Insomnia affects the ability to sleep, which may also result in symptoms that affect a person’s performance throughout the day, including excessive daytime sleepiness and poor concentration.
People with insomnia have problems:
- sleeping well
- getting enough sleep
- enjoying good quality sleep
The effects on sleep can affect a person’s ability to function during the day, leading to various symptoms that impair their work performance, relationships, and overall health and well-being.
Lack of sleep or not getting enough sleep regularly is a common problem. More than
This article discusses insomnia, common symptoms, possible causes, diagnosis, and treatments.
Insomnia is the most common type of sleep disorder. It can occur despite having a good sleep environment and adequate opportunity for sleep.
Read more about the science of sleep.
A person with insomnia may experience:
- difficulty falling asleep
- difficulty staying asleep
- early morning awakenings
- difficulty going back to sleep
The condition can be short term, or acute, lasting for a
Insomnia can also be long term, or chronic, occurring
Insomnia is common. According to preliminary research, about 1 in 4 U.S. people develop acute insomnia each year. Around 6–10% have symptoms that meet the diagnostic criteria for insomnia.
Having the following symptoms may be a sign that a person has insomnia.
Difficulty falling asleep at night
A person with insomnia may find it difficult to initiate sleep in the early sleep stage. This is called sleep-onset or initial insomnia.
Certain triggers may cause a person to have trouble falling asleep, such as:
- drinking caffeine
- experiencing a lot of stress
- having poor sleep hygiene
It can also occur as a symptom of other conditions, such as:
- delayed sleep phase syndrome
- childhood phobias
- restless legs syndrome
- chronic psychophysiological insomnia
Daytime fatigue or sleepiness
Persistent sleep difficulties can lead to excessive daytime sleepiness or hypersomnolence.
A person with excessive daytime sleepiness finds it difficult to stay awake and alert during the day. They have a strong urge to sleep during daytime hours. A person may unintentionally fall asleep or do so at inappropriate times and report feeling “tired all the time.”
Waking up during the night
Some people have trouble maintaining their sleep after initiating sleep.
During sleep, frequent arousals can lead to fragmented sleep. Rapid eye movement is a sign of high brain arousal during sleep, which causes insomnia to occur during the night.
Read more about waking up at night.
It may occur because of conditions such as:
Older adults are more likely to wake up in the middle of the night.
Other causes of sleep maintenance insomnia include:
- major depression
- central and obstructive sleep apnea
- periodic limb movement disorder
Read more about depression and insomnia.
Waking up early and not being able to get back to sleep
A person with insomnia may habitually wake very early and cannot go back to sleep. Researchers refer to this as terminal insomnia or sleep offset insomnia.
Low motivation or energy
A 2022 study found insomnia blunted reward responsiveness, resulting in anhedonia, or loss of pleasure or interest in previously enjoyed activities.
Deep sleep greatly influences the body’s energy production and enhances its ability to produce energy. Sleep-deprived people have an impaired ability to perform tasks that require additional energy, including schoolwork and meal preparation.
Poor concentration, memory, or focus
Sleep deprivation affects cognitive performance. In a small
A study from 2020 with 16 male participants found that 36 hours of sleep deprivation led to problems in working memory.
Increased errors or accidents and lack of coordination
Results from a
Mood and mental health conditions
Sleep affects mood. A
People experiencing sleeping difficulties throughout the year are
- generalized anxiety disorder
- major depressive disorder (MDD)
- bipolar disorder
Doctors recognize that sleep disturbances are one of the
Worry or anxiety about sleeping
Some people who have insomnia experience worry or apprehension about not being able to fall or stay asleep, which is called somniphobia. Recurrent sleep paralysis or nightmares commonly cause these feelings.
Using medication or alcohol to fall asleep
A 2018 study reported that 20–30% of people with insomnia said they use alcohol as a sleep aid because of its sedative effects.
However, this effect tends to wear off after a few hours as the liver metabolizes alcohol. Alcohol can also have the opposite effect on sleep and sleep quality.
Read more about the links between alcohol and insomnia.
If a person has trouble falling asleep without using alcohol, they can reach out to a doctor for support.
A combination of factors contributes to insomnia, including:
- being female
- older age (65 years and older)
- psychosocial factors, such as stress from work
- developmental conditions, such as delayed milestones and separation anxiety
- certain personality traits, such as perfectionism and excessive worrying
- certain psychiatric conditions, such as mood and anxiety disorders
- misusing alcohol and substances
- heavy caffeine consumption
- heavy smoking
There is no specific test to diagnose insomnia. A doctor will perform a physical exam to look for and rule out other possible causes of insomnia. They will also ask questions and may ask a person to answer an insomnia questionnaire.
A doctor may also ask a person to keep a sleep log or diary to note their sleep patterns for 2–4 weeks.
If they suspect the presence of other sleep disorders, the doctor may refer the person for a sleep study.
The treatment for insomnia divides into two categories: nonpharmacological and pharmacological.
Nonpharmacological treatments are the first line of treatment for insomnia. They are
Nonpharmacological treatments include:
- proper sleep hygiene
- behavioral therapy
- stimulus control therapy
- sleep restriction therapy
- relaxation therapy
Read more about insomnia self-care tips.
If nonpharmacological treatments aren’t working, a doctor may prescribe medication to help with insomnia, such as:
- benzodiazepine receptor agonist drugs
- tricyclic antidepressants
- melatonin receptor agonists
- sedating antipsychotics
- orexin (hypocretin) antagonists
Insomnia is a sleep disorder that affects one’s quality of life. It can lead to other physical and mental health problems.
People with insomnia may experience various symptoms during the day. These include feeling excessively tired, difficulty concentrating, and low motivation.
People who feel dissatisfied with their sleep can ask their doctor to evaluate them for insomnia or another sleep disorder. Getting the right diagnosis and treatment can help people improve their sleep and feel better.