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What is Insomnia?

Published August 4th, 2022 by Chris Riley
Fact Checked by
Jacqueline Hensler
Medically Reviewed:
Dr. Angel Rivera

Insomnia is a sleep disorder that can cause difficulty falling or staying asleep which can lead to daytime sleepiness, poor work or school performance, and problems with mood or concentration among others.

It can be caused by many factors but there are several different ways it can be treated too.

If you are experiencing symptoms of insomnia, it is important to see your doctor for diagnosis and treatment to help avoid any complications.

In this article, we will explain insomnia, its symptoms, how it is diagnosed, and what your treatment options are if you have it while also providing tips on how to prevent getting it in the first place.

What is insomnia?

Insomnia is the most common sleep disorder that can make it difficult to fall asleep, stay asleep, or both with about 25-35% of adult Americans suffering from it every year.

You either have acute insomnia which is a short-term insomnia disorder lasting for days or weeks, or chronic insomnia disorder which is long-term insomnia characterized by having difficulty sleeping three days a week for three months or more.

It can also be classified as primary insomnia, meaning it is not caused by another medical condition, and secondary insomnia, which is when your insomnia is due to an underlying physical or mental health condition.

Other terms that relate to insomnia include:

  • Sleep-onset insomnia which means you have difficulty falling asleep
  • Sleep maintenance insomnia means you have difficulty staying asleep
  • Mixed insomnia means you have trouble falling asleep and staying asleep
  • Paradoxical insomnia which means that you believe you were asleep longer than you were

man having difficulty sleeping image

What are the symptoms of insomnia?

When you have insomnia there are various symptoms that you may display that are both physical and psychological.

The most common symptoms of insomnia include:

  • Difficulty falling asleep
  • Difficulty staying asleep
  • Waking up too early
  • Excessive daytime tiredness or daytime impairment
  • Fatigue
  • Memory problems
  • Trouble concentrating
  • An increased risk of accidents or falling down
  • Irritability
  • Depression
  • Anxiety
  • Gastrointestinal problems
  • Lethargy or a lack of motivation
  • Tension headaches
  • Problems at work, school, or with relationships

If you have these symptoms you need to see your doctor or health care provider for a diagnosis.

What are the causes of insomnia?

There are many different causes of insomnia and it can be difficult to identify what the root cause is for you. Some of the most common causes include:

Stress

If you are stressed out about something in your life whether it be work, school, finances, or personal relationships, this can lead to difficulty falling asleep and staying asleep.

Medical conditions

There are many different medical conditions and health issues that can cause insomnia such as:

  • Aging
  • Arthritis
  • Asthma
  • Cancer
  • Chronic pain
  • Gastroesophageal reflux disease (GERD)
  • Heartburn
  • Hyperthyroidism and other endocrine issues
  • Diabetes
  • Heart disease
  • Peripheral neuropathy (nerve damage)
  • Chronic obstructive pulmonary disease (COPD)

Mental disorders

Insomnia is not only caused by physical conditions but mental conditions as well. The most common mental health disorders to cause insomnia include:

  • Bipolar disorder
  • Depression
  • Anxiety
  • Post-traumatic stress disorder (PTSD)
  • Schizophrenia
  • Dementia
  • Alzheimer's disease
  • Parkinson's disease
  • Attention deficit/hyperactivity disorder (ADHD)
  • Autism spectrum disorder (ASD)

Medications

Certain medications can lead to insomnia as a side effect.

Examples of drugs that may cause insomnia include some medications for asthma, blood pressure, and antidepressants.

Over-the-counter medications can also contain stimulants such as caffeine so be sure to read the label before buying and using them.

Changing schedules

If your schedule shifts frequently at work to different times of the day or you work the night shift you are more likely to have insomnia due to changes in your circadian rhythm which is your internal clock that determines your sleep-wake cycle.

Also, if you are up at night more frequently due to changes in your life such as having a newborn then you also may experience insomnia.

Other sleep disorders

There are other sleep disorders that can cause insomnia such as restless legs syndrome and obstructive sleep apnea.

Restless legs syndrome is feeling the urge to move your legs while you are still and obstructive sleep apnea is when your airway becomes blocked during sleep which can cause you to stop breathing for a short period of time.

Alcohol, nicotine, or caffeine

Nicotine and caffeine are both stimulants that will keep you more alert and can cause you to stay up later. Alcohol can make you more sleepy but there is a greater chance that it will be disrupted sleep.

It is recommended that you use all of them in moderation and none close to your bedtime. There are also some illicit drugs that can cause insomnia such as cocaine or ecstasy.

