Evolution of insomnia: transition from acute to chronic disorder

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.

1. The international classification of sleep disorders, revised. 3 rd ed. Darien, Il: American Academy of Sleep Medicine; 2014.

2. The ICD-10 Classification of Mental and Behavioural Disorders Diagnostic criteria for research. Geneva: World Health Organization; 1993. 263 p. Available at: https://www.who.int/classifications/icd/en/bluebook.pdf.

3. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013. 991 p. Available at: https://www.appi.org/diagnostic_and_statistical_manual_of_mental_disorders_dsm-5_fifth_edition.

4. Ellis J.G., Gehrman P., Espie C.A., Riemann D., Perlis M.L. Acute insomnia: current conceptualizations and future directions. Sleep Med Rev. 2012;16(1):5-14. doi: 10.1016/j.smrv.2011.02.002.

5. Ellis J.G., Perlis M.L., Neale L.F., Espie C.A., Bastien C.H. The natural history of insomnia: Focus on prevalence and incidence of acute insomnia. J Psychiatr Res. 2012;46(10):1278-1285. doi: 10.1016/j.jpsy-chires.2012.07.001.

6. Leblanc M., Merette C., Savard J., Ivers H., Baillargeon L., Morin C.M. Incidence and Risk Factors of Insomnia in a Population-Based Sample. Sleep. 2009;32(8):1027-1037. doi: 10.1093/sleep/32.8.1027.

7. Morin C.M., Belanger L., LeBlanc M., Ivers H., Savard J., Espie C.A. et al. The Natural History of Insomnia. Arch Intern Med. 2015;169(5):447-453. doi: 10.1001/archinternmed.2008.610.

8. Hardison L., Gaines H., Neimeyer R.A., Lichstein K. Insomnia and complicated grief symptoms in bereaved college students. Behav Sleep Med. 2005;3(2):99-111. doi: 10.1207/s15402010bsm0302_4.

9. Davidson L., Fleming R., Baum A. Chronic stress, catecholamines, and sleep disturbance at three mile island. J Hum Stress. 1987;13(2):75-83. doi: 10.1080/0097840X.1987.9936798.

10. Fiorentino L., Ancoli-Israel S. Sleep dysfunction in patients with cancer. Curr Treat Options Neurol. 2007;9(5):337-346. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951736/.

11. Hobfoll S.E. T he ecology of stress. Washington. DC: Hemisphere; 1988. p. doi: 10.1002/smi.2460050415.

12. Spielman AJ., Caruso L.S., Glovinsky P.B. A behavioral perspective on insomnia treatment. Psychiatr Clin North Am. 1987;10(4):541-553. doi: 10.1016/s0193-953x(18)30532-x.

13. Spielman A.J., Glovinsky P.B. Introduction. The Varied Nature of Insomnia. In: Hauri PJ. (ed.). Case studies in insomnia. New York: Plenum Press; 1991. 254 p.

14. Baker L.D., Baldwin D.S., Garner M. Daytime intrusive thoughts and subjective insomnia symptoms. Psychiatry Res. 2015;229(3):1038-1042. doi: 10.1016/j.psychres.2015.02.022.

15. Hall M., Baum A. Intrusive thoughts as determinants of distress in parents of children with cancer. J Appl Soc Psychol. 1995;25(14):1215-1230. doi: 10.1111/j.1559-1816.1995.tb02615.x.

16. Hall M., Buysse M.A., Dew M.A., Prigerson H.G., Kupfer DJ., Reynolds C.F. 3rd. Intrusive thoughts and avoidance behaviors are associated with sleep disturbances in bereavement-related depression. Depress Anxiety. 1997;6(3):106-112. Available at: https://pubmed.ncbi.nlm.nih.gov/9442984/.

17. Reynolds C.F. 3rd, Hoch C.C., Buysse DJ., Houck P.R., Schlernitzauer M., Pasternak R.E. et al. Sleep after spousal bereavement: a study of recovery from stress. Biol Psychiatry. 1993;34(11):791-797. doi: 10.1016/0006-3223(93)90068-o.

18. Drake C., Richardson G., Roehrs T., Scofield H., Roth T. Vulnerability to Stress-related Sleep Disturbance and Hyperarousal. Sleep. 2004;27(2):285-291. doi: 10.1093/sleep/27.2.285.

