Overview
Insomnia means sleep that is too short, fragmented, or not refreshing and begins to affect daytime function. It can be brief or chronic; early attention improves mood, cognition, and health.
Common Symptoms
Difficulty falling asleep
Trouble initiating sleep at bedtime.
Night awakenings
Waking multiple times and struggling to fall back asleep.
Early morning waking
Awakening too early and unable to return to sleep.
Daytime impairment
Fatigue, poor concentration, mood changes during the day.
Types of insomnia
Occurs without another clear medical or psychiatric cause.
Related to pain, medication, psychiatric issues, or substance use.
Short-lived (days to weeks), often following stressors.
Lasts a month or more and typically needs structured treatment.
What causes insomnia?
Insomnia has many contributors. Stress and worry, irregular schedules (shift work), certain medications, medical conditions (like pain, breathing problems, or hormonal changes), caffeine, alcohol, and poor sleep habits all play a role. Mental health conditions such as anxiety, PTSD, and depression frequently co-occur with chronic sleep loss.
How insomnia is evaluated
A clinician will ask about sleep patterns, daily routines, medical history, medications, and substance use. Tools such as a sleep diary or wearable sleep trackers help document patterns. When underlying medical or psychiatric causes are suspected, targeted testing or specialist referral may be recommended.
Two weeks of bedtime and wake time recording helps identify triggers and patterns.
A review of mental and physical health, medications, and daily habits.
Evidence-based treatments
For chronic insomnia, structured behavioral approaches are preferred. Below are common, evidence-backed options clinicians use.
Therapy targeting thoughts and behaviors that keep sleep problems going.
Focused habit and routine changes for faster benefit.
Breathing, progressive relaxation, and mindfulness to lower arousal.
Light exposure and schedule adjustments when rhythms are off.
CBT‑I components
Strengthen the bed–sleep connection (leave bed if awake).
Temporarily limit time in bed to consolidate sleep.
Address anxious or unhelpful sleep thoughts.
Habits supporting sleep: caffeine timing, screens, routine.
Medications & medical review
Medications can help short-term but are usually not a long-term fix. A clinician should review current medicines and health factors that affect sleep.
Medications that worsen sleep, interactions, and short-term symptomatic aids when appropriate.
When to consider medical options
Consider medication only after non-drug strategies have been tried or when insomnia is severe and disabling. Typical reasons include safety concerns, severe impairment, or as a short bridge while therapy begins.
- Severe daytime impairment or safety risk.
- No access to behavioral treatments and rapid relief needed.
- As short-term bridge during treatment initiation.
All medication decisions should be individualized and monitored by a clinician.
Practical self-help steps
- Keep a consistent sleep-wake schedule, even on weekends.
- Create a calm, dark, and cool bedroom; reserve the bed for sleep and intimacy.
- Limit caffeine and nicotine, especially in the afternoon and evening.
- Avoid heavy meals and alcohol close to bedtime.
- Wind down with relaxing, screen-free activities before bed.
- Use a brief sleep diary to track progress and share with your clinician.
Frequently Asked Questions
Get expert answers to the most common questions about insomnia, treatments, and when to seek help.
How long does insomnia usually last?
Short-term insomnia often lasts days to weeks and is linked to acute stressors or changes. Chronic insomnia persists for a month or more and usually benefits from structured treatments like CBT-I.
Timeline
Track sleep patterns for two weeks to spot persistent problems and discuss with a clinician.
Can lifestyle changes fix sleep problems?
Many people improve with consistent sleep schedules, limiting caffeine and screens, and optimizing the sleep environment. CBT-I combines these habits with behavioral techniques for best results.
Practical steps
Start with a regular bedtime and wind-down routine; try these for several weeks before concluding they aren't helping.
Are sleep trackers useful?
Trackers can help identify patterns but have limits. Use them alongside a sleep diary and clinician input to guide diagnosis and treatment.
Use thoughtfully
Share tracker summaries with your clinician rather than relying on raw nightly scores alone.
When should I see a doctor?
See a clinician when sleep problems are persistent, cause daytime impairment, or when there are safety concerns (falls asleep while driving, thoughts of harming self, or suspected sleep apnea).
Seek help
Persistent insomnia often responds to structured treatments; a clinician can help create a plan.
References & further reading
- American Academy of Sleep Medicine: Clinical guidelines for insomnia.
- CBT-I resources and treatment summaries (clinical reviews).
- Patient-oriented materials on sleep hygiene and healthy sleep routines.