According to the DSM-5, the criteria for insomnia disorder include:
- Intense dissatisfaction with the quality or amount of sleep caused by trouble falling asleep, difficulty staying asleep and waking up too early in the morning without being able to fall back asleep
- Sleep issues create a significant amount of stress that begins to impact aspects of daily life
- Sleep problems occur at least three nights each week and persist for at least three months
- Poor sleep occurs even when there is enough time devoted to sleep and rest
One type of insomnia, called primary insomnia, lasts for a month or more and is related to external stressors in the person’s life. The causes of primary insomnia include:
- Major life changes, like moving
- High stress
- Travel or work changes
- Bad habits, like napping or going to bed too early or late
According to the American Academy of Sleep Medicine:
- Stress can result in adjustment insomnia, which may affect up to 20% of people each year
- Poor sleeping habits in children can lead to behavioral insomnia of childhood, affecting 30% of children
- Prescription drugs, substance abuse, medical disorders, and mental health conditions can cause insomnia, with about 3% of the population having this type of sleep issue. Specific causes include depression, drug withdrawal, obesity and anemia
- A person with high anxiety and worry could have psychophysiological insomnia, a condition affecting about 2% of the population and about 15% of sleep center patients.
Cost of Insomnia
Insomnia takes a heavy toll in the workplace. According to the American Academy of Sleep Medicine, insomnia costs:
- 11.3 days of work for the average worker every year
- $2,280 in lost productivity for the average worker each year
- A total of $63.2 billion for the entire nation [USA] in lost productivity per year
Treatments can be expensive as well. The cost of filling a generic sleeping pill prescription may run $200 per year, while a course of psychotherapy for insomnia can cost up to $1,200.
The American Sleep Association notes the human cost of insomnia is steep, with about 1,600 deaths and 40,000 injuries caused by drowsy driving each year. Additionally, a significant portion of the 100,000 hospital deaths caused by medical errors each year can be attributed to sleep deprivation.
Insomnia Prognosis and Outlook
Overall, the prognosis and outlook for insomnia are favorable. However, it’s essential to keep in mind some risk factors associated with a poorer prognosis, including:
- High anxiety, worry and tendency to repress feelings
- Being an older woman
- Family members with insomnia
- Poor sleeping conditions
- Excessive caffeine use
- Drug and alcohol use
- Irregular sleep schedules
