Insomnia

Overview

Insomnia is a common sleep disorder that can make it hard to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. It can sap not only your energy level and mood but also your health, work performance, and quality of life.

A person lying awake in bed, looking at the clock.

Types of Insomnia

Insomnia comes in various forms. It can be classified based on its duration and frequency, or based on its causes.

Acute Insomnia

Acute insomnia is brief and often happens because of life circumstances. For example, if you can't sleep the night before an exam or after receiving stressful or bad news. Many people may have experienced this type of transient insomnia, which tends to resolve without any treatment.

Chronic Insomnia

Chronic insomnia is disrupted sleep that occurs at least three nights per week and lasts at least three months. Chronic insomnia disorders can have many causes. Changes in the environment, unhealthy sleep habits, shift work, other clinical disorders, and certain medications could lead to a long-term pattern of insufficient sleep.

Causes of Insomnia

Insomnia can be caused by a wide variety of things, including medical conditions, psychological issues, and certain substances. It can also be a result of certain biological factors.

Medical Conditions

Some examples of medical conditions that can cause insomnia are:

Psychological Issues

Insomnia can also be caused by psychological issues such as:

Depression, including suicidal thoughts
Anxiety, such as generalized anxiety disorder or post-traumatic stress disorder
Mania, which can cause a person to feel hyperactive and awake

Substances

Certain substances and activities, including eating patterns, can also contribute to insomnia:

Caffeine, especially when consumed in large amounts or close to bedtime
Tobacco, which can disrupt your sleep patterns and lead to insomnia
Alcohol, which can interfere with your sleep cycle and cause you to wake up in the middle of the night

Symptoms of Insomnia

Insomnia itself may be a symptom of an underlying medical issue. However, there are several signs and symptoms that are often associated with insomnia:

Difficulty falling asleep at night
Waking up during the night
Waking up too early
Not feeling well-rested after a night's sleep
Daytime tiredness or sleepiness
Irritability, depression or anxiety
Difficulty paying attention, focusing on tasks or remembering
Increased errors or accidents
Ongoing worries about sleep

Diagnosis of Insomnia

To diagnose insomnia, your health care provider will perform a physical exam and ask about your medical history. They may also ask about your sleep history. You may be asked to keep a sleep diary for a week or two, keeping track of your sleep patterns and how you feel during the day.

Treatment of Insomnia

Treatment for insomnia depends on the cause and severity of your sleep disruption. In some cases, treating an underlying health issue can resolve the insomnia. In other cases, direct treatment of insomnia may be necessary.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy for Insomnia (CBT-I) can help you control or eliminate negative thoughts and actions that keep you awake and is generally recommended as the first line of treatment for people with insomnia.

Medications

Several types of sleep medications are available to help manage insomnia. Some are available over-the-counter (OTC), and some are available only with a prescription.

Lifestyle Changes

In some cases, changes in lifestyle can help improve sleep, such as:

Regular physical activity
Avoiding large meals before bedtime
Avoiding caffeine and alcohol close to bedtime
Maintaining a regular sleep schedule

Prevention of Insomnia

Prevention of insomnia primarily involves good sleep habits. For example:

Be consistent. Go to bed at the same time each night and get up at the same time each morning, including on the weekends
Make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature
Remove electronic devices, such as TVs, computers, and smart phones, from the bedroom
Avoid large meals, caffeine, and alcohol before bedtime
Get some exercise. Being physically active during the day can help you fall asleep more easily at night.