difficulty falling asleep or staying asleep, or regularly wakes up earlier than they want to, even though they are allowing enough time in bed for sleep, said AASM spokesperson Indira Gurubhagavatula, MD, MPH, director of the sleep medicine fellowship and professor of sleep medicine at the University of Pennsylvania Perelman School of Medicine.

“Lots of people have what’s called acute insomnia, or ‘adjustment’ insomnia, usually in response to a stressful situation,” Gurubhagavatula told Health.

Stress, anxiety, or worrying can actually play a role in disrupting a person’s circadian rhythm, which explains its connection to insomnia, added Nathan Baumann, PhD, clinical psychologist and sleep disorder expert at South Psychology in Colorado.

“One important component of sleep is our circadian rhythm, which is the cycle of energy and rest that our body experiences daily,” Baumann told Health. “When it is interrupted, it can lead to long-term disruptions.”

Acute insomnia “may last for a few days or even weeks,” said Gurubhagavatula. “The symptoms usually resolve after the person deals with the stress, or the source of the stress goes away.”

Sometimes, though, the insomnia does not go away. Insomnia can become “chronic” if it lasts for three months or longer, and occurs at least three times a week, Gurubhagavatula said.³ You also could have chronic insomnia if these bouts of sleeplessness last for less than three months, but keep coming back continually over a period of months or years.

“[A person could even have chronic insomnia if they] take medications chronically to fall asleep and feel they just cannot sleep without the aid of sleeping pills,” she added.

This type of insomnia usually affects multiple areas of a person’s daily life. Beyond just difficulty falling or staying asleep, Gurubhagavatula said, those with chronic insomnia might experience the following:

• Being dissatisfied with their sleep quality
• Feeling like they’re not sleeping enoug
• Experiencing anxiety about sleep
• Having daytime tiredness, fatigue, low energy, or sleepiness
• Getting headaches
• Being irritable
• Feeling achy and nauseated
• Falling asleep at the wheel or getting into a crash

Getting Diagnosed With Chronic Insomnia

To be diagnosed with chronic insomnia, your sleep challenges must rise to the level of causing significant distress or impairment in your social relationships, work, education, or other important areas of functioning, said Baumann.

In addition to happening multiple nights a week over a period of several months, “these disruptions [also] must not be better explained by another sleep disorder or a substance use episode,” he explained.

To determine if you have diagnosable chronic insomnia, take stock of and monitor your sleep issues, said Shmaya Krinsky, PsyD, a licensed psychologist and founder of Anxiety and Behavioral Health Psychotherapy in New York.

Krinsky said people should watch for the following symptoms:

• Taking more than 30 minutes to fall asleep at least three nights a week
• Having frequent awakenings or prolonged periods of wakefulness during the night
• Experiencing stress, mood disturbances, difficulty concentrating, or challenges remembering things

“If these symptoms are persistent, it is advisable to consult a healthcare professional, typically a primary care physician or a sleep specialist,” Krinsky told Health. “They can rule out other medical or psychological conditions that may be causing the symptoms.”

A doctor might do this by looking through your medical history, doing a physical exam, asking you to keep a sleep diary, or doing polysomnography, he explained.

What Is Polysomnogrpahy?

Also known as a sleep study, polysomnography is a test that is used to diagnose sleep disorders. It not only monitors what you do in your sleep, but also how your body responds and functions while you sleep. Sleep studies can be conducted in a sleep center overnight, or patients can do them at home with a portable device.⁴

What You Can Do About Chronic Insomnia

Though chronic insomnia can seriously impact a person’s health and well-being, there are treatment options available.

According to the AASM, the most effective treatment for chronic insomnia is cognitive behavioral therapy for insomnia (CBT-I).

“Many people come to a sleep doctor hoping for a quick fix with a pill,” said Gurubhagavatula. “However, the first-line therapy for insomnia is not a pill. It is [CBT-I].”

This therapy approach, which typically lasts six to eight sessions, includes behavioral changes and cognitive strategies. While the treatment will be different for everyone, it may include going to bed at the same time every night, getting out of bed when you can’t sleep, and managing fears about not being able to sleep.¹

According to Gurubhagavatula, research has shown that CBT-I works as well as medications and lasts longer.

“People who go through CBT-I are more satisfied with their sleep one year later than if they had taken medications,” she explained.

CBT-I also doesn’t have unwanted side effects that can sometimes accompany medications, such as dizziness, risk of falling, incompatibility with other drugs or alcohol, and more, Gurubhagavatula said.

That said, people with chronic insomnia will often self-medicate with over-the-counter medications such as Benadryl (diphenhydramine) or melatonin. But these drugs only cause increased drowsiness and are typically not good long-term solutions, Baumann said.

Instead, people can complement therapy with better sleep hygiene practices, Gurubhagavatula advised. For instance, try cutting back on caffeine, getting exposure to light in the mornings and evening, exercising regularly, avoiding smoking and drinking, and setting a regular bedtime and wake time, she said.

“Keep your bedroom environment cool, dark, quiet, and comfortable,” she explained. “And try to avoid bright light during the hour before bedtime. If you have chronic pain, acid reflux, or other health conditions that you know keep you from sleeping, address these issues with your healthcare professional.”