What Is Insomnia?
Insomnia is a sleep disorder in which you have trouble falling and/or staying asleep.
The condition can be short-term (acute) or can last a long time (chronic). It may also come and go.
Acute insomnia lasts from 1 night to a few weeks. Insomnia is chronic when it happens at least 3 nights a week for 3 months or more.
Types of Insomnia
There are two types of insomnia: primary and secondary.
- Primary insomnia: This means your sleep problems aren’t linked to any other health condition or problem.
- Secondary insomnia: This means you have trouble sleeping because of a health condition (like asthma, depression, arthritis, cancer, or heartburn); pain; medication; or substance use (like alcohol).
You might also hear about:
- Sleep-onset insomnia: This means you have trouble getting to sleep.
- Sleep-maintenance insomnia: This happens when you have trouble staying asleep through the night or wake up too early.
- Mixed insomnia: With this type of insomnia, you have trouble both falling asleep and staying asleep through the night.
- Paradoxical insomnia: When you have paradoxical insomnia, you underestimate the time you're asleep. It feels like you sleep a lot less than you really do.
Insomnia Causes
Primary causes of insomnia include:
- Stress related to big life events, like a job loss or change, the death of a loved one, divorce, or moving
- Things around you like noise, light, or temperature
- Changes to your sleep schedule like jet lag, a new shift at work, or bad habits you picked up when you had other sleep problems
- Your genes. Research has found that a tendency for insomnia may run in families.
Secondary causes of insomnia include:
- Mental health issues like depression and anxiety
- Medications for colds, allergies, depression, high blood pressure, and asthma.
- Pain or discomfort at night
- Caffeine, tobacco, or alcohol use, as well as use of illicit drugs.
- Hyperthyroidism and other endocrine problems
- Other sleep disorders, like sleep apnea or restless legs syndrome
- Pregnancy
- Alzheimer's disease and other types of dementia
- ADHD
- PMS and menopause
Insomnia Risk Factors
Insomnia affects women more than men and older people more than younger ones. Young and middle-age African Americans also have a higher risk.
Other risk factors include:
- Long-term illness
- Mental health issues
- Working night shifts or shifts that rotate
Insomnia Symptoms
Symptoms of insomnia include:
- Sleepiness during the day
- Fatigue
- Grumpiness
- Problems with concentration or memory
Insomnia Diagnosis
Your doctor will do a physical exam and ask about your medical history and sleep history.
They might tell you to keep a sleep diary for a week or two, keeping track of your sleep patterns and how you feel during the day. They may talk to your bed partner about how much and how well you’re sleeping. You might also have special tests at a sleep center.
Insomnia Treatment
Acute insomnia may not need treatment.
If it’s hard for you to do everyday activities because you’re tired, your doctor may prescribe sleeping pills for a short time. Medicines that work quickly but briefly can help you avoid problems like drowsiness the next day.
Don’t use over-the-counter sleeping pills for insomnia. They might have side effects, and they tend to work less well over time.
For chronic insomnia, you’ll need treatment for the conditions or health problems that are keeping you awake. Your doctor might also suggest behavioral therapy. This can help you change the things you do that make insomnia worse and learn what you can do to promote sleep.
Insomnia Complications
Our bodies and brains need sleep so they can repair themselves. It’s also crucial for learning and keeping memories. If insomnia is keeping you awake, you could have:
- A higher risk of health problems like high blood pressure, obesity, and depression
- A higher risk of falling, if you’re an older woman
- Trouble focusing
- Anxiety
- Grumpiness
- Slow reaction time that can lead to a car crash
Insomnia Prevention
Good sleep habits, also called sleep hygiene, can help you beat insomnia. Here are some tips:
- Go to sleep at the same time each night, and get up at the same time each morning. Try not to take naps during the day, because they may make you less sleepy at night.
- Don’t use phones or e-books before bed. Their light can make it harder to fall asleep.
- Avoid caffeine, nicotine, and alcohol late in the day. Caffeine and nicotine are stimulants and can keep you from falling asleep. Alcohol can make you wake up in the middle of the night and hurt your sleep quality.
- Get regular exercise. Try not to work out close to bedtime, because it may make it hard to fall asleep. Experts suggest exercising at least 3 to 4 hours before bed.
- Don't eat a heavy meal late in the day. But a light snack before bedtime may help you sleep.
- Make your bedroom comfortable: dark, quiet, and not too warm or too cold. If light is a problem, use a sleeping mask. To cover up sounds, try earplugs, a fan, or a white noise machine.
- Follow a routine to relax before bed. Read a book, listen to music, or take a bath.
- Don’t use your bed for anything other than sleep and sex.
- If you can't fall asleep and aren’t drowsy, get up and do something calming, like reading until you feel sleepy.
- If you tend to lie awake and worry about things, make a to-do list before you go to bed. This may help you put your concerns aside for the night.
