Chronic insomnia is persistent difficulty initiating or maintaining sleep — or experiencing non-restorative sleep — at least three nights per week for more than three months, with consequences for daytime functioning. It is not just not sleeping: it includes the distress of attempting to sleep and real impairment in concentration, mood, and energy.
Concept origin
Spielman, Saskin, and Thorpy's (1987) 3P model distinguishes predisposing, precipitating, and perpetuating factors, explaining why acute insomnia becomes chronic. The AASM and ICSD-3 (2014) establish the current diagnostic criteria.
How it manifests
- ▸ Difficulty falling asleep for more than 30 minutes
- ▸ Frequent nighttime awakenings or very early morning waking
- ▸ Feeling of non-restorative sleep despite adequate time in bed
- ▸ Daytime fatigue, irritability, or cognitive difficulties
Therapeutic approach
Cognitive-Behavioral Therapy for Insomnia (CBT-I) is the first-line treatment recommended by all international clinical guidelines. It combines sleep restriction, stimulus control, sleep hygiene, and restructuring of dysfunctional beliefs about sleep.
Related concepts
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