Insomnia

Definition

Insomnia is trouble falling asleep, staying asleep through the night, or waking up too early in the morning.

Episodes of insomnia may come and go or be long-lasting.

The quality of your sleep is as important as how much sleep you get.

Alternative Names

Sleep disorder - insomnia; Sleep issues; Difficulty falling asleep; Sleep hygiene - insomnia

Causes

Sleep habits we learned as children may affect our sleep behaviors as adults. Poor sleep or lifestyle habits that may cause insomnia or make it worse include:

The use of some medicines and drugs may also affect sleep, including:

Physical, social, and mental health issues can affect sleep patterns, including:

Health problems may also lead to problems sleeping and insomnia:

With age, sleep patterns tend to change. Many people find that aging causes them to have a harder time falling asleep, and that they wake up more often.

Symptoms

The most common complaints or symptoms in people with insomnia are:

People who have insomnia are sometimes consumed by the thought of getting enough sleep. But the more they try to sleep, the more frustrated and upset they get, and the harder sleep becomes.

Lack of restful sleep can:

Exams and Tests

Your health care provider will do a physical exam and ask about your current medicines, drug use, and medical history. Usually, these are the only methods needed to diagnose insomnia.

Treatment

Not getting 8 hours of sleep every night does not mean your health is at risk. Different people have different sleep needs. Some people do fine on 6 hours of sleep a night. Others only do well if they get 10 to 11 hours of sleep a night.

Treatment often begins by reviewing any medicines or health problems that may be causing or worsen insomnia, such as:

You should also think about lifestyle and sleep habits that may affect your sleep. This is called sleep hygiene. Making some changes in your sleep habits may improve or solve your insomnia.

Some people may need medicines to help with sleep for a short period of time. But in the long run, making changes in your lifestyle and sleep habits is the best treatment for problems with falling and staying asleep.

Different methods of talk therapy, such as cognitive behavioral therapy for insomnia (CBT-I), may help you gain control over anxiety or depression.

Outlook (Prognosis)

Most people are able to sleep by practicing good sleep hygiene.

When to Contact a Medical Professional

Call your provider if insomnia has become a problem.

References

Anderson KN. Insomnia and cognitive behavioural therapy-how to assess your patient and why it should be a standard part of care. J Thorac Dis. 2018;10(Suppl 1):S94-S102. PMID: 29445533 pubmed.ncbi.nlm.nih.gov/29445533/.

Chokroverty S, Avidan AY. Sleep and its disorders. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 102.

Vaughn BV, Basner RC. Disorders of sleep. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 377.


Review Date: 5/10/2020
Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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