Insomnia is one of the most common sleep disorders, and it can present as either short-term (acute) or long-term (chronic). Effective treatment typically includes evidence-based approaches such as cognitive behavioral therapy for insomnia (CBT-I), medication when appropriate, and improvements in sleep hygiene.

At The Insomnia and Sleep Institute of Arizona care is guided by safe, effective, and individualized treatment plans. Seeing a sleep specialist first is essential to receiving an accurate diagnosis, which then informs the most appropriate course of treatment.

How Common Is Insomnia in the United States?

How Common Is Insomnia in the United States?

Insomnia significantly impacts quality of life. Approximately33% of adults in the U.S. report experiencing  insomnia symptoms at some point in their lives(1). However, insomnia is more than occasional poor sleep.

It involves persistent difficulty falling asleep, staying asleep, or waking too early despite adequate opportunity for rest.

Stress and depression are two of the strongest contributors to insomnia. During the COVID-19 pandemic, both increased dramatically—especially among medical professionals. For many, what began as short-term insomnia may have progressed into chronic insomnia over time.

Insomnia Among Medical Staff: What the Data Shows

A study published in Frontiers in Psychiatry in April 2020 examined psychological distress among healthcare workers during the COVID-19 outbreak (2). Researchers surveyed 1,563 medical staff using a questionnaire that measured insomnia, anxiety, and depression symptoms. 36.1% of participants reported insomnia symptoms (based on the Insomnia Severity Index). Higher risk was associated with:

  • Lower education levels
  • Strong uncertainty about controlling COVID-19
  • Fear of infection
  • Lack of psychological support
  • Working in isolation units
  • Physician roles (to a lesser extent compared to other staff)

The authors emphasized the need for targeted psychological and sleep-related interventions, particularly for those facing higher sociopsychological stress.(2).

Early Pandemic Impact on Sleep

Although this study was published early in the pandemic, it captured a critical period when uncertainty and stress were especially high. Medical workers faced:

  • Fear of infecting themselves or their families
  • Concern for colleagues’ safety
  • Social isolation
  • Constant exposure to distressing news and mortality data

These factors contributed not only to insomnia, but also to anxiety, stress, and emotional exhaustion. (2).

The Role of Stress in Insomnia

“Stress is considered the primary cause of insomnia,” according to the authors. Some previous research has been published related to insomnia and those working in medical care during the SARS outbreak.

Interestingly, some studies suggest physicians may report slightly lower insomnia rates than other healthcare workers, possibly due to more consistent daytime schedules compared to shift-based roles. However, this is not universal and varies by setting (2).

Risk Factors for Chronic Insomnia in Medical Staff

In conclusion, the researchers suggested possible interventions for medical staff suffering from insomnia, and in particular for those with higher sociopsychological risk factors.

They especially recommend cognitive insomnia behavior therapy for insomnia (CBT-I), which is one of the three primary treatments available at The Insomnia and Sleep Institute of Arizona. They also recommend sleep hygiene as well as stimulation control, relaxation therapy, and sleep restriction. Each of these can also be part of a guided sleep hygiene best practice.

Acute vs Chronic Insomnia

Insomnia is classified as short-term or chronic based on duration and frequency of symptoms.

Acute (Short-Term) Insomnia (3)

  • Lasts days to weeks
  • Difficulty falling or staying asleep despite adequate opportunity
  • Often triggered by stress, illness, or life changes
  • Daytime effects include fatigue, poor focus, and mood changes
  • Affects up to one-third of people; 4%–22% meet clinical criteria
  • More common in women, especially after menopause
  • This form of insomnia is often linked to a temporary state of heightened alertness (hyperarousal), including elevated cortisol, heart rate, and metabolism.

Chronic Insomnia Disorder (4)

  • Occurs at least 3 nights per week for 3 months or longer
  • Causes significant daytime impairment (fatigue, irritability, poor performance)
  • Diagnosed primarily through reported symptoms

Chronic insomnia is associated with:

  • Depression, anxiety, and PTSD
  • High blood pressure
  • Chronic pain, asthma, and GERD
  • Sleep apnea and substance use

It is often explained through a three-factor model:

  • Predisposing factors (genetics, baseline anxiety)
  • Precipitating factors (stressful events)
  • Perpetuating factors (poor sleep habits, worry about sleep)

Shift Work and Circadian Rhythm Disruption

Shift work disrupts the body’s circadian rhythm, the internal clock governing sleep-wake cycles, hormone release, metabolism, and alertness. This rhythm is strongly influenced by the light-dark cycle (5). Night or rotating schedules misalign internal clocks with environmental cues, leading to internal circadian desynchronization (6).

People who put in 48 hours or more each week were more likely to report:

  • Shorter sleep duration
  • Poor sleep quality
  • Increased insomnia symptoms (7). 

Shift Work Sleep Disorder (SWSD) is a clinically recognized circadian rhythm condition that affects people who work nontraditional schedules, causing difficulty sleeping when they try to rest and excessive sleepiness when they need to be awake (8).

Long-Term Health Effects of Chronic Insomnia

Chronic insomnia is more than feeling tired or wired at night. When sleep stays disrupted for months, research shows it can gradually affect your heart, metabolism, mood, brain function, immune system, and even long-term survival.

