What Is Insomnia?
Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or both, even if you have ample time and a bedroom environment conducive to restful sleep. An insomnia diagnosis requires these sleep troubles to also cause daytime impairments, such as sleepiness or difficulty concentrating.
Up to two-thirds of people occasionally experience insomnia symptoms. These bouts of sleeplessness may or may not meet the criteria for a formal diagnosis of insomnia, depending on how long they last and whether they cause distress or interfere with daily functioning. But it is important for anyone who has concerns about their sleep to discuss them with a health professional for proper diagnosis and treatment.
Types of Insomnia
The two main types of insomnia are acute insomnia and chronic insomnia. Acute insomnia describes sleep difficulties that last for a few days or weeks, but not longer than three months. Short-term insomnia can often be traced to an external cause or life stressor like divorce, the death of a loved one, or a major illness. If acute insomnia persists over multiple months, it becomes classified as chronic insomnia.
Chronic insomnia is when a person experiences sleeping difficulties and related daytime symptoms, like sleepiness and attention issues, at least three days per week for longer than three months. It is estimated that about 10% to 15% of people have chronic insomnia.
What are the symptoms of insomnia?
Symptoms of insomnia include:
- difficulty falling asleep
- waking up a lot during the night
- waking up too early, and not being able to go back to sleep
- not feeling refreshed when you wake up
Insomnia can lead to the symptoms during the day, including:
- tension headaches
- low energy, feeling tired or being too sleepy to do normal activities
- poor memory and concentration
- worrying about sleeping
- feeling irritable, moody or losing motivation and interest in doing things
- feeling restless, being aggressive or impulsive
- feeling sleepy when sitting quietly
People experience insomnia differently, and you might only have some of these symptoms.
What Causes Insomnia
There is no main cause of insomnia. However, research suggests that in many people insomnia likely results from certain types of physiological arousal at unwanted times, disrupting normal patterns of sleep. Examples of such arousal can include a heightened heart rate, a higher body temperature, and increased levels of specific hormones, like cortisol.
A person’s family history, age, and gender may also play a role in their susceptibility to insomnia. Additionally, insomnia disorders often occur alongside mental health disorders, including depression and anxiety. It is believed that the cause of insomnia may be distinct in people who have both insomnia and mental health conditions.
Risk Factors for Insomnia
While there is no single cause of insomnia, studies have identified factors that can put a person at a greater risk for experiencing insomniaTrusted SourceAmerican Academy of Sleep Medicine (AASM) AASM sets standards and promotes excellence in sleep medicine health care, education, and research. View Source. These include, but are not limited to:
- Being a woman or assigned female at birth
- Older age
- Lower socioeconomic status
- Medical conditions like diabetes and chronic pain
- Other sleep disorders such as restless legs syndrome and sleep apnea
- Mood disorders including depression and anxietyTrusted SourceNational Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source
- Having an immediate family member with insomnia
It is important to note that not everyone who has one or more of these risk factors will have insomnia, and not everyone with insomnia will have one of these risk factors.
How Is Insomnia Diagnosed?
Doctors generally diagnose insomnia by evaluating a person’s sleep habits and medical history.
Typically, a patient’s description of their symptoms informs their insomnia diagnosis. A doctor may instruct patients to keep a sleep diary for a week or more, which can provide insight about a person’s sleep duration, perceived sleep quality, and lifestyle choices that may contribute to sleep problems. Other self-reporting diagnostic tools, including the Pittsburgh Sleep Quality Index, may be used by medical professionals in a clinical setting to determine the severity of insomnia symptoms.
If a doctor needs to rule out other sleep disorders that could be causing a person’s symptoms, other assessments, such as a sleep study, may be ordered.
Treatments for Insomnia
Treatment for insomnia depends on how long a person has been experiencing sleep issues and any specific factors that are contributing to their sleep loss. If insomnia is associated with another condition, such as sleep apnea or depression, treatment of the other condition often improves sleep.
It is important to get help with insomnia sooner than later. For people with short-term insomnia, care may be focused on discussing practices to support sleep hygiene. Temporary use of a prescription sleep aid may be an option if the insomnia is causing high levels of concern or distress.
A few treatment approaches are available for people with insomnia that persists for weeks or months.
Cognitive Behavioral Therapy for Insomnia (CBT-I)
Experts consider cognitive behavioral therapy for insomnia (CBT-I) to be the most effective initial treatment for chronic insomnia. CBT-I helps people manage anxiety they feel about their sleep issues and establish better sleep habits.
Sleep Medications
If a person experiences significant symptoms from insomnia, or in cases where CBT-I does not help, medication may be recommended. Medication can help promote sleep but may also come with side effects, such as daytime drowsiness or confusion.
Homeopathic Treatments
Some people with insomnia may be interested in exploring other options, such as melatonin or dietary supplements, yoga, hypnosis, or aromatherapy. However, scientific evidence supporting the use of these methods to treat insomnia is lacking at this timeTrusted SourceNational Center for Complementary and Integrative Health (NICCH) NCCIH funds and conducts research to help answer important scientific and public health questions about complementary health approaches.
Lifestyle Changes
Maintaining healthy sleep habits after insomnia treatment may help keep insomnia from returningTrusted SourceMedline Plus MedlinePlus is an online health information resource for patients and their families and friends.
- Set a sleep schedule: Maintain the same bedtime and wake time every day, even on weekends.
- Establish a dedicated sleep space: Reserve use of the bed for only sex and sleep.
- Be mindful of substance use: Curb consumption of caffeine, alcohol, or nicotine, especially near bedtime
- Control light exposure: Try to keep the bedroom both dark and quiet, and refrain from watching television or using other electronics that emit blue light before bed.
- Keep sleep-related anxiety in check: If you are experiencing anxiety about sleep troubles, get out of bed and try a relaxing activity like reading, taking a bath, or meditating.
- Adjust your eating habits: Avoid eating large meals too close to bedtime.