19. Drake C.L., Pillai V., Roth T. Stress and Sleep Reactivity : A Prospective Investigation of the Stress-Diathesis Model of Insomnia. Sleep. 2014;37(8):1295-1304. doi: 10.5665/sleep.3916.

20. Fernandez-Mendoza J., Vela-Bueno A., Vgontzas A.N., Ramos-Platon MJ., Olavarrieta-Bernardino S., Bixler E.O., De la Cruz-Troca JJ. Cognitive-emotional hyperarousal as a premorbid characteristic of individuals vulnerable to insomnia. Psychosom Med. 2010;72(4):397-403. doi: 10.1097/PSY.0b013e3181d75319.

21. Ellis J., Cropley M. An examination of thought control strategies employed by acute and chronic insomniacs. Sleep Med. 2002;3(5):393-400. doi: 10.1016/s1389-9457(02)00039-4.

22. Taylor L.M., Espie C.A., White C.A. Attentional Bias in People With Acute Versus Persistent Insomnia Secondary to Cancer. BehavSleep Med. 2003;1(4):200-212. doi: 10.1207/S15402010BSM0104_3.

23. Bootzin R.R. Stimulus control treatment for insomnia. In: Proceedings, 80th Annual Convention APA. 1972.

24. Morin C.M. Insomnia: psychological assessment and management. New York: Guildford Press; 1993. 238 p. doi: 10.1002/smi.2460100113.

25. Shimodera S., Watanabe N., Furukawa T.A., Katsuki F., Sasaki M., Perlis M. Change in quality of life after brief behavioral therapy for insomnia in concurrent depression: analysis of the effects of a randomized controlled trial. J Clin Sleep Med. 2014;10(4):433-439. doi: 10.5664/jcsm.3624.

26. Jansson-Flojmark M., Linton SJ. The role of anxiety and depression in the development of insomnia: Cross-sectional and prospective analyses. Psychol Heal. 2006;21(3):383-397. doi: 10.1080/14768320500129015.

27. Wicklow A., Espie CA. Intrusive thoughts and their relationship to acti-graphic measurement of sleep: towards a cognitive model of insomnia. Behav Res Ther. 2000;38(7):679-693. doi: 10.1016/s0005-7967(99)00136-9.

28. Ellis J.G., Perlis M.L., Bastien C.H., Gardani M., Espie C.A. The Natural History of Insomnia: Acute Insomnia and First-onset Depression. Sleep. 2014;37(1):97-106. doi: 10.5665/sleep.3316.

29. Riemann D., Baglioni C., Bassetti C., Groselj L.D., Ellis J.G., Espie C.A. et al. European guideline for the diagnosis and treatment of insomnia. J Sleep Res. 2017;26(6):675-700. doi: 10.1111/jsr.12594.

30. Ellis J.G., Cushing T., Germain A. Treating Acute Insomnia: A Randomized Controlled Trial of a “Single-Shot” of Cognitive Behavioral Therapy for Insomnia. Sleep. 2015;38(6):971-978. doi: 10.5665/sleep.4752.

31. Poluektov M.G., Buzunov R.V., Averbukh V.M., Verbitskiy E.V., Zaharov A.V., Kel’manson I.A. et al. Project of clinical recommendations on diagnosis and treatment of chronic insomnia in adults. Consilium Medicum. Nevrologiya i revmatologiya = Consilium Medicum. Neurology and Rheumatology 2016;(2):41-51. (In Russ.) Available at: https://con-med.ru/magazines/neurology/neurology-02-2016/proekt_klinicheskikh_rekomen-datsiy_po_diagnostike_i_lecheniyu_khronicheskoy_insomnii_u_vzroslykh.

32. Varkevisser M., Kerkhof G.A. Chronic insomnia and performance in a 24-h constant routine study. J Sleep Res. 2005;14(1):49-59. doi: 10.1111/j.1365-2869.2004.00414.x.

33. Wilson SJ., Nutt DJ., Alford C., Argyropoulos S.V., Baldwin D.S., Bateson A.N. et al. British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia , parasomnias and circadian rhythm disorders. J Psychopharmacol. 2010;24(11):1577-1600. doi: 10.1177/0269881110379307.

34. Morin C.M., Vallieres A., Ivers H., Savard J., Merette C., Bastien C., Billargeon L. Cognitive Behavioral Therapy, Singly and Combined With Medication, for Persistent Insomnia. JAMA. 2009;301(19):2005-2015. doi: 10.1001/jama.2009.682.