If you’ve ever spent a night tossing and turning in bed instead of sleeping, you are decidedly not alone. Americans have a sleep problem—as in, far too many of us are not getting the quantity or quality of sleep we need on a regular basis. That’s an issue that sleep experts refer to as “insomnia”—or the inability to fall and/or stay asleep.
This condition affects millions of people every year. In fact, a whopping 30 to 40 percent of adults in America report that they’ve experienced symptoms of insomnia at some point within the past year, while 10 to 15 percent of American adults report having chronic insomnia.
Note: The content on Sleepopolis is meant to be informative in nature, but it shouldn’t taken as medical advice, and it shouldn’t take the place of medical advice and supervision from a trained professional. If you feel you may be suffering from any sleep disorder or medical condition, please see your healthcare provider immediately.
In spite of the widespread prevalence of insomnia, many people are still in the dark about the definition, symptoms, causes, and treatment options for this condition. So here it is all in one place: everything you need to know about insomnia—including how to find relief from sleepless nights.
What Is Insomnia?
Insomnia is classified as a sleep disorder. It’s primarily defined by an inability to fall asleep and/or stay asleep. Basically, it deals with both sleep quantity and sleep quality. When either of those things is poor, there’s a good chance someone is dealing with insomnia.
As noted above, this condition is incredibly common. Most people will experience at least one bout of insomnia at some point in their lives. These brief brushes with insomnia are typically related to stress or a traumatic event. Still other people will experience long-term insomnia that persists for months or even years. (We’ll touch more on the different types of insomnia below.)
While the definition of insomnia is pretty straightforward, the symptoms, causes, risk factors, and health consequences of insomnia can be far-reaching and complex. So let’s dive into the nitty gritty of this frustrating condition.
What Are Some Types of Insomnia?
Researchers have identified several varieties of insomnia, which can be categorized in different ways. Many sources identify three main types of insomnia, all of which relate to the duration of the condition:
- Transient insomnia is distinguished by insomnia symptoms that last for a few days or weeks totaling less than one month at a time. Symptoms may come and go over the course of the month.
- Acute insomnia is defined as insomnia symptoms that last for one to six months at a time. As with transient insomnia, symptoms may come and go during this time. This is the most common form of insomnia.
- Chronic insomnia is often the most debilitating form of insomnia. It’s classified as insomnia that lasts for six months or more—even years. Researchers believe most cases of chronic insomnia are related to another physical or mental health condition(s). While symptoms may not occur every night, they’re likely to occur at least three nights every week.
Note: Some sources identify the time periods associated with each of these types of insomnia a little differently, but the general idea always applies: Transient insomnia persists for the least amount of time, while chronic insomnia is the most long-lasting.
In addition to these duration-related categories, sleep experts have identified two broader categories that speak more to the cause(s) of a person’s insomnia. These are defined in the following ways:
- Primary insomnia is distinguished as insomnia that is not caused by another mental or physical health condition or other causative factor.
- Secondary insomnia (also known as co-morbid insomnia) is defined as insomnia that results from or occurs alongside another issue, such as lifestyle factors, medications, or other health conditions. Most (but not all) cases of chronic insomnia fall into this category.
While the type of insomnia may vary from person to person, the symptoms of insomnia are fairly consistent. We’ll take a look at those symptoms in the next section.
What Are the Symptoms of Insomnia?
All cases of insomnia are classified by an inability to fall or stay asleep. If those were the only symptoms of insomnia, that would be unpleasant enough. But the unfortunate reality is that poor sleep quantity and/or quality can produce a range of other symptoms. Those include the following:
- Having trouble falling back asleep after waking up in the middle of the night
- Waking up earlier than needed or intended in the morning
- Feeling tired and/or groggy upon waking up
- Daytime fatigue and tiredness
- Anxiety and/or depression
- Irritability and/or mood swings
- Difficulty concentrating and focusing
- Trouble remembering things and retaining new information
- Tension headaches
- Reduced coordination
- Increased errors and accidents at home and/or on the job
- Diminished work performance overall
- Trouble engaging in social activities
- Gastrointestinal issues
- Anxiety that is specifically related to sleep
- Over-reliance on sleeping pills or supplements in order to sleep
These symptoms may manifest a bit differently from person to person, but odds are good that people who suffer from insomnia will experience at least a few of the symptoms on this list. People may find that their symptoms range from mild to severe or fluctuate over time. No matter how they manifest, symptoms can seriously interfere with a person’s quality of life.
