Insomnia

Overview

Definition

Insomnia is a sleep disorder. It may make it hard to fall asleep, stay asleep, or get restful sleep.

Insomnia may be:

  • Short-term (acute)—lasts a few days to a few weeks
  • Long-term (chronic)—lasts more than 4 weeks

Causes

Insomnia happens for many reasons. Short-term insomnia is often caused by:

  • A life crisis or stress
  • Noise
  • A room that is too hot or too cold
  • Changes in surroundings
  • Jet lag or other sleep-wake problems

The cause of long-term insomnia is not always clear. It can be caused by:

  • Mental health problems, such as depression, anxiety, or post-traumatic stress disorder
  • Arthritis, fibromyalgia, or other long-term pain
  • Heart disease
  • Problems that affect breathing, such as asthma, chronic obstructive pulmonary disease (COPD), or sleep apnea
  • Hyperthyroidism
  • Gastroesophageal reflux disease (GERD) or an ulcer

Both types of insomnia can be due to:

  • Behaviors such as:
    • Using caffeine, alcohol, or other substances
    • Smoking
    • Sleeping on an irregular schedule—such as with shift work
    • Problems coping with stress
    • Napping too much in the afternoon or evening
  • Certain medicines, such as:
    • Antidepressants, stimulants, and pain relievers
    • Steroid hormones, decongestants, and certain asthma medicines

Risk Factors

Insomnia is more common in women at and after menopause. It is also common in adults 50 years of age or older.

The risk is higher for those with any problems listed above.

SymptomsandDiagnosis

Symptoms

Insomnia may cause:

  • Problems falling asleep or staying asleep
  • Waking up too early
  • Not feeling refreshed after sleep
  • Daytime sleepiness
  • Uneasiness and problems thinking

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam may be done. The doctor will ask about your sleep, habits, schedule, and medicines.

If the cause is not clear, a sleep study may be done. This is done in a special lab. A technician will look at brain activity, breathing, and movement as you sleep.

Treatments

Treatment

The goal is to improve sleep. This may be done by treating underlying problems or behaviors. Other options are:

  • Sleep medicines—usually for a short time
  • Relaxation techniques and physical activity—to ease stress
  • Herbs or melatonin
  • Sleep restriction—a program that limits time in bed to sleeping time only
  • Reconditioning—using the bed only for sleep and sex
  • Cognitive behavioral therapy—talk therapy with a mental health counselor

Prevention

To reduce the risk of insomnia:

  • Do regular physical activity.
  • Get treatment for health problems.
  • Do not use substances that disrupt sleep.
  • Learn and use good sleep practices.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Sleeplessness)

RESOURCES

National Heart, Lung, and Blood Institute https://www.nhlbi.nih.gov 

National Sleep Foundation https://sleepfoundation.org 

CANADIAN RESOURCES

Sleep On It https://sleeponitcanada.ca/ 

Canadian Sleep Society https://css-scs.ca 

References

Insomnia. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/insomnia. Accessed February 25, 2021.

Insomnia. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/insomnia. Accessed February 25, 2021.

Insomnia in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/insomnia-in-adults. Accessed February 25, 2021.

Patel D, Steinberg J, Patel P. Insomnia in the elderly: a review. J Clin Sleep Med. 2018;14(6):1017-1024.