Chronic insomnia can be exacerbated by the very attempts to force sleep, according to Dr. Ashkan Lee Naraghi, a board-certified pulmonologist and sleep specialist. With years of experience managing this often misunderstood condition, he clarifies the definition and implications of chronic insomnia, along with effective treatment strategies not widely known to patients.
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Dr. Naraghi defines insomnia as difficulty falling asleep, maintaining sleep, or waking up too early, despite having adequate opportunities to sleep. Symptoms must occur at least three times per week for three months to be considered chronic insomnia. This condition has significant consequences, including daytime fatigue and impaired concentration.
Research shows a link between chronic insomnia and increased risks of heart disease and cognitive decline. Dr. Naraghi emphasizes that while these associations are serious, they reflect correlation rather than direct causation. Patients should be alert to warning signs indicating medical urgency, such as chest pain or confusion, and he reassures that early diagnosis and treatment can mitigate dementia risks.
Common habits can worsen insomnia, including excessive screen time before bed, watching the clock, and self-medicating with sleep aids or alcohol. Dr. Naraghi explains that these behaviors can condition the brain to associate the bedroom with anxiety rather than rest. The goal of insomnia management should be to rebuild confidence in sleep rather than forcing it.
While melatonin is often seen as a sleep remedy, Dr. Naraghi points out that it is not a sleeping pill but a hormone that regulates circadian rhythms. Its effectiveness for chronic insomnia is inconsistent, and misuse can lead to next-day grogginess and false reassurance about sleep issues.
Cognitive Behavioral Therapy for Insomnia (CBT-I) is recommended as a structured program that treats the underlying causes of insomnia. Dr. Naraghi advocates for more widespread access to CBT-I, noting that many patients are first prescribed medications rather than offered this effective therapy. He stresses that insomnia management must consider individual circumstances, particularly for those experiencing life changes such as pregnancy or dealing with chronic pain.
Dr. Naraghi advises that if insomnia lasts for more than a few weeks or affects daily functioning, it is essential to consult a sleep specialist. Signs that warrant professional help include reliance on sleep aids, experiencing accompanying conditions like sleep apnea, or impacting overall quality of life.
Looking ahead, Dr. Naraghi sees promise in more personalized and accessible treatment options, including virtual CBT-I programs. He expresses hope for new medications that target wakefulness rather than merely sedate the mind. As the understanding of sleep disorders evolves, he encourages those suffering from insomnia to seek help, stating that effective solutions are available.