What Causes Insomnia?
The list of possible causes of insomnia is all over the board. Here are some of the most common causes of insufficient sleep:
- Medical conditions. Certain health issues can cause insomnia directly or indirectly—by, for example, creating other symptoms that make it harder to fall or stay asleep. Medical conditions that may provoke insomnia include allergies, asthma, arthritis, cancer, chronic pain, diabetes, endocrine issues, gastrointestinal issues (such as acid reflux), and neurological conditions (such as Parkinson’s disease). Other sleep disorders, such as Restless Leg Syndrome or sleep apnea, may also cause insomnia.
- Medications. Some medications can provoke symptoms of insomnia. These include certain medications used for allergies, asthma, birth control, the common cold, depression, heart disease, high blood pressure, and thyroid disease.
- Mental health issues. There seems to be a strong link between insomnia and mental health issues such as anxiety and depression. This can create a nasty feedback loop: While anxiety and depression can provoke insomnia, insomnia can also cause anxiety and depression—thereby making it harder to break the cycle of restless nights.
- Stress. While stress could fall under the umbrella of “mental health issues,” it deserves its own category here due to the fact that it’s one of the most common culprits in provoking acute insomnia. Whether you’re feeling stressed because of relationship issues or pressures at work, stress can make it harder to unwind and decrease your chances of enjoying high-quality sleep.
- Neurotransmitter issues. Newer research suggests some people may experience insomnia because of issues with the way sleep and wakefulness cues operate in their brain. For example, it’s possible some people’s brains experience chemical interactions that interfere with healthy sleep-wake cycles. While more research is needed here, the evidence so far suggests biology may play a role in some people’s insomnia.
- Food and beverage choices. Consuming alcohol, caffeine, and/or heavy meals shortly before bedtime can make it harder to fall asleep or increase the likelihood of waking up during the wee hours of the night.
- Nicotine use. Because nicotine is a stimulant, the use of cigarettes or other tobacco products may contribute to insomnia—especially when these products are used in the hours leading up to bed.
- Lifestyle factors. A number of lifestyle factors may play a role in provoking insomnia. These include working up until bedtime, working irregular hours (such as shift work), traveling a lot (especially across time zones), not maintaining a regular sleep-wake schedule, and so on.
- Poor sleep habits. This can include factors such as napping a lot during the day, watching TV or using blue-light-emitting electronics in bed, working in bed, or attempting to sleep in an uncomfortable environment (such as one that is loud, dirty, excessively cold or hot, and so on).
- Miscellaneous factors. While the other entries on this list represent some of the most common causes of insomnia, they’re certainly not the only factors that might contribute to the sleep disorder. Other miscellaneous factors include sleeping beside a disruptive partner, having young children who are likely to wake you up at night, pregnancy, and so on.
Some of these factors may be more likely to provoke a short bout of acute insomnia (as in the case of temporary stress), while others may be more likely to contribute to insomnia over the long-term (as in the case of a chronic illness or shift work that goes on for years).
Even if insomnia starts out as acute, it’s not uncommon for it to become a bigger issue—no matter the original cause. This is primarily because insomnia can trigger sleep anxiety, which can then make it harder to fall and stay asleep even after the original insomnia trigger has passed.
Who Is At Risk for Insomnia?
Once you understand the potential causes of insomnia, you can probably guess many of its risk factors. While insomnia can happen to anyone at any time, several factors make it more likely that someone will experience the condition. Those risk factors include the following:
- Gender. While researchers are still trying to determine exactly why this is the case, data suggests women are much more likely to experience insomnia than men. One possible factor may be hormones: The hormonal shifts brought about by pregnancy, premenstrual syndrome, and/or menopause can all interfere with sleep.
- Aging. People over the age of 60 are more likely to experience insomnia than people who are younger. This may be a result of bodily changes, medical conditions, or medications that are more common among older populations. Additionally, adolescents are generally more likely to experience insomnia than non-elderly adults.
- Lifestyle factors. The way people live their lives during the day can influence the way they’re able to sleep (or not) at night. For example, the following factors can all make it harder to fall or stay asleep: Drinking alcohol or caffeine in the hours leading up to bed, using cigarettes or other tobacco products, exercising right before bedtime (or not exercising at all), working night shifts, performing mentally rigorous activities right before bed, or adopting an irregular sleep-wake schedule.
