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.

According to the Centers for Disease Control and Prevention (CDC), adults need at least 7–9 hours of sleep in every 24-hour period, depending on their age.

Research shows that around 25% of people in the United States experience insomnia each year, but around 75% of these people do not develop a long-term problem.

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.

This article looks at what insomnia is, as well as its causes, symptoms, diagnosis, and treatments.

What does it mean to be ‘an insomniac’?

A person with insomnia has difficulty falling asleep or staying asleep. They may consistently wake up too early.

This 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 chronic diseases, such as:

• obesity
• diabetes
• 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, commonly called GERD
• chronic obstructive pulmonary disease, known as COPD
• chronic pain

Often, symptoms of another health issue or natural transition cause difficulty sleeping. During menopause, for example, hormonal changes can lead to night sweats, which can interrupt sleep.

In people with Alzheimer’s disease, changes in the brain disrupt or change sleeping patterns.

Also, some people have a rare genetic disorder called fatal familial insomnia, which prevents sleep and can be life threatening.

Symptoms of insomnia

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

• daytime fatigue or sleepiness
• irritability, depression, or anxiety
• gastrointestinal symptoms
• low motivation or energy
• poor concentration and focus
• a lack of coordination, leading to errors or accidents
• worry or anxiety about sleeping
• using medication or alcohol to fall asleep
• tension headaches
• difficulty socializing, working, or studying

A lack of sleep is a key factor in motor vehicle accidents, according to experts.

Types of insomnia

Insomnia can be classified by duration:

• Acute, transient insomnia is a short-term problem.
• Chronic insomnia can last for months or years.

Doctors also classify it by cause:

• Primary insomnia is an issue by itself.
• Secondary insomnia is a result of another health issue.

In addition, they classify it by severity:

• Mild insomnia involves a lack of sleep that leads to tiredness.
• Moderate insomnia may affect daily functioning.
• Severe insomnia has a significant impact on daily life.

Doctors also consider other factors when identifying the type of insomnia, including whether the person consistently wakes up too early or has trouble:

• falling asleep
• staying asleep
• getting restorative sleep

Treatments

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

• counseling
• cognitive behavioral therapy, or 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.

Other health issues

Anyone with acid reflux or a cough might benefit from raising their upper body with one or more extra pillows.

Ask a doctor about ways of managing a cough, pain, and any other symptoms that are affecting sleep.

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.

Risk factors

Insomnia can occur at any age, but some factors increase the risk. These include:

• traveling across time zones
• working in shifts
• being older
• using caffeine, medications, drugs, or alcohol
• having a family history of insomnia
• experiencing significant life events
• being pregnant
• going through menopause
• having certain physical or mental health conditions
• being female

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 see a doctor, who can help identify the cause and recommend a solution.

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