Insomnia occurs when you’re unable to get the sleep you need to feel refreshed. Causes range from stress to jet lag to pregnancy to chronic health conditions. Treatments include therapy, medications, and lifestyle changes.
Insomnia refers to a type of sleep disorder.
If you live with insomnia, you may:
- find it difficult to fall asleep, stay asleep, or both
- wake up from several hours of sleep not feeling refreshed
- experience fatigue and difficulty functioning throughout the day
Quality sleep plays an important role in overall well-being. Not getting the sleep you need on a regular basis can have a pretty big impact on mental and physical health, not to mention quality of life.
Among sleep disorders, insomnia is the most common.
According to the American Psychiatric Association (APA):
- about a third of all adults report some insomnia symptoms
- 6 to 10 percent of adults have symptoms severe enough to meet the diagnostic criteria for insomnia disorder
Read on to learn all about the main symptoms and causes of insomnia, plus tips on possible strategies and treatments to help you get back to sleeping soundly.
You can typically recognize insomnia by the following symptoms:
- waking too early and finding yourself unable to fall back asleep
- spending a lot of the night lying awake, worrying you won’t fall asleep
- a consistent pattern of interrupted or broken sleep that doesn’t refresh you
- trouble falling asleep after going to bed
As a result, you might begin to experience other symptoms related to lack of sleep, including:
- fatigue
- irritability and other mood changes
- difficulty concentrating or remembering things
Experts describe insomnia in a few different ways, depending on its specific characteristics:
- Acute insomnia refers to short-term sleeping difficulties that generally last no more than a few weeks.
- Chronic insomnia refers to insomnia that affects your sleep for 3 or more days each week on a regular basis, typically for a period of 3 months or longer.
- Onset insomnia describes difficulty falling asleep. Trouble getting to sleep might happen as a result of caffeine use, mental health symptoms, or other common insomnia triggers, but it can also develop with other sleep disorders.
- Maintenance insomnia refers to trouble remaining asleep once you get to sleep, or consistently waking up too early. This type of insomnia might relate to underlying health and mental health symptoms — but lying awake and worrying you won’t get enough sleep can make it worse.
- Behavioral insomnia of childhood involves consistent trouble falling asleep, refusing to go to bed, or both. Children with this condition often benefit from learning self-soothing strategies and following a regular sleep routine.
Insomnia can also be primary (idiopathic) or secondary (comorbid).
Primary insomnia doesn’t stem from any clear cause or existing health or mental health condition. Secondary insomnia, in contrast, relates to underlying causes, including:
- chronic pain or illness
- mental health conditions like depression or anxiety
- shift work
- certain medications
Typically, the type of insomnia you experience has a lot to do with the underlying causes of insomnia.
Possible causes of acute insomnia, for example, might include:
- stress
- an upsetting or traumatic event
- changes to your sleep habits, like sleeping in a hotel, new home, or with a partner for the first time
- physical pain or illness
- jet lag
- certain medications
Chronic insomnia can occur on its own or as a result of:
- chronic pain conditions, such as arthritis or back pain
- psychological issues, such as anxiety, depression, or substance use disorders
- sleep apnea and other sleep disorders
- health conditions such as diabetes, cancer, gastroesophageal reflux disease (GERD), or cardiovascular disease
Risk factors for insomnia
Insomnia can affect people of any age or sex, though it most commonly develops in:
- older adulthood
- just before, during, and after menopause
Risk factors associated with insomnia include:
- high levels of stress, which might relate to life challenges, financial difficulties, or family and relationship concerns
- traveling to different time zones
- a sedentary lifestyle
- varying sleep-wake times or an irregular schedule, which might happen with frequent changes in work hours or shift work
- taking naps
- drinking a lot of caffeine
- alcohol and tobacco use
- difficulty winding down at bedtime.
Insomnia is common during pregnancy, especially in the first and third trimesters.
You might have trouble sleeping for a range of reasons, including:
- bodily changes, like fluctuating hormones, nausea, and an increased need to urinate
- increased stress and anxiety about the increasing responsibilities you’ll face as a new parent
- pain, such as cramps and back discomfort
The good news is that pregnancy-related insomnia usually passes and doesn’t affect your baby’s development. All the same, getting the right amount of sleep is important for your overall well-being.
Lifestyle changes that could help with insomnia in pregnancy include:
- getting regular physical activity
- eating a balanced diet
- staying hydrated
- maintaining a consistent sleep schedule
- practicing relaxation techniques during the day to help ease anxiety and promote calm
- taking a warm bath before bed
Check with your healthcare team before trying any new exercise routines, medications, or supplements just to make sure they’re safe during pregnancy.
Children can develop insomnia, too — and often for the same reasons as adults. These reasons might include:
- stress
- medications
- heavy caffeine intake
- physical or mental health conditions
If your child has trouble falling asleep or staying asleep, or if they frequently wake up too early, they may have insomnia.
Symptoms of insomnia in children often include:
- daytime sleepiness or restlessness
- irritability and mood changes
- repeated disciplinary issues
- problems with memory and focus
The first step to treating insomnia in children generally involves setting a firm bedtime and sticking to it. Other helpful tips include:
- creating a soothing bedtime routine
- following good sleep hygiene practices, like avoiding screen time near bedtime
- reducing sources of stress in your child’s life
A therapist or pediatrician can offer more guidance on treating insomnia in children.
According to 2019 research,
A few different factors contribute to insomnia in older adulthood, and these can have something of a domino effect:
- Age-related changes in the circadian rhythms responsible for your sleep-wake cycle can make it harder to fall asleep or stay asleep.
- If you’re retired, you may no longer have a consistent daytime schedule or get regular social interaction, both of which can contribute to insomnia.
- Social isolation can contribute to loneliness and increase your chances of experiencing depression, which can also raise your risk of sleep problems.
- Health concerns related to aging, including chronic pain conditions, can also affect your sleep.
- If you’re not getting enough sleep at night, you might feel drowsy and fatigued during the day. You might be more inclined to nap as a result. Napping, of course, can leave you less tired at bedtime, fueling a cycle of sleeplessness.
If you experience insomnia, a therapist or clinician can offer more support with finding helpful treatment options.
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