- Chronic illness. A number of chronic illnesses may increase the risk of developing insomnia. This is partly because many of these illnesses create pain, which can distract people from falling or staying asleep. Chronic diseases that may raise a person’s insomnia risk include Alzheimer’s disease, arthritis, diabetes, fibromyalgia, heart disease, kidney disease, lung disease, Parkinson’s disease, Restless Leg Syndrome, and sleep apnea.
- Medication use. Some medications may have side effects that can interfere with sleep. These include certain asthma medications, cough and cold remedies, decongestants, depression treatments, diet pills, high blood pressure medications, Parkinson’s disease medications, seizure disorder medications, and steroids.
- Travel. As anyone who’s ever flown around the world can attest, jet lag can be a major trigger for insomnia. Frequent travel (especially across time zones) may also contribute to the sleep disorder.
- Psychological factors. Insomnia is frequently associated with psychological distress such as anxiety disorders, bipolar disorder, depression, trauma, and plain old stress resulting from relationship issues, illness or death in the family, pressures at school or work, and so on. As a result, people who are dealing with these conditions have a higher risk of developing insomnia.
- Sleep environment. If someone is trying to sleep in an environment that isn’t conducive to sleep, that’s going to significantly increase their chance of having insomnia. For example, a bedroom that is noisy, cold or hot, or brightly lit can make it hard to fall or stay asleep. Same goes for an uncomfortable mattress or a disruptive sleep partner or children.
No matter why a person develops insomnia, the health consequences of this sleep disorder can have serious ramifications for a person’s wellbeing. We’ll dive into those side effects in the next section.
What Are the Health Consequences of Insomnia?
If you’ve ever tossed and turned all night only to get up to an early alarm, you know how challenging it can be to make it through the day. When you’re sleep deprived, it becomes harder to sustain your daily routines at work and at home.
If your insomnia only lasts a few days, you’ll likely survive not much worse for wear. But when you multiply those symptoms over several weeks or months, you can probably guess that the long-term consequences of insomnia aren’t great.
In fact, insomnia can impact our lives in serious and far-reaching ways. The health consequences of insomnia include the following:
- Impaired immune function
- Increased risk of chronic disease including diabetes, heart disease, and hypertension
- Increased risk of mood disorders such as anxiety and depression
- Difficulty concentrating
- Difficulty remembering things and retaining new information
- Impaired judgement, reasoning, and problem-solving abilities
- Impaired performance at work or school
- Increased risk of making errors and being in accidents, due partly to impaired reaction times
- Diminished sex drive and fertility
- Increased signs of aging, especially in the skin
- Increased risk of weight gain
- Reduced life expectancy
Those are some serious ramifications, and they speak to the importance of effectively diagnosing and treating insomnia. In fact, an accurate diagnosis is the first step to finding relief from insomnia.
How Is Insomnia Diagnosed?
If you think you’re struggling with insomnia, it’s important to consult a medical professional. They’ll be able to assist you in determining whether or not you do have the condition. In order to diagnose insomnia, your health care provider will probably do the following:
- Take a complete medical history, including your mental health history
- Ask about your sleep habits
- Conduct a physical exam to rule out other health issues
- Ask about your social environment
- Suggest that you keep a sleep diary in order to track your sleep patterns and identify any factors that might be contributing to your sleep issues
- (Possibly) suggest that you employ one or several tests to better understand your sleep habits. This might include questionnaires such as the Epworth Sleepiness Scale or a mental health examine to determine whether depression or anxiety might be a factor
- (Possibly) suggest that you participate in an overnight sleep study to measure your sleep quality using tools such as a polysomnography (which records brain waves during sleep) or actigraphy (which measures movement and sleep-wake patterns)
In some cases, doctors are able to diagnose insomnia pretty easily. In others, the process can be a little more involved. No matter what, it’s important to advocate for yourself until you’ve reached a diagnosis that can inform your best steps for moving forward.
What Are Some of the Best Insomnia Remedies or Treatments for Insomnia?
While the consequences of insomnia can feel debilitating and even life-altering, the good news is there are a wide variety of treatments for insomnia that can help people manage or alleviate their condition. Some of the most effective insomnia remedies include the following:
- Addressing the underlying cause. In the case of secondary insomnia, sometimes all it takes to sleep better is to get the primary cause of the issue under control. For example, if your insomnia is partly the result of asthma keeping you up at night, a more effective asthma treatment plan might reduce or eliminate the insomnia.
