Overview
Insomnia is a sleep problem in which a person has difficulty getting enough good-quality sleep despite having the chance to sleep. Some people mainly struggle to fall asleep, while others wake often during the night or wake too early. Insomnia can last a few days or weeks, or it can continue for months.
Key Symptoms
Common symptoms include trouble falling asleep, waking often during the night, waking earlier than intended, and feeling unrefreshed after sleep. During the day, people may feel tired, irritable, worried about sleep, or have trouble concentrating. Some people also notice reduced performance at work, school, or while driving.
Causes and Risk Factors
Insomnia can be linked to stress, changes in routine, travel across time zones, shift work, and poor sleep habits such as irregular bedtimes. It may also be associated with mental health conditions, chronic pain, breathing problems during sleep, digestive symptoms, hormone changes, and substance use including alcohol, nicotine, and caffeine. Some medicines and stimulants can also interfere with sleep.
Who Is Affected
Insomnia can affect children, teenagers, adults, and older adults, although causes may differ by age. It is more common during times of stress and may be more likely in people with chronic medical conditions or mental health concerns. Older adults may also notice sleep changes related to aging, illness, or medicines.
Prevention
Helpful steps include keeping a regular sleep and wake time, creating a quiet and comfortable sleep space, and limiting caffeine, nicotine, and alcohol close to bedtime. It may also help to avoid large meals late at night, reduce screen use before bed, and get daylight exposure and physical activity during the day. Addressing stress and keeping naps short, if taken at all, can also support sleep.
Diagnosis and Tests
A healthcare professional usually starts by asking about sleep patterns, daytime symptoms, stress, medicines, and medical history. A sleep diary may be suggested to track when you sleep and wake. In some cases, further evaluation is needed to look for related conditions such as sleep apnea, mood disorders, restless legs symptoms, or other health problems.
Treatment Categories
Treatment depends on the cause and how long symptoms have been present. It often includes sleep education, improving sleep habits, and structured therapy approaches that help change thoughts and behaviors that keep insomnia going. Care may also include reviewing medicines and treating related medical or mental health conditions.
Living With It
Living with insomnia can be frustrating, and worrying about sleep can sometimes make sleep harder. Keeping a simple sleep routine and tracking patterns can help you notice triggers such as stress, caffeine, or irregular schedules. If daytime sleepiness affects driving, operating machinery, work, or school, it is important to seek medical advice.
When to Seek Medical Care
Seek medical care if sleep problems last for several weeks, keep returning, or affect daytime functioning, mood, memory, work, school, or safety. You should also seek care if snoring, breathing pauses during sleep, leg discomfort, severe worry, depression, substance use, or chronic pain may be contributing. A healthcare professional can help look for underlying causes and discuss treatment options.