Revised: 11/03/09. Copyright © 2006 Clinical Research Associates of Tidewater. All rights reserved.
Insomnia is an inability to sleep well. It's a common problem, affecting almost everyone at one time or another. A person with insomnia may have difficulty falling asleep or staying asleep, wake up frequently during the night, or wake up earlier than desired the next morning, resulting in symptoms such as daytime fatigue, irritability, poor memory, loss of productivity, and decreased enjoyment of family and social life.
Most people have an occasional restless night, often related to short-term stress. For some people, however, poor-quality sleep is a recurring or even a lifelong problem. Temporary insomnia, lasting days to weeks, affects about 50% of adults. Insomnia that lasts more than 6 weeks may affect up to 10% to 15% of adults.
What are the symptoms?
The symptoms of insomnia vary. You may have difficulty falling asleep, so you may toss and turn for what seems like a long time. You may wake up and have trouble falling back to sleep, perhaps several times during the night. You may wake up too early and feel unrefreshed in the morning or tired or irritable during the day.
Temporary insomnia, which can last anywhere from a night or two up to several weeks, may be caused by:
A single stressful event.
A period of emotional stress.
Temporary pain or discomfort.
Disturbances in the sleeping environment, such as noise, light, or sleeping in a different bed.
A change in the normal sleep pattern, such as might be caused by jet lag or working a late shift.
Temporary insomnia usually resolves in less than a month. But it's important to pay attention to it since excessive daytime sleepiness can have serious consequences, such as accidents while driving or at work. Also, temporary insomnia can develop into chronic poor-quality sleep, particularly if you begin to worry about your inability to sleep.
Chronic insomnia can last months or even years, and may be caused by:
Mental or emotional conditions, such as depression or anxiety, or stress. These are the leading causes of insomnia in adults.
Poor sleep habits, such as watching television in bed or keeping an irregular bedtime schedule, or apprehension or excessive worry about falling asleep, which often plagues people with insomnia.
An underlying medical condition such as a breathing problem, heart condition, hormonal or digestive disorder, or chronic pain.
Use of stimulants such as tobacco and caffeine.
Lack of regular physical activity.
Prescription, nonprescription, or illegal drugs.
A different sleep disorder, such as sleep apnea.
It is important to talk with your health professional about your sleep patterns and to have any health problem or sleep disorder diagnosed and, if necessary, treated. Insomnia can contribute to depression, automobile and industrial accidents, loss of jobs, marital and social problems, increased alcohol consumption, and poor health.
Insomnia is not a disease, and no specific test can diagnose it. But since an inability to sleep well is often related to an underlying cause, your doctor will probably assess your current health, medical history, and any medications you may be taking.
A physical exam, blood tests (which may include thyroid testing or hormonal testing for menopause), and, in some cases, sleep studies may be done to help identify or rule out medical problems that may be causing the insomnia. Your insomnia may improve or disappear when the underlying cause is treated.
Your doctor may also ask you about your sleep history: how well you sleep, how long you sleep, bedtime habits, and any unusual behaviors. You may be asked to keep a sleep diary, which is a record of your sleep patterns for a week or two. If your symptoms point to mental health concerns, you may be assessed by a mental health professional.