Michael Jubinville, MPH
Insomnia is a sleep disorder. It may cause many sleep problems. These include trouble falling asleep, waking in the middle of the night, or waking very early in the morning. It may also be a sleep that's not restful. Insomnia can be a short-term problem, or it can be chronic. Chronic insomnia lasts for more than 4 weeks.
Insomnia happens for many reasons. Short-term insomnia is often caused by temporary situations or problems with the environment such as:
There may be no clear reason for chronic insomnia. It may also be linked to other health or mental problems such as:
Both chronic and short-term insomnia may be due to
Risk Factors TOP
Insomnia is more common in women during and after menopause. It is also common in adults 50 years of age or older.
Your chances of insomnia are higher for having any of the problems listed above.
Insomnia may cause:
When Should I Call My Doctor?
Call your doctor if you are having frequent insomnia. Let your doctor know if you're having a hard time getting through the day.
You will be asked about your symptoms and health history. A physical exam will be done. You will also be asked about your job, eating habits, and drug and alcohol use.
You will also be asked about your schedule and sleep patterns. You may be asked to keep a sleep diary. This will include information about your naps, bedtime, and how often you wake during the night. Your doctor will review the medicines you take, including over-the-counter medicines and herbal supplements. Your answers may point to a cause.
You may be watched in a sleep lab. This may be done if the cause isn't clear. It may be also done to find out if you have a sleep disorder. You will need to spend the night in a special center. Your movements, breathing, and brain activity will be monitored. This will allow your doctor to identify a treatable condition that is affecting your sleep.
Treat Underlying Medical Conditions
Many physical and mental disorders can disrupt sleep. Getting them treated may help restore normal sleep patterns.
Identify and Modify Behaviors That Worsen Insomnia
There are steps you can take to help get a good night's rest. You may be advised to lower your intake of certain items or avoid them to see if your sleep improves. You may be asked to:
Your sleep habits can also affect how well you sleep. Steps that may help you sleep better:
Sleeping pills are available by prescription or over-the-counter. Most doctors don't want you to use them for a long time. They can cause dependency. This is a physical change in your body. It makes your body depend on the drug for sleep.
Proper use of certain sleep medicines may improve sleep. Most of these medicines are only approved for use for a short time. They can cause drowsiness, lightheadedness, and headache. Serious problems such as abnormal thinking, behavior changes, or suicidal thoughts can happen.
Many over-the-counter sleep medicines contain diphenhydramine. This can make you feel groggy and might help you fall asleep. But, it has serious side effects. Most people should avoid using it regularly.
Exercise can help you get a better sleep. It can reduce stress and allow your body to reach a deeper state of relaxation. The timing of exercise is important. It's best to do it early in the day if you have sleeping problems. If you have to exercise later in the day, make sure you are done at least a few hours before bedtime.
Herbal Therapies and Supplements TOP
Some people use the herb valerian to help insomnia. Others take melatonin. It is not clear that these supplements help. Talk to your doctor before taking any herbs or supplements.
Relaxation Therapy TOP
This therapy may reduce or eliminate anxiety and body tension. It stops the mind from racing and allows the muscles to relax. This can support a restful sleep. The therapy may include deep breathing and progressive relaxation.
Sleep Restriction TOP
A sleep restriction program is a strict sleep program. It limits the amount of time in bed to only the time that you are actually sleeping. Previous sleep logs will determine the amount of time allowed in bed. The time you spent sleeping will be used to determine the amount of time you can spend in bed. At first, your time in bed may seem short, usually about 5 hours. More time is slowly added until you get to a normal night's sleep.
Cognitive Behavioral Therapy TOP
Cognitive behavioral therapy (CBT) is a form of talk therapy. This means that you discuss your thoughts, feelings, and behaviors with a mental health professional. CBT focuses on how the way you think affects the way you feel and act. CBT may have more lasting effects than medication.
Reconditioning helps people associate the bed and bedtime with sleep. This means not using the bed for activities other than sleep and sex. As part of the reconditioning process, the person is usually advised to go to bed only when sleepy.
To help lower your chances of insomnia:
National Heart, Lung, and Blood Institute
National Sleep Foundation
Better Sleep Council Canada
Canadian Sleep Society
Insomnia. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/insomnia. Updated July 25, 2017. Accessed August 21, 2018.
Insomnia. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/insomnia. Accessed August 21, 2018.
Insomnia in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114839/Insomnia-in-adults. Updated August 19, 2018. Accessed August 21, 2018.
Jacobs GD, Pace-Schott EF, Stickgold R, Otto MW. Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison. Arch Intern Med . 2004;164(17):1888-1896.
Morin CM, Vallieres A, Guay B, et al. Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial. JAMA. 2009;301(19):2005-2015.
Last reviewed June 2018 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 8/21/2018