Sleep onset insomnia is a type of sleep disorder where a person has difficulty initiating or falling asleep and may experience sleep quality issues as a result.

Insomnia is a common sleep problem that affects approximately 33–50% of the adult population in the United States.

Healthcare professionals may use the term sleep onset insomnia to describe when someone experiences a significant delay in falling asleep. Similarly, they may use the term sleep maintenance insomnia to describe when a person experiences difficulty staying asleep. An individual with insomnia may experience one or both problems.

People with insomnia may also experience one or more of the following symptoms:

Sleep quality issues can affect an individual’s overall well-being and physical and mental health. A person can speak with a healthcare professional to address any form of insomnia and help prevent further complications and symptoms from interfering with their daily life.

This article discusses the potential causes of sleep onset insomnia, treatment options, and when to consult a doctor.

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Several causes may contribute to sleep onset insomnia, including older age and certain lifestyle factors.

Stress

Experts suggest that experiencing stress and anxiety about work, school, money, relationships, and other factors may raise a person’s risk of developing insomnia or worsen it. Additionally, worrying about how much sleep they are getting or looking at a clock while trying to sleep may also have the same effects.

Older age

The risk of developing insomnia increases with age, although a person may develop the condition at any age.

Some experts suggest the condition is more common among older adults and those experiencing perimenopausal and postmenopausal transitions.

Some researchers suggest that older adults may be more likely to experience insomnia for various reasons, including:

  • changes in the sleep cycle, for example, if a person retires from work
  • changes to the sleep environment, for example, if someone moves to a retirement community or care home
  • age-related circadian rhythm change and the presence of other sleep disorders, such as sleep apnea
  • taking certain medications or living with certain diseases, such as diabetes and hypertension

Lifestyle

Lifestyle factors, such as not exercising enough during the day or using electronic devices too close to bedtime, may affect a person’s sleep quality. Other lifestyle factors that may increase the risk of developing insomnia include:

  • deviating from their usual routine often, including sleep schedules
  • experiencing interruptions to sleep, such as waking up often to care for a baby
  • using caffeine, alcohol, nicotine, or recreational drugs
  • taking long naps

Genetics

Experts suggest insomnia sometimes runs in families, and a person’s genes may affect whether they are a deep or light sleeper.

Additionally, an older 2016 review evaluated research on the genetics of insomnia. The results showed that there are genes responsible for several potential molecular mechanisms in the development of insomnia. However, the researchers highlighted that further studies into genetics and insomnia are necessary.

Life events

Certain life events may lead to significant sleep disturbances and increased stress and anxiety levels. These may include:

  • a death of a loved one
  • a divorce
  • job loss
  • financial stress

Psychiatric and psychological conditions

Research indicates that insomnia and certain psychiatric and psychological conditions may have links. Some of these conditions include:

Certain medications

Many medications may cause insomnia as a side effect. Some research suggests that using these medications has increased over the past decade.

A person should speak with a doctor about potential side effects before using any medications and if they notice insomnia symptoms after starting a new medication.

Treatment options for insomnia may vary between people. A healthcare professional can recommend treatments on an individual basis. Treatment typically involves:

  • sleep-inducing medications, such as:
    • benzodiazepine receptor agonists
    • orexin receptor antagonists
    • benzodiazepines
    • melatonin receptor agonists
  • cognitive behavioral therapy for insomnia (CBT-I), which involves:
    • cognitive therapy
    • stimulus control therapy
    • sleep restriction therapy
    • sleep education
    • relaxation or meditation therapy
  • making lifestyle changes, such as:
    • going to bed and getting up around the same time every day, including weekends
    • managing stress
    • limiting naps
    • getting regular physical activity during the daytime
    • limiting consumption of alcohol, nicotine, and caffeine
    • eating meals at the same time every day

Sleep disorders, such as insomnia, may lead to sleep deprivation or sleep deficiency, which can affect other areas of life, such as:

  • work
  • school
  • driving
  • social functioning
  • concentration

If someone has trouble falling or staying asleep, feels tired during the day, and finds that insomnia symptoms interfere with their daily life, they should consider speaking with a medical professional.

Sleep onset insomnia is a subtype of insomnia, which is when a person has difficulty falling asleep. Insomnia may affect someone’s mental and physical health, so they should speak with a healthcare professional if they consistently have difficulty falling or staying asleep.

Several treatment options for people with insomnia are available. These include medications, CBT-I, and making lifestyle changes. A healthcare professional can help identify which treatments may work best individually.