Acute vs. Chronic: Types of insomnia and their causes
Insomnia is characterised by a persistent difficulty falling or staying asleep, as well as waking up too early. It’s a pervasive sleep disorder, affecting as many as 16 million people in the UK1.
Insomnia is a complicated, multi-layered condition with an array of mutually reinforcing causes. You can experience acute insomnia – which lasts for a few weeks or days – or chronic insomnia – which persists for much longer.
Here, we explore the different types of insomnia, distil the common causes of each, and provide some guidance on managing them.
What are the symptoms of insomnia?
You have insomnia if you regularly experience the following symptoms:2
Struggle to fall asleep
Wake up several times during the night
Wake up early and cannot go back to sleep
Lie awake at night
Feel tired after waking up
Struggle to nap despite feeling tired
Feel irritable and tired throughout the day
Struggle to concentrate during the day
What are the different types of insomnia?
There are two main types of insomnia: chronic insomnia and acute insomnia.
Chronic insomnia is a long-term pattern of sleeplessness. Insomnia is considered chronic if you’ve experienced trouble sleeping at least three nights a week for three months or longer. Chronic insomnia can affect people of all ages and is more common in women.
What causes chronic insomnia?
Chronic insomnia has many potential triggers.
Pain or discomfort at night from long-term medical conditions
Some medications, such as antidepressants or beta-blockers
Overuse of stimulants, like caffeine, illicit drugs, or nicotine
Lifestyle patterns, such as shift-work or frequently travelling across time zones
A disruptive bed partner
Chronic insomnia treatment options:
Cognitive behavioural therapy for insomnia (CBT-i) is the preferential chronic insomnia treatment since it doesn’t have the health risks associated with sleep medication3.
This therapy looks at your sleep from a 360-degree angle. It involves educating yourself on optimal sleeping hygiene practices and recognising how certain behaviours and beliefs can interfere with your ability to sleep.
There are many components of CBT-i, as we outline below.
Sleep hygiene focuses on improving your habits around sleep. Specifically, it involves cultivating healthy daily practices – supporting your emotional health, getting enough exposure to morning light, avoiding caffeine after midday, exercising, and reducing alcohol consumption at night – optimising your bedroom for sleep – ensuring your sleep environment is dark, temperate, and quiet – and following a relaxing wind-down routine.
Sleep restriction supports sleep quality and quantity by reducing the amount of time you spend lying in bed awake. A CBT-i therapist will ask you to keep a personal sleep diary, which they will then use to determine how much you sleep at night compared to the amount of time you lie awake. The aim is to reduce the amount of time spent in bed to consolidate sleep.
Sleep experts also agree that practising relaxation methods can reduce insomnia. Some of these techniques include breathing exercises, muscle relaxation, guided meditation, and yoga, which help the body and mind prepare for rest.
What is a natural cure for chronic insomnia?
There isn’t one single natural cure for chronic insomnia. However, there’s a range of natural aids to support sleep and help manage insomnia.
Magnesium contributes to normal muscle and psychological function, making it a useful addition to support your sleep quality and quantity.
Valerian root is a traditional herbal remedy used for the temporary relief of night-time disturbances and mild anxiety.
Theanine and Lemon Balm
The soothing blend of Theanine and Lemon Balm is often recommended for those who want to improve their sleep.
St John’s Wort
St John’s Wort is a traditional herbal medicinal product used to relieve the symptoms of slightly low mood and mild anxiety.
Tart cherry juice
Tart cherry juice is rich in the sleep hormone melatonin, which is why it’s widely taken before bed.
Soaking in a relaxing Epsom salt bath can prepare your body and mind for rest at night.
Experiencing short-lived episodes of sleeplessness is known as acute insomnia. A significant life event or stressor usually triggers this type of insomnia. Acute insomnia typically resolves naturally when the stressor goes away.
What causes acute insomnia?
There are many reasons why you may experience acute insomnia.
Physical or emotional discomfort
Significant life stress, such as grief, divorce, moving house, or job loss
Environmental factors that disrupt sleep, like extreme temperatures (cold or hot), light, or noise
Some medications, such as those to treat depression or allergies, may disturb sleep
How long does acute insomnia last?
Acute insomnia lasts for less than three months. However, acute insomnia can persist and become chronic insomnia if the stressful incident or stressor remains unresolved.
Acute insomnia treatment options
Unlike chronic insomnia, acute insomnia doesn’t usually need treatment. Often, a spell of sleeplessness gradually improves as you learn to cope with the stressful event or, indeed, the stressor dissipates.
Still, acute insomnia can be prevented and managed with healthy sleep hygiene practices. And since stress and anxiety almost always contribute to acute insomnia, it’s important to pay close attention to supporting your emotional health at this time.
Other terms for insomnia
Although insomnia is generally categorised as chronic or acute, the following terms are also used to describe the condition.
Sleep onset insomnia
Sleep onset insomnia describes struggling to fall asleep at the beginning of the night. It’s often associated with restlessness and the idea of tossing and turning in bed. Individuals with sleep onset insomnia will lie in bed for longer than 20-30 minutes before falling asleep, which reduces total sleep time.
Sleep maintenance insomnia
Sleep maintenance insomnia describes difficulty maintaining sleep throughout the night. Often, this means rousing at least once during the night and being unable to fall back to sleep for at least 20-30 minutes. Fragmented sleep reduces both sleep quality and quantity.
Early morning awakening insomnia
Early morning awakening insomnia describes waking up long before a person plans or wants to.
Being stuck in a negative feedback loop of tiredness and insomnia can be incredibly challenging. However, we hope you feel empowered to manage and prevent acute or chronic insomnia by understanding its causes and potential treatment options.
For more advice on improving your sleep hygiene, please explore the rest of our Sleep Health Hub.
- NHS UK. (2021). Insomnia. Available online: https://www.nhs.uk/conditions/insomnia; Aviva.com. (2021). Sleepless cities revealed as one in three adults suffer from insomnia. Available: https://www.aviva.com/newsroom/news-releases/2017/10/Sleepless-cities-revealed-as-one-in-three-adults-suffer-from-insomnia?
- nhs.uk. 2021. Insomnia. [ONLINE] Available at: https://www.nhs.uk/conditions/insomnia/
- Psychology Today. 2021. Cognitive Behavioral Treatment for Insomnia (CBTi) Defined. [ONLINE] Available at: https://www.psychologytoday.com/us/blog/sleep-health-and-wellness/201904/cognitive-behavioral-treatment-insomnia-cbti-defined
Olivia Salter has always been an avid health nut. After graduating from the University of Bristol, she began working for a nutritional consultancy where she discovered her passion for all things wellness-related. There, she executed much of the company’s content marketing strategy and found her niche in health writing, publishing articles in Women’s Health, Mind Body Green, Thrive and Psychologies.