Introduction
Insomnia is a common sleep disorder characterized by persistent difficulty falling asleep, staying asleep, or waking too early despite adequate opportunity and environment for sleep, resulting in daytime impairment. Insomnia can be short-term (acute) or long-term (chronic), and it is one of the most frequently reported health complaints, with significant negative effects on mood, cognitive function, physical health, and quality of life.
Causes
Insomnia is often driven by psychological factors such as stress, anxiety, depression, or a hyperaroused state that makes it hard to relax at bedtime. Lifestyle factors including irregular sleep schedules, caffeine or alcohol use, excessive screen exposure before bed, and shift work can contribute. Medical conditions (chronic pain, respiratory issues), medications, and certain psychiatric disorders are also common underlying causes.
Symptoms
Symptoms include difficulty initiating sleep, difficulty maintaining sleep or frequent nighttime awakenings, waking earlier than desired, unrefreshing sleep, and associated daytime consequences such as fatigue, difficulty concentrating, irritability, mood disturbances, decreased motivation, and impaired performance at work or school. To be classified as chronic insomnia, these symptoms must occur at least three nights per week for at least three months.
Diagnosis
Diagnosis is primarily clinical, based on a detailed sleep history, sleep diary, and assessment of contributing medical and psychiatric factors. The clinician will review sleep habits, medication use, mental health history, and any symptoms suggesting other sleep disorders such as sleep apnea. Formal sleep studies (polysomnography) are typically reserved for cases where another sleep disorder is suspected.
Treatment
Cognitive behavioral therapy for insomnia (CBT-I) is the most effective and recommended first-line treatment, addressing the thoughts and behaviors that perpetuate poor sleep. Components include sleep restriction, stimulus control, relaxation training, and sleep hygiene education. Medications such as prescription sleep aids may be used short-term but carry risks of dependence. Treating any underlying psychiatric or medical conditions that contribute to insomnia is also essential.
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.