What is acute insomnia? How to diagnose and treat your short-term sleeping troubles

From insider.com

Acute insomnia, or short-term insomnia, is when you're having sleep troubles that last for less than a month at a time. 

Often, acute insomnia is the result of stress, and once the event causing stress passes, you should be able to sleep better. 

However, acute insomnia can still affect other areas of your life, and it's important to know how to treat your sleep troubles and get through it. 

This article was medically reviewed by Alex Dimitriu, MD, psychiatrist and founder of Menlo Park Psychiatry and Sleep Medicine. 

Anyone who has laid awake in bed staring at the clock, mentally calculating how many hours of sleep they will get if they fall asleep right now, knows the struggle of insomnia.

The sleep disorder is incredibly common, with acute cases affecting as many as 25% of Americans a year, according to a study from the University of Pennsylvania.
Insomnia can manifest in different ways for different people. Some have trouble falling asleep, others have trouble staying asleep, and some have difficulty with both.
However, when those sleep issues start to have a negative impact on your daily life, that's when it goes from just a few days of bad sleep to a concerning case of insomnia.

Insomnia can last for days, weeks, or even years. Generally, it is considered acute insomnia when it lasts for less than a month at one time, and chronic insomnia when it continues for longer, usually three months at one time.

Symptoms

The symptoms of insomnia, whether acute or chronic, are similar. They include:

• Lying awake for a long time before falling asleep
• Waking up during the night 
• Waking up early and being up for the day
• Feeling as if you haven't slept 
• Irritability, depression, or anxiety
• Difficulty paying attention, focusing or remembering
• Worrying about sleep

The severity of the symptoms generally worsens the longer insomnia persists.

Ashley Moore, a licensed clinical professional counsellor and lecturer at University of New England, says that for an acute case of insomnia, "the level of physiological and cognitive symptoms we are going to see are probably not going to be as severe as someone who has been experiencing insomnia for months."

Causes

Moore says many of her clients experience acute insomnia, typically during a time of stress or major change. The causes are usually psychological in nature, such as:

• Major life changes like moving or starting a new job
• Changes in your sleep schedule, like from work or travel
• Stressors like a sick family member or financial concerns
• Poor sleep habits, like not having a consistent bedtime
• Anxiety over having insomnia

Having anxiety about insomnia is a major concern because it can prolong the insomnia, or even worsen it.

Imagine someone has trouble sleeping for a few nights. "Now every night [they are] going to bed they are fearful that they're not going to be able to sleep," Moore says.  "So, their anxiety level is up and now their anxiety is actually making it harder to sleep."

While acute insomnia can turn into chronic insomnia, it usually won't — about 75% of those with acute insomnia will recover, meaning it takes them fewer than 15 minutes to fall asleep, or who spend fewer than 15 minutes awake during the night at least five times a week.

Most of the time, insomnia resolves itself when the stressor triggering it is resolved or at least addressed. For instance, if your insomnia is triggered by anxiety over starting a new job, it will likely go away once you have settled into work.
"It probably is going to resolve itself for most individuals," Moore says. "But there always is an individual's own tendencies and coping strategies and baseline anxiety that is going to play into that."

Treatment

Before you panic that you will never get another good night's sleep, Moore suggests trying to pinpoint what is triggering your insomnia and address it, if possible.
At the same time, improving your sleep habits, referred to as sleep hygiene, can help. This includes avoiding caffeine, alcohol and nicotine before bed, getting regular exercise, and skipping long daytime naps. Moore says most of the time, lifestyle changes will be the most beneficial.
Here are some more lifestyle tips to get better sleep:

Make your bedroom sleep-friendly

This might seem obvious, but it's critical: make sure your room is quiet and dark. Light can disrupt your circadian rhythm, delaying the release of melatonin, a hormone that helps you sleep.

People who live in areas with bright street lights are more likely to report trouble sleeping, according to a 2016 study. Especially for light sleepers, noise can disrupt sleep. Things like white noise machines or ear plugs can help with that, and black out curtains can block outside light.

The second part of creating a sleep-friendly room may be harder for most of us. You should only use your bedroom for two things: sleep and sex. The idea is to condition your mind and body so that being in your bed triggers sleepiness.
This is called stimulus control, and it's been used as treatment for insomnia since the 1970s, according to a review published in 2012. That means no watching TV, eating, working or even texting from bed.

Limit screens before bed

Speaking of TV and texting, it's also a good idea to limit screen time before bed. The blue light that comes from electronics is particularly good at suppressing melatonin, the hormone that helps make you sleepy.

Harvard researchers found it suppresses melatonin twice as long compared to green light. Cell phones and computers often have "night mode" features that reduce the amount of blue light your screen emits. Blue light blocking glasses have also become popular in recent years, although the science is split on how much they really help.

Light issues aside, there is another problem with watching TV or scrolling through social media before bed. It is mentally stimulating.

"People are often talking about experiences or fears or grief on social media. We're being exposed to this psychologically stimulating content," Moore says. "It's things that will peak our anxiety a little bit — even those of us who don't tend toward a trace level of anxiety."
Turn off the TV and put down your phone an hour or two before bed, and try doing something you enjoy that is also relaxing, whether it is reading a book, crocheting, listening to music or doing gentle yoga.

If you can't fall asleep, get up

Don't lay in bed for hours trying to sleep. It's only going to make it harder. For one thing, you don't want to condition your mind to associate your bed with lying awake.

This goes back to the concept of stimulus control. Lying awake in bed trains your brain to associate bed with wakefulness rather than sleep. It's also likely that the longer you lay in bed, the more anxious you will get about not being able to sleep.

"We tell ourselves things like, 'Oh my gosh, I'm going to have a hard time falling asleep again' and 'Oh my goodness, I'm so tired and I have to work in the morning,'" Moore says.  "Those types of stories come into our brain and can increase our anxiety and actually make it harder to fall asleep."
Try going to bed at your normal time, but if you are still awake after 20 to 30 minutes, get out of bed or read a book (just stay away from screens). Once you feel tired enough to fall asleep, try getting back in bed. Moore says this applies even to people who wake up in the middle of the night.

Keep a regular schedule

Finally, experts suggest keeping a regular schedule. Again, it has to do with how our bodies become conditioned to our routines.

"That's the last thing people want to hear—when I tell them if they get up at 7 o'clock in the morning on the weekdays they should get up at 7 o'clock in the morning on the weekend, too," Moore says.
But, it is important. It helps condition our bodies and can lead to better, longer sleep. For example, a study published in BMC Public Health looked at 160 university students. Researchers found that the more irregularity in a person's bedtime schedule, the less sleep they got a night. The study also suggested the quality of sleep decreased with irregular bedtime schedules.

In a similar study published in the journal Scientific Reports, researchers at Brigham and Women's Hospital found students with irregular sleep schedules had delayed release of melatonin and even had lower grade point averages.

Not keeping a regular sleep schedule can also disrupt your circadian rhythm, or your body's internal 24-hour clock. If you have ever had to switch your sleep schedule for shift work or travelled to a different time zone, you've likely experienced this.

When to seek professional help

If your insomnia is lasting more than a few weeks, and creeping into chronic insomnia territory, it may be time to reach out to your doctor or therapist.
This is especially true if the stressor that triggered your insomnia has resolved but you are still having trouble sleeping.

While sleep aids — both over-the-counter and prescription — may be able to help, trying to improve sleep hygiene through lifestyle changes should come first.

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