Evolution of insomnia: transition from acute to chronic disorder

Abstract

Due to the divergence of the acute insomnia conceptualization and difficulties in diagnostics, this phenomenon attracts comparatively little attention in the medical literature. Patients don’t seek medical attention and prefer self-treatment or wait for selfrecovery. This paper aims to review the literature concerning understanding the position of chronic insomnia in existing human models, systematization of aspects, related to insomnia development, and evidence of this relation. Apparently, acute insomnia is a non-specific hyperreaction to distress which tends to self-recovery. Ineffective coping strategies, dysfunctional thinking, and violation of sleep hygiene rules predispose transition from acute to chronic form. This is evidenced by epidemiological data: 1-year prevalence of acute insomnia in adults is about 30% among which 16-19% of cases are diagnosed for the first time and 7,4% become chronic.Understanding of acute insomnia heterogeneity, as well as pathogenesis and predictors of chronization, reveals the perspectives for personalized treatment and prophylaxis. Acute insomnia is routinely managed with short-term prescription of GABAA receptor agonists, antihistamines, phytotherapy, while cognitive-behavioral therapy is commonly used for the chronic form of insomnia. Identification of behavioral and cognitive predictors of insomnia chronization enables management of insomnia with cognitive-behavioral therapy even in the early stages.

Keywords

• sleep
• acute insomnia
• chronic insomnia
• pathogenesis
• stress
• predictors