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The Causes, Symptoms, and Treatment of Comorbid Insomnia

Comorbid insomnia
Written by:

Rabia Khaliq

MSc in Applied Psychology

Umar Javed



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The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient’s unique health circumstances and needs.Read more

Depending on the individual, seven to nine hours of sleep [1*] is usually recommended for adults. Still, not everyone can ensure this amount of sleep because of external factors or insomnia.

Insomnia is a common sleep problem that can make it difficult to get to sleep or stay asleep. Sleep disturbances associated with medical and psychiatric disorders are known as comorbid insomnia or secondary insomnia. It is not unusual for common sleep disorders to coexist with other medical conditions.

Moreover, people can be affected by insomnia in different ways, and distinguishing between its different forms can be useful for health professionals and people with insomnia.

Insomnia is treatable. Get professional assistance from health experts at MEDvidi.

What is Comorbid Insomnia?

Insomnia is defined as disturbed sleep in the presence of sufficient opportunity and conditions for sleep, in a statement from the National Institutes of Health (NIH) State-of-the-Science Conference [2*] . With this concept, insomnia is distinguished from sleep deprivation, where opportunities for sleep are few. Insomnia can make it difficult to get sleep, stay asleep, or avoid waking up too early.

However, in comorbid insomnia (a type of chronic insomnia), the word “comorbid” is used because it is not often obvious which condition causes insomnia when they are present together. The disorders that it coexists with may be caused by sleeplessness. Comorbid insomnia is more common than primary insomnia or other types of insomnia.

Comorbid Insomnia Symptoms

Comorbid insomnia can result in the following symptoms:

  • Difficulty sleeping at night
  • Having a nighttime awakening
  • Having trouble recovering from a night’s sleep
  • Daytime drowsiness or fatigue
  • Anger, sadness, anxiety, or irritability
  • Inability to concentrate, pay attention, or remember
  • Increased mistakes or mishaps
  • Persistent concerns about sleep

Check your symptoms using our SmartCare Symptom Checker to know if you should consider seeing a doctor.

Common Comorbidities With Insomnia

More generally, insomnia is thought to be brought on by a hyperarousal state that interferes with going to sleep or remaining asleep. Both mental and physical hyperarousal is possible, and various external factors and medical conditions can bring it on. Several physical and psychological ailments can both cause and exacerbate sleeplessness in people.

The most frequent comorbid disorders with insomnia are listed below:

  • Psychiatric disorders. Anxiety disorders, depression, bipolar disorder, attention deficit hyperactivity disorder (ADHD), substance use disorder, and post-traumatic stress disorder (PTSD).
  • Medical conditions. Chronic obstructive pulmonary disease (COPD), gastroesophageal reflux disease (GERD), cancer, heart diseases, thyroid problems, and diabetes.
  • Neurological diseases. Alzheimer’s disease, Parkinson’s disease, dementia, Huntington’s chorea, and Tourette’s syndrome.
  • Chronic pain. Chronic pain due to headaches, osteoarthritis, or rheumatoid arthritis may cause insomnia.
  • Other sleep disorders. Obstructive sleep apnea syndrome, restless leg syndrome, and circadian rhythm sleep disorders may lead to severe insomnia.
Common comorbidities of insomnia

How to Prevent Comorbid Insomnia?

You can frequently get better sleep by altering your lifestyle and adjusting your evening routine and bedroom arrangement:

  • Be sure to avoid large meals, caffeine, and alcohol before going to bed.
  • Try to be physically active during the day, preferably outside.
  • Reduce caffeine intake, especially at night, including coffee, sodas, and chocolate.
  • Every day, including weekends, go to bed and wake up simultaneously.
  • Phones, TVs, laptops, and other screens should be put away at least 30 minutes before sleep.
  • Make your bedroom a cool, quiet, and dark haven.
  • Use calming music, a nice book, or meditation to relax.

At MEDvidi, seek a doctor for insomnia and check your symptoms using our SmartCare Symptom Checker.

Comorbid Insomnia Treatment

Both pharmacological and non-pharmacological treatments are available for insomnia.

Pharmacological Treatment

Currently, the FDA [3*] has approved the following drugs for the treatment of insomnia:

  • Nonbenzodiazepines sedative hypnotics
  • Benzodiazepines
  • Tricyclic antidepressants
  • Melatonin agonists
  • Barbiturates

Non-pharmacological Treatment

Research [4*] has shown CBT to be more effective than sleep pharmaceuticals in treating comorbid insomnia. Following therapy techniques were found to be effective in treating insomnia.

  • Cognitive techniques. Writing down anxieties or concerns in a diary before bed may prevent someone from actively trying to solve them while striving to sleep.
  • Stimulus control. This requires changing the habits that train your mind to resist sleep. A component of this method is creating a sleep and wake schedule.
  • Sleep restriction. Limiting your time in bed, especially avoiding naps, is part of this therapy. Your daytime sleep will prevent you from sleeping when it’s bedtime.
  • Relaxation techniques. You can relax [5*] by using breathing exercises, yoga, guided meditation, and other methods to loosen up your muscles and regulate your breathing and heart rate.

When choosing the best course of action for older adults with comorbid insomnia, it is crucial to consider the effects of any treatment on the patient’s general health and interactions with other medications.

Bottom Line

A combination of behavioral therapy and a few sleep-related lifestyle adjustments can be used to effectively treat comorbid insomnia. Consult your physician if your inability to sleep affects your quality of life.


5 sources
  1. National Sleep Foundation's sleep time duration recommendations: methodology and results summary. (2015)
    Source link
  2. National Institutes of Health State of the Science Conference Statement: Manifestations and Management of Chronic Insomnia in Adults June 13–15, 2005
    Source link
  3. Sleep Disorder (Sedative-Hypnotic) Drug Information. (2023)
    Source link
  4. Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review. (2012)
    Source link
  5. Relaxation treatment for insomnia: a component analysis. (1983)
    Source link
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Written by:

Rabia Khaliq

MSc in Applied Psychology

Umar Javed



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Evidence Based

This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of experts strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers
in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.