Insomnia is a sleep disorder that makes it difficult to fall asleep or stay asleep. If a person has insomnia, they may also wake up too early and not be able to get back to sleep.

Generally, adults need at least 7 to 9 hours of sleep in every 24-hour period, depending on their age. Getting sufficient sleep is vital for maintaining good mental and physical health. However, insomnia is a common sleep problem that can disrupt how much sleep a person gets.

When insomnia lasts for up to a few weeks, a health expert may refer to it as acute insomnia. When it lasts for 3 months or longer, it is known as chronic insomnia. Short-term insomnia can lead to daytime fatigue, difficulty concentrating, and other problems. In the long term, it may increase the risk of various diseases.

What does it mean to be ‘an insomniac’?

Insomnia is the most common sleep complaint. A person with insomnia has difficulty falling asleep or staying asleep. They may consistently wake up too early. Sleep deprivation can lead to issues such as:

• daytime sleepiness and lethargy
• a general feeling of being mentally and physically unwell
• mood changes, irritability, and anxiety

Also, the issues above can contribute to insomnia — they may be causes, effects, or both.

In addition, insomnia may play a role in the development of:

• obesity
• anxiety
• accidents and injury
• diabetes
• high blood pressure
• stroke
• cardiovascular disease
• depression

It can also undermine school and work performance and limit a person’s ability to do daily activities.

Causes of insomnia

Insomnia can result from a range of physical and psychological factors. Often, the cause is a temporary problem, such as short-term stress. In some other instances, insomnia stems from an underlying medical condition.

Common causes include:

• having jet lag, switching shifts at work, or dealing with any other changes to the body’s internal clock
• the room being too hot, cold, or noisy, or the bed being uncomfortable
• caring for someone in the house, if it disrupts sleep
• getting too little physical exercise
• having night terrors or bad dreams
• using recreational drugs, such as cocaine or ecstasy

In some people, stress or a mental health issue is responsible for insomnia. A person may be experiencing:

• depression
• anxiety
• bipolar disorder
• schizophrenia

Some other health conditions that can limit sleep include:

• restless legs syndrome
• an overactive thyroid
• sleep apnea
• gastrointestinal reflux disease (GERD)
• chronic obstructive pulmonary disease (COPD)
• chronic pain
• Alzheimer’s disease

In rare cases, some people may inherit a condition known as fatal familial insomnia. This genetic condition can cause sleep problems and brain damage that eventually lead to death.

Risk factors

Many different factors can increase the risk of insomnia. These can include

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• older age
• family history of insomnia
• certain occupations, such as shift or night work, or jobs that require traveling to different time zones
• stress
• being female
• experiencing frequent sleep interruptions, such as waking up often to care for a baby
• taking long naps during the day
• getting too little exercise during the day
• using caffeine, nicotine, alcohol, or recreational drug
• using media technology, such as screen devices, in the bedroom before bed

Additionally, certain drugs can make it hard to fall or stay asleep. These can include:

• antidepressants
• beta-blockers
• decongestants
• diuretics
• nicotine replacement medications
• steroids

Resources for healthy sleep

To discover more evidence-based information and resources on the science of healthy sleep, visit our dedicated hub.

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Symptoms of insomnia

Apart from disrupted sleep, insomnia can lead other issues, such as:

• daytime fatigue or sleepiness
• irritability, depression, or anxiety
• low motivation or energy
• poor concentration and focus
• a lack of coordination and rash actions, which can lead to errors or accidents Y
• concerns or frustrations about sleeping
• poor performance at school or work
• difficulty socializing, working, or studying

Treatments

The best approach can depend on the underlying cause and the type of insomnia, but some options include:

• cognitive behavioral therapy (CBT)
• prescription medications
• over-the-counter sleep aids
• melatonin

However, there is not enough strong evidence to prove that melatonin helps with sleep.

Home care strategies

A number of remedies and tips can help manage insomnia. They involve changes to:

Sleeping habits

When possible, it can help to:

• Go to bed and wake up at the same times, establishing a routine.
• Avoid using any device with a screen right before bed.
• Start winding down an hour before bedtime, for example, by taking a bath.
• Keep telephones and other devices outside of the bedroom.
• Ensure that the room is a comfortable temperature before bedtime.
• Use blackout blinds or curtains to darken the room.

Dietary habits

• Avoid going to bed hungry. Have a healthy snack before bed, if necessary.
• However, avoid eating a heavy meal within 2–3 hours of going to bed.
• Limit caffeine and alcohol intake, especially at night.
• Have a healthful, varied diet to boost overall well-being.

Well-being and relaxation

• Exercise regularly, but not within 4 hours of bedtime.
• Do breathing and relaxation exercises, especially before sleeping.
• Find something that helps you sleep, such as soothing music or reading.
• Try not to nap during the day, even if you feel sleepy.
• Receive medical attention for any mental health issues, such as anxiety.

Diagnosing insomnia

A sleep specialist can help diagnose and treat sleep problems. They may:

• ask the person about their medical history, sleep patterns, and use of drugs and alcohol
• do a physical examination
• test for underlying conditions
• request an overnight sleep test to record sleep patterns
• suggest wearing a device that tracks movement and sleep-wake patterns

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), a doctor may diagnose insomnia if the following criteria are met:

• dissatisfaction with sleep quality or quantity
• significant distress with personal functioning in daily life due to sleep difficulty
• the sleep difficulty occurs at least 3 times a week
• the sleep difficulty is present for at least 3 months
• the sleep difficulty occurs despite adequate opportunity and circumstances for sleep
• a complaint of one or more of the following sleep difficulties:
  • difficulty initiating sleep
  • difficulty maintaining sleep
  • early morning awakening
  • nonrestorative sleep

Takeaway

Insomnia is a common problem. It can result from a range of issues, which may involve physical or mental health. In some cases, they are environmental or relate to lifestyle factors, such as shift work and caffeine or alcohol use.

A lack of sleep can lead to a variety of problems, ranging from mild tiredness to chronic illness.

Anyone who experiences ongoing trouble sleeping and feels that it is affecting their daily life should consult a doctor, who can help identify the cause and recommend a solution.

Conclusion

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