Insomnia is a common sleep disorder in sleep medicine. So it's not uncommon for us to get asked "will insomnia go away on its own"?

The short answer is: it depends.
It depends on how bad your trouble sleeping is, and how long it's been going on.

But don't listen to us. Here's the science.

Symptoms Of Insomnia vs Chronic Insomnia Disorder

Symptoms of insomnia include trouble falling asleep, staying asleep, waking early and experience difficulty in your daytime despite going to bed and having adequate opportunity for sleep.

Approximately 30% of adults experience symptoms of insomnia in a given year.

But symptoms can be as short as one night depending on your timeframe. So symptoms aren't that useful a gauge of insomnia.

What's more important is persistence of symptoms.

That's how we define the diagnosis of insomnia as a syndrome or disorder.

Around 10% - 16% of the population will meet criteria for an insomnia disorder (find out the difference between acute insomnia, short term insomnia, and chronic insomnia).

It is more likely among females, the elderly, those with anxiety and/or depression, and people suffering from medical conditions.

Chronic insomnia leads to higher healthcare costs, absenteeism, disability and people with insomnia also have an increased risk of hypertension and depression. 

The Science

In order to better understand the persistence, remission, and relapse in individuals with severe sleep difficulties, and to compare those with symptoms only vs those with insomnia disorder, Charles M. Morin Ph.D. of Université Laval, Canada and his team conducted a three-year study involving 388 participants whose average age was 44.8 years old. 

The findings provide greater clarity on the normal pattern and time course of insomnia and sleep difficulties.

At the outset of the research, 119 of these individuals had an established insomnia disorder/syndrome (Insomnia Syndrome Group) - defined as having symptoms averaging out at three nights per week or more, persisting for a minimum of one month, and causing considerable distress or daily impairment.

The remaining 269 individuals only had symptoms of insomnia (Sleep Problems Group) that were not serious enough to be in the Insomnia Syndrome Group. 

Do Insomnia Symptoms Go Away?

A total of 269 individuals in the Sleep Problems Group at baseline were tracked over a three-year period.

After one year:

• 38.4% had achieved good sleeping patterns;

• 48.7% still exhibited signs of sleep problems (remained in the Sleep Problems Group).

• 12.9% were diagnosed with Insomnia Syndrome (i.e. things had become more serious). 

 (good sleeping patterns was defined as “no sleep issues in past month” which is probably not long enough, see our clinical comment below).

Does Chronic Insomnia Go Away On Its Own?

A total of 119 participants in the Insomnia Group group at baseline were also tracked over the three-year period.

After one year:

• 17% had achieved good sleeping patterns;

• 37% had symptoms of insomnia (they moved to the Sleep Problems Group); and

• 46% remained in the Insomnia Syndrome group.

Insomnia Can Last A Long Time

The study found that 74% of all the individuals in the study suffered from insomnia for at least a year and 46% experienced it for the entirety of the 3-year period. 

Those initially in the Insomnia Group had a higher rate of persistence, at 66.1%, than those in the Sleep Problems Group, which was 37.2%. 
Approximately 25% of those that experienced remission of their insomnia during the study (no symptoms in the prior month) eventually experienced relapse.

Overall, the study found that the most likely experience for individuals in both groups was persistence of their problems over the three years.

However, the authors did note that those who presented with insomnia symptoms only at baseline displayed an increased likelihood of getting better rather than worsening to full insomnia syndrome status.

Clinical Comment:

We generally advise people that symptoms under a month, aka acute insomnia, can go away by themselves and so don't necessarily need treatment. Improving your sleep hygiene could help.

Once you get to one month or more of regular trouble falling or staying asleep you have a 50/50 chance things will improve. Again, better sleep habits may help.

After that, unfortunately insomnia usually sticks around and you'll need to seek cognitive behavioral therapy for insomnia, the American Academy of Sleep Medicine recommended approach to treat chronic insomnia. Good sleep hygiene won't cut it because sleep hygiene is not a cure for insomnia disorder.

It’s also important to note that insomnia has two common patterns.

One pattern is just persistently bad sleep.

The other pattern is sleep problems that come and go, waxing and waning over time. This repeating pattern may not last for a period of 3 months at any given time but is also considered chronic insomnia by most sleep specialists because it does not tend to go away by itself.

It’s also important to note that this study is probably overly positive. Why?

Because each follow up in this study asked people how their sleep was in the past month. Because insomnia can wax and wane for people, the researchers are likely underestimating the persistence of insomnia in their groups as naturally some would have had better sleep in the past month, only to relapse again. 

The study was published in Archives Of Internal Medicine (Morin et al., 2009).

Article Author: Dan Ford Sleep Psychologist