Unhealthy sleep habits

There are certain habits that can lead to insomnia such as:

  • Eating before bedtime
  • Exercising close to bedtime
  • Watching television or using electronic devices in bed
  • Working in bed

Avoid all of these poor sleep habits if you have insomnia and need quality sleep.

Being elderly

As you age, you are at a greater risk of insomnia due to changes in your sleep patterns as well as physical and mental conditions that are more common with age.

Your sleeping patterns also naturally change as you get older and you are more likely to take medications that may have the potential side effects of making it more difficult to fall asleep and stay asleep.

Uncomfortable sleep environment

Your sleep environment needs to be dark, quiet, and cool in order to fall asleep and stay asleep.

If any of these are not met it can make it difficult for you to sleep through the night.

Hormonal shifts

Shifts in your hormone levels can make it difficult to fall asleep and this affects women more commonly than men.

These usually occur if you are going through puberty, menopause, premenstrual syndrome (PMS), or are pregnant. If you are pregnant it may also be difficult to find a comfortable way to sleep too.

What are the complications caused by insomnia?

Insomnia can not only affect your sleep habits but it can also lead to other problems too including:

  • Difficulty concentrating, focusing, or remembering can affect your performance at your job or in school
  • Mood swings or irritability
  • Increased risk of accidents or injury
  • Weakened immune system
  • Obesity
  • Diabetes
  • Heart disease
  • High blood pressure
  • Depression
  • Anxiety
  • Substance abuse

If you have chronic insomnia it is important to get diagnosed and treated as soon as possible to avoid these potential complications and decrease your risk for health problems.

How is insomnia diagnosed?

If you are having sleep difficulty, it is important to see your doctor to rule out any underlying medical conditions which can sometimes be accomplished through a physical exam and blood test.

Your doctor will also ask about your sleep habits and how long you have been experiencing symptoms. They may ask about your medical history such as medications you are taking, your work schedule, and any other stressors in your life as well as any relevant family history.

Be sure to give as much information as possible to help your doctor make the most accurate diagnosis. A sleep diary could be recommended to record your sleep history including any sleep disturbances or events over the course of a week or two to give your doctor a more accurate picture of your symptoms.

Finally, your doctor may ask you to do a sleep study called polysomnography which is usually performed overnight in a sleep lab with a sleep specialist although at-home tests are now also available for the diagnosis of insomnia.

What are the treatment options for insomnia?

There are two common options for the treatment of insomnia and these include cognitive behavioral therapy for insomnia (CBT-I) or medications. Cognitive behavioral insomnia therapy is a form of psychotherapy that helps you to change your thoughts and behaviors around sleep.

The goal of this therapy is to help you to establish healthy sleep habits, increase your hours of sleep, and improve your sleep quality.

Medications are also an option but need to only be used short-term as they can be addictive and have many side effects. You may be prescribed medication although there are over-the-counter medications like antihistamines that can make you drowsy.

Melatonin is a hormone produced in your brain to help promote sleep and is also available as a supplement now although more research needs to be conducted before any conclusions can be made about its efficacy.

Always speak to your doctor or health care provider before starting any new medication or supplement.

Can insomnia be prevented?

There are some things you can do to help prevent insomnia or at least make it less likely that you will experience it. These include:

  • Maintaining a regular sleep schedule by having the same sleep time and waking up at the same time every day
  • Creating a comfortable and relaxing sleep environment and utilizing any tools that may help you sleep such as a sleep mask or white noise machine
  • Limiting exposure to blue light from screens at least an hour before bedtime
  • Avoiding caffeine, nicotine, and alcohol before bedtime
  • Getting regular exercise or physical activity but not too close to bedtime
  • Eating a healthy diet and avoiding large meals or consuming lots of beverages at least a couple of hours before bed
  • Managing stress levels and practicing relaxation techniques such as yoga, deep breathing exercises, or meditation
  • Talking to your doctor about substituting any medication you are taking that may be causing insomnia
  • Avoiding naps
  • Only using your bedroom for sleeping and sex
  • Using a bedtime routine to relax that can include a warm bath, reading a book, or listening to music

If you are struggling with insomnia, talk to your doctor about what treatment options may be best for you. Insomnia is a common problem but it does not have to diminish your quality of life.

Summary

Insomnia is a common sleep disorder characterized by difficulty sleeping and it can be caused by a variety of things that can either be mental or physical.

It is treatable and there are treatment options available including cognitive behavioral therapy for insomnia, prescription sleep medicines, and over-the-counter sleep medicines and supplements. Which one is right for you is up to your doctor.

There also are methods to prevent insomnia too that can help you sleep at night which we listed above. If you have any more questions about insomnia, please consult with your doctor or health care provider.

References and sources:

NIH

Mayo Clinic

WebMD

Cleveland Clinic

Sleep Foundation

MedicalNewsToday

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