Insomnia occurs when you’re unable to get the sleep you need to feel refreshed. Causes range from stress to chronic health conditions. Treatments include therapy, medications, or lifestyle changes.

Insomnia is a type of sleep disorder.

Among sleep disorders, insomnia is the most common. According to the American Psychiatric Association (APA), about a third of adults report some insomnia symptoms.

A note for Veterans

Insomnia is a common and complex obstacle for Veterans. To address sleep, Veterans and their caregivers can explore how other elements of health, such as nutrition, mental wellness, and fitness, contribute to improving rest.

Take a look at our resources.

Typical insomnia symptoms include:

  • waking too early and finding yourself unable to fall back asleep
  • spending a lot of the night lying awake, worrying you won’t fall asleep
  • a consistent pattern of interrupted or broken sleep that doesn’t refresh you
  • trouble falling asleep after going to bed

As a result, you might begin to experience other symptoms related to lack of sleep, including:

Experts describe insomnia in different ways, depending on its characteristics:

  • Acute insomnia: short-term sleeping difficulties that generally last no more than a few weeks.
  • Chronic insomnia: insomnia that affects your sleep for at least 3 days every week for a period of 3 months or longer. It can be primary (idiopathic) or secondary (comorbid).
  • Onset insomnia: difficulty falling asleep. Trouble getting to sleep might happen as a result of caffeine use, mental health symptoms, or other common insomnia triggers, but it can also develop with other sleep disorders.
  • Maintenance insomnia: trouble remaining asleep once you get to sleep, or consistently waking up too early. This type of insomnia might relate to underlying health and mental health symptoms — but lying awake and worrying you won’t get enough sleep can make it worse.
  • Behavioral insomnia of childhood: consistent trouble falling asleep, refusing to go to bed, or both. Children with this condition often benefit from learning self-soothing strategies and following a regular sleep routine.

Causes of insomnia can vary depending on which type you have.

Possible causes of acute insomnia are recent stressors, such as an upsetting or traumatic event or jet lag.

Chronic insomnia can occur as a result of:

Risk factors for insomnia

Insomnia is related to age, sex, and genetics. It’s more common:

Other risk factors associated with insomnia include:

Insomnia and pregnancy

Insomnia is common during pregnancy, especially in the first and third trimesters.

Pregnancy-related insomnia usually passes and doesn’t affect your baby’s development. But getting the right amount of sleep is important for your overall well-being.

Lifestyle changes that could help include:

  • eating a balanced diet
  • maintaining a consistent sleep schedule
  • practicing relaxation techniques during the day to help ease anxiety and promote calm

Children and teens can develop insomnia often for the same reasons as adults.

Symptoms can include:

  • daytime sleepiness or restlessness
  • irritability and mood changes
  • repeated disciplinary issues
  • problems with memory and focus

The first step to treating insomnia in children generally involves setting a firm bedtime and sticking to it. Other helpful tips include:

  • creating a soothing bedtime routine
  • following good sleep hygiene practices, like avoiding screen time near bedtime
  • reducing sources of stress in your child’s life

A therapist or pediatrician can offer more guidance on treating insomnia in children.

According to 2019 research, up to 75 percent of older adults experience some symptoms of insomnia.

Different factors contribute to insomnia in older adulthood, and these can have a domino effect:

  • age-related changes in the circadian rhythms
  • retirement, as you may no longer have a consistent daytime schedule or get regular social interaction
  • social isolation can contribute to loneliness and increase your chances of experiencing depression
  • health concerns related to aging, including chronic pain conditions
  • daytime napping — if you’re not getting enough sleep at night — can leave you less tired at bedtime, fueling a cycle of sleeplessness

If you experience insomnia, a therapist or clinician can offer more support in finding helpful treatment options.

To diagnose insomnia, a healthcare professional will ask questions about:

  • any existing medical conditions
  • physical and mental health symptoms you’ve noticed
  • stressors in your personal or professional life
  • sleep history, including how long you’ve had symptoms and how they affect you

This can help determine the underlying causes of your sleep problems. They may also ask you to keep an app-based or written sleep log for 2 to 4 weeks, tracking:

  • what time you go to bed
  • the approximate time it takes you to fall asleep
  • any instances of repeated waking in the night
  • what time you wake up each day

They may order medical tests or blood work to help rule out medical conditions that can interfere with sleep.

If they suspect you could have an underlying sleep disorder, such as obstructive sleep apnea, they may recommend a sleep study.

You’ll likely receive a clinical diagnosis of insomnia if your sleep difficulties occur at least 3 nights a week for a minimum of 3 months and if they create major distress or difficulties in your daily life.

You have a number of options for treating insomnia, including therapy, medications and supplements, and natural remedies.

Cognitive behavioral therapy for insomnia (CBT-I)

The American College of Physicians (ACP) recommends CBT-I as a first-line treatment for chronic insomnia in adults.

With support from a therapist, you can learn specific techniques to address insomnia, including:

  • Stimulus control: teaches you to get out of bed and find a quiet and relaxing activity until you feel sleepy, limiting the time you may lie awake and worry about falling asleep
  • Sleep restriction: restricts and then gradually increases the amount of time you spend in bed
  • Bright light therapy: exposes you to bright light in the morning or evening, depending on whether you have more trouble falling asleep or staying asleep

A therapist may also offer guidance on relaxation techniques and sleep hygiene practices that address behaviors that prevent you from getting quality sleep.

A therapist can also identify underlying mental health symptoms contributing to insomnia or making your symptoms worse. Addressing these triggers and contributing factors can go a long way toward relieving insomnia.

Medications and supplements

Your clinician might prescribe medication (or Z-drugs) if therapy and lifestyle changes don’t work. Example medications are:

Over-the-counter (OTC) supplements like melatonin can offer some relief from insomnia. Melatonin supplements may slightly decrease the time it takes you to fall asleep.

Support for melatonin as an insomnia treatment remains inconclusive. Experts have yet to confirm whether it’s safe to use melatonin long term, though it’s generally considered safe for short-term use.

Check in with a healthcare professional before trying supplements like melatonin or OTC medications to help ease insomnia. These medications may interact with other prescription and OTC medications or cause side effects.

If you’re pregnant, always ask your healthcare team before taking any medications or supplements.

Other approaches

Lifestyle changes and home remedies can often help manage insomnia symptoms. Try:

Your brain can’t carry out important functions that keep it running smoothly when you don’t get enough sleep. That may be why you feel foggy and have trouble focusing when you get insufficient sleep.

Insomnia can have more serious health effects over time. It’s linked to:

Insomnia can also increase your risk of:

  • making errors and worsened performance at school or work
  • car accidents
  • difficulty remembering

It’s not always possible to prevent insomnia, but these tips may help you get the sleep you need:

  • Try to maintain roughly the same sleep-wake schedule, even on weekends.
  • Create a relaxing bedtime routine that prepares you to sleep.
  • Dim the lights and put down electronic devices an hour before bedtime.
  • Avoid napping, especially if you know sleeping during the day keeps you awake at night.

Insomnia is a sleep disorder that can affect your mental and emotional health and physical well-being.

Causes and risk factors vary depending on the type of insomnia, but many treatments exist.

Connect with a healthcare professional as soon as possible if you think you have insomnia. They can help you explore possible causes and offer support in finding the best insomnia treatment for your needs.