Adjustment insomnia, also referred to as acute insomnia, is characterized by a difficulty in initiating or maintaining sleep that lasts for a few days or weeks. This contrasts with chronic insomnia, which persists for months to years. Studies show that 15-20% of adults experience adjustment insomnia at least once a year. It can occur at any age but there is an increased prevalence in older adults. Women are more at risk than men. Adjustment insomnia typically coincides with a stressful life event. The most common stressors include career problems, financial hardship, health problems, family/relationship conflicts and dealing with the death of a friend or family member.
Adjustment insomnia tends to subside when the stressful event is resolved. However, it can evolve into chronic insomnia due to exacerbating factors including poor stress management, anxiety, poor sleep hygiene, or substance abuse. In many cases, adjustment insomnia requires no treatment since it is short lived. However, if the condition is causing distress and impeding your daily life, a doctor may prescribe sleeping medications or sleep aids like melatoninfor a limited period of time in order to combat some of the symptoms. If adjustment insomnia lasts longer than a few days, you should seek medical advice as extended periods of disrupted sleep can have negative consequences on your physical and mental health.
If the problem persists, you may need to undergo polysomnography; a sleep test which records heart rate, breathing rate, brain activity as well as eye and leg movements in order to evaluate whether another sleep disorder may account for your symptoms. Other strategies include maintaining a sleep diary to monitor sleep/wakefulness patterns. A blood test can be performed to assess for other medical conditions that could contribute to the insomnia. Good sleep hygiene practices such as going to bed at scheduled times, avoiding the intake of stimulants (e.g. caffeine) before bed, selecting a comfortable mattress and a bedroom environment that is quiet and cool are all vital for maintaining a good sleeping pattern.
Reviewed by Dr. Emma Mitchell, PhD,
ELLIS, J. G., PERLIS, M. L., NEALE, L. F., ESPIE, C. A. & BASTIEN, C. H. 2012. The natural history of insomnia: focus on prevalence and incidence of acute insomnia. J Psychiatr Res, 46, 1278-85. AVIDAN, A. & ZEE, P.C. 2011. Handbook of sleep medicine
Adjustment insomnia, or acute insomnia, is a short term form of insomnia. It typically lasts anywhere from a few days to a few months at maximum, and is routinely caused by stress, anxiety or some form of depression or worry. The onset of adjustment insomnia is usually quick, coinciding with something of importance that just occurred in a person’s life. In some cases it may develop slowly, and gradual development of it may make it more difficult to detect in the people experiencing it.
When the issues causing the stress or condition are remedied, the sleep problems usually follow suit. If the adjustment insomnia continues for a long time though, it may lead to a period of unstable sleep even after the situation is resolved, as the body becomes used to shortened or aggravated sleeping periods.
Specific issues that may be causing stress that could lead to short term insomnia are any major change in a person’s life, be it moving, getting a new job, dealing with the death of a friend or family member, etc., as well as relationship conflicts, financial issues, illness, or any type of uncertainty about the future. Adjustment insomnia can also be brought on by positive emotions such as excitement. Insomnias triggered by positive emotions rarely last more than a few nights.
It is common for people to experience adjustment insomnia multiple times throughout their lives, and in any cases involving very short term insomnia, seeking treatment is not necessary. Dealing with the insomnia by turning to alcohol or other drugs can often exacerbate the problem, and should be avoided. If the short term insomnia is causing enough distress or hardship that waiting for it to pass is not an option, you can consult your doctor about sleeping medications or other methods to help you achieve better sleep until it subsides.
As many as 20% of adults deal with acute insomnia at least once each year, and over 90% of adults will deal with it at least once in their lives, though they may not recognize it for what it is and attribute it to other things. It can occur at any age, but is more often found in adults than children, and women are at a higher risk of having it than men, based on their tendency to over analyze situations and work themselves up. Children rarely deal with such stress related issues, and acute insomnia in children is mainly brought on by excitement, and only lasts one or two nights. People with prior histories of insomnia are prone to suffer through it again at some point, or often.
Detection of adjustment insomnia is often disregarded, because of its short term effects. In people who routinely get very good sleep, but suddenly find themselves struggling to fall asleep or stay asleep for consecutive nights, it is likely that you have a short term insomnia. If you find yourself unusually tired, cranky, or without much energy during the day, you may be going through adjustment insomnia.
If the adjustment insomnia lasts longer than a few days, you should seek help, as extended periods of poor sleep can have bad effects on your health and psyche. A healthcare professional will often try to decipher what it is that has caused your sudden poor sleeping behavior. You may already be aware of the issues that are causing it.
If problems persist, you may need to undergo polysomnography – a sleep test, to show the extent of your problems, and to ensure that it isn’t another sleep disorder causing your troubles. Other tests could include a written test to analyze your state of mind, and a blood test to check for other medical problems that could either be compounding the stress, or leading to the poor sleep on their own.
While adjustment insomnia is usually caused by stressful issues, it may be that changes in your sleeping habits or environment are causing the short term insomnia, and if these aren’t changed, could lead to a long term or chronic case of insomnia.
Following proper sleep hygiene, such as going to bed at scheduled times, avoiding the intake of stimulants when nearing bed time, having a comfortable bed and pillow, and having a quiet and comfortable bedroom, are all important for good sleep.
Reviewed September, 2007
Dr. Lin Enilak