- Healthy sleep habits. A few simple tweaks in your sleep habits may make all the difference when it comes to falling and staying asleep. Good sleep hygiene involves maintaining a regular sleep-wake schedule, using the bed for nothing other than sleep and sex, avoiding blue light exposure in the hours leading up to bed, ensuring that your bedroom stays cool, dark, and quiet, investing in a comfortable mattress and bedding, and so on.
- Lifestyle changes. Exercising regularly, eating well, avoiding alcohol and stimulants, ditching nicotine, and creating a relaxing bedtime routine (and implementing it every evening) can all improve your capacities for obtaining high-quality sleep.
- Relaxation techniques. A variety of relaxation techniques may help you unwind and adopt the restful state necessary for falling and staying asleep. These include gentle yoga, progressive muscle relaxation, meditation, breathing exercises, and so on.
- Sunlight exposure. Getting plenty of exposure to daylight (especially in the morning) helps maintain the body’s natural circadian rhythms, which are responsible for maintaining a consistent sleep-wake schedule.
- Cognitive Behavioral Therapy (CBT). This proven form of therapy can help you address anxiety and other thought patterns that might make it more challenging to fall asleep each night. These benefits can be explored in individual or group sessions.
- Medications. Prescriptions and over-the-counter meds can come with their own set of unpleasant side effects, so it’s a good idea to use prescriptions as a last resort. That being said, if all other treatment options fail, your doctor might recommend prescription sleeping pills or other sleep aids. Make sure to talk to your doctor before trying over-the-counter options.
If you’ve tried these ideas and nothing seems to be working, it’s definitely time to consult a medical professional. Insomnia is considered to be a very treatable condition, so continue to advocate for yourself until you’ve found a treatment plan that works for you.
What Are Some Insomnia Myths?
While more people are getting educated about insomnia (partly because the condition is so prevalent), there are still a lot of insomnia myths floating around out there. So let’s deconstruct some of these falsehoods once and for all.
Myth #1: Insomnia only happens to Nervous Nellies.
Reality: As we’ve now seen, insomnia can happen for a huge number of reasons. While anxiety is a (very valid) cause of insomnia, it’s only one among a large list of factors that can provoke this sleep disorder.
Myth #2: Insomnia is just the inability to fall asleep.
Reality: As noted above, insomnia might consist of the inability to fall asleep. Or it might manifest as frequent wake-ups during the night, waking up early, or feeling extra sleepy upon waking. Bottom line? Just because you’re able to fall asleep quickly, that doesn’t mean you’re immune from other manifestations of insomnia.
Myth #3: If you can’t sleep, you should just lie there.
Reality: Staring at the ceiling for hours on end isn’t going to help you fall back asleep. In fact, it’s likely to escalate your anxiety—thereby making it harder to doze off again. It also teaches your brain to associate the bed with not sleeping, which is the exact opposite of what you want. Therefore, most experts agree that if you haven’t fallen back asleep within 15 or 20 minutes of waking up, you’re better off getting out of bed and participating in a relaxing activity such as listening to soothing music or reading.
Myth #4: Alcohol and TV can help combat insomnia.
Reality: While it might be tempting to serve yourself a nightcap in the hopes of unwinding before bed, alcohol is proven to impair sleep quality and increase the risk of waking up during the night. Meanwhile, TV poses its own downsides: Watching TV (especially the news) can be stressful, which can make it harder to unwind before bed. Additionally, TVs emit the blue light that is notorious for interfering with sleep-wake cycles. So ditch the alcohol and TV in favor of a good book and chamomile tea.
Myth #5: If you only wake up for short periods during the night, it won’t impair your sleep quality.
Reality: Sure, it might not seem like such a big deal if you only wake up for 20-minute increments during the night. But the reality is waking up for any amount of time during the night causes you to lose much more than a few minutes of sleep. In fact, studies suggest interrupted sleep is just as bad for you as insufficient sleep.
Finding Relief from Insomnia
The occasional night of poor sleep is a normal part of life. But if insomnia is interfering with your quality of life on a regular basis, then it’s important to consult a medical professional. They’ll be able to help you accurately diagnose your condition and develop a treatment plan that’s tailored to your specific needs and lifestyle preferences. There are plenty of remedies for insomnia, so don’t give up until you’ve found a treatment plan that enables you to get more and better sleep.