From the Guidelines
Secondary insomnia is a sleep disorder that occurs as a result of another condition or factor, such as a medical condition, medication, substance use, or psychological disorder, disrupting normal sleep patterns. This condition is characterized by difficulty initiating or maintaining sleep, or early-morning waking, causing significant distress or impairment in daily activities, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition 1. The underlying causes of secondary insomnia can be diverse, including:
- Medical conditions like chronic pain, respiratory issues, gastrointestinal problems, or neurological disorders
- Medications such as stimulants, antidepressants, and corticosteroids
- Substance use, particularly alcohol, caffeine, and nicotine
- Psychological disorders like depression or anxiety Treatment of secondary insomnia primarily involves addressing the underlying cause, which may be supplemented with sleep hygiene improvements, cognitive behavioral therapy for insomnia (CBT-I), and short-term medication use, as recommended by the American Academy of Sleep Medicine 1. CBT-I is a particularly effective approach, incorporating behavioral therapies like sleep restriction and stimulus control, cognitive therapy to change dysfunctional beliefs about sleep, and sleep hygiene education 1. Proper diagnosis of the root cause is essential for successful treatment of secondary insomnia, as managing the underlying condition can lead to significant improvement in sleep quality and related impairments.
From the Research
Definition of Secondary Insomnia
- Secondary insomnia is a type of insomnia that occurs in conjunction with another medical or psychiatric condition, such as chronic pain or clinical depression 2, 3.
- It is also known as comorbid insomnia, and its diagnosis and treatment can be complex due to the underlying condition that accompanies it 2, 4.
Characteristics of Secondary Insomnia
- Secondary insomnia can manifest as difficulty falling asleep, staying asleep, or both, and can have a significant impact on a person's quality of life 2, 3.
- It is often associated with other conditions such as depression, anxiety, and chronic pain, and can be a challenge to diagnose and treat due to the complexity of the underlying condition 2, 5.
Treatment of Secondary Insomnia
- Treatment of secondary insomnia often focuses on addressing the underlying condition, but may also involve direct treatment of the insomnia symptoms 2, 3.
- Cognitive behavioral therapy for insomnia (CBT-I) is a recommended treatment approach for secondary insomnia, as it can be effective in improving sleep quality and reducing symptoms of insomnia 4, 3.
- Pharmacological treatments, such as hypnotic medications, may also be used to treat secondary insomnia, but their effectiveness and safety should be carefully evaluated 2, 6.