How Chronic Insomnia Affects Your Health

Research links long-term insomnia to:

  • Higher risk of hypertension and cardiovascular disease such as coronary heart disease and heart failure (9).
  • Impaired glucose metabolism and increased risk of type 2 diabetes (9).
  • Greater likelihood of depression and anxiety disorders, and related problems such as substance misuse (10).
  • People with insomnia may have daytime problems with attention, memory, and concentration. (11).
  • Slower reaction time, lower work or school performance, and higher risk of accidents (12).
  • Broader immune and endocrine changes, with higher risk of several chronic diseases (13).

Chronic insomnia disrupts key systems that regulate stress, metabolism, and immune function, particularly the hypothalamic-pituitary-adrenal (HPA) axis, keeping the body in a prolonged state of stress (14,13).

Because of these effects, insomnia should be treated as a medical condition, not a temporary inconvenience.

How Insomnia Is Diagnosed

Insomnia is diagnosed through a comprehensive clinical evaluation rather than a single test (3,4). This typically includes:

  • A detailed sleep history
  • Identification of sleep patterns and disruptions
  • Assessment of daytime functioning
  • Patients are often asked to keep a sleep diary for 1–4 weeks, tracking:
  • Bedtime and wake time
  • Night awakenings
  • Naps
  • Sleep quality

Clinicians also rule out other sleep disorders such as sleep apnea, restless legs syndrome, or narcolepsy. Validated tools may include:

  • Insomnia Severity Index (ISI)
  • Pittsburgh Sleep Quality Index (PSQI)

Sleep studies are not usually required unless another disorder is suspected. (3,4).

When to Seek Treatment for Insomnia

Medical professionals are just one group affected by the psychological strain of the pandemic. If you or your child are experiencing new or worsening insomnia symptoms, evaluation and treatment can make a meaningful difference. 

Early intervention, especially with CBT-I and targeted behavioral strategies, can improve sleep, reduce long-term health risks, and restore daytime functioning.

To learn more or schedule an evaluation, contact The Insomnia & Sleep Institute of Arizona in Phoenix, Scottsdale, or Gilbert by completing the online form to schedule an evaluation.

References

  1. Hilty, D. (2009). Algorithms for the assessment and management of insomnia in primary care. Patient Preference and Adherence, 9. https://doi.org/10.2147/ppa.s2670
  2. Zhang, C., Yang, L., Liu, S., Ma, S., Wang, Y., Cai, Z., Du, H., Li, R., Kang, L., Su, M., Zhang, J., Liu, Z., & Zhang, B. (2020). Survey of Insomnia and Related Social Psychological Factors Among Medical Staff Involved in the 2019 Novel Coronavirus Disease Outbreak. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00306
  3. Momin, R. R., Aslam, S. P., & Ketvertis, K. (2025, April 22). Short-Term Insomnia. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554516/
  4. McNamara, S., Spurling, B. C., & Bollu, P. C. (2025, March 28). Chronic Insomnia. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK526136/
  5. Module 2. How Shift Work and Long Work Hours Increase Health and Safety Risks | NIOSH | CDC. (2025, May). Cdc.gov. https://www.cdc.gov/niosh/work-hour-training-for-nurses/longhours/mod2/01.html
  6. Boivin, D. B., Boudreau, P., & Kosmadopoulos, A. (2021). Disturbance of the Circadian System in Shift Work and Its Health Impact. Journal of Biological Rhythms, 37(1), 3–28. https://doi.org/10.1177/07487304211064218
  7. CDC. (2026, January 12). Shift Work and Sleep. NIOSH Science Blogs. https://www.cdc.gov/niosh/blogs/2016/shift-work.html
  8. employment practice designed to make use of, or provide service across, part of or all 24 hours of each day of the week. (2004, October 9). Wikipedia.org; Wikimedia Foundation, Inc. https://en.wikipedia.org/wiki/Shift_work
  9. Javaheri, S., & Redline, S. (2017). Insomnia and Risk of Cardiovascular Disease. Chest, 152(2), 435–444. https://doi.org/10.1016/j.chest.2017.01.026
  10. What doctors wish patients knew about insomnia. (2025, April 25). American Medical Association. https://www.ama-assn.org/public-health/prevention-wellness/what-doctors-wish-patients-knew-about-insomnia
  11. Brownlow, J. A., Miller, K. E., & Gehrman, P. R. (2020). Insomnia and Cognitive Performance. Sleep Medicine Clinics, 15(1), 71–76. https://doi.org/10.1016/j.jsmc.2019.10.002
  12. Insomnia – Symptoms and causes. (2025). Mayo Clinic; https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167
  13. Yun, S., & Jo, S. (2021). Understanding insomnia as systemic disease. Yeungnam University Journal of Medicine, 38(4), 267–274. https://doi.org/10.12701/yujm.2021.01424
  14. AlDabal, L., & BaHammam, A. S. (2011). Metabolic, Endocrine, and Immune Consequences of Sleep Deprivation. The Open Respiratory Medicine Journal, 05(1), 31–43. https://doi.org/10.2174/1874306401105010031

 

Disclaimer: The information provided in this blog post is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always consult with a licensed healthcare provider for recommendations specific to your individual health needs.