Insomnia is a common sleep disorder in adults, causing trouble falling asleep or staying asleep, even when your sleeping conditions are ideal. Insomnia is not a form of sleep apnea, and requires a different treatment approach.
The types of insomnia
According to the National Sleep Foundation, people suffer from three main types of insomnia:
A brief episode of difficulty sleeping, usually caused by a life event such as a stressful change in a person’s job, receiving bad news or travel.
Often acute insomnia resolves without any treatment.
A long-term pattern of difficulty sleeping. Insomnia is usually considered chronic if a person has trouble falling asleep or staying asleep at least three nights per week for three months or longer.
Some people with chronic insomnia have a long-standing history of difficulty sleeping. Chronic insomnia has many causes.
Insomnia that occurs with another condition. Psychiatric symptoms—such as anxiety and depression—are known to be associated with changes in sleep. Certain medical conditions can either cause insomnia or make a person uncomfortable at night, as in the case of arthritis or back pain, which may make it hard to sleep.
The main causes of insomnia
Depending on the type of insomnia, there are several causes that your primary care provider can help you with. In general, acute insomnia is usually caused by a temporary event, while chronic insomnia is usually caused by ongoing stress, life events or habits that disrupt sleep.
Common causes of insomnia include:
- Caffeine, nicotine and alcohol. The first two are stimulants, so using them in the late afternoon or evening can keep you from falling asleep at night. Alcohol also prevents deeper stages of sleep and often causes people to wake more often at night.
- Changes in activity. If you stop being as active as you normally are, which can happen as you age, the lack of activity can interfere with sleep.
- Eating too much late in the evening.
- Irregular sleep habits. Make your bed and bedroom comfortable, and try to avoid stimulating activities right before bed such as TV, computers, video games smartphones or other screens.
- Medical conditions or the use of certain drugs. Treating the medical condition may help improve sleep, but chronic insomnia may persist afterward.
- Schedule. Your circadian (24-hour) rhythms guide your sleep-wake cycle, metabolism and body temperature. Disrupting this can lead to insomnia, which commonly happens with traveling.
- Sleep disorders. Sleep apnea interferes with sleep but requires specialized treatment. Restless legs syndrome may prevent you from falling asleep, and treating this would be part of your personalized treatment plan.
- Stress about work, school, health, finances or family—plus stressful life events—can make your mind overly active, leading to insomnia.
How to treat your insomnia
Your primary care provide will work with you on the best treatment plan for your type of insomnia and other factors. Your plan may include:
- Cognitive and behavioral treatments. A therapist or sleep specialist can help you learn these nonmedical treatments so you can do them on your own:
- Progressive muscle relaxation, or other relaxation techniques: Teaches you how to systematically tense and relax muscles to calm your body and induce sleep. You can also try breathing exercises, mindfulness, meditation and guided imagery to help you relax, fall asleep and return to sleep.
- Stimulus control: Helps build an association between your bedroom and sleep by limiting the type of activities allowed in the bedroom.
- Cognitive behavioral therapy (CBT): Includes behavioral changes plus a cognitive component challenge to your unhealthy beliefs and fears around sleep and teach rational, positive thinking.
- Medical treatments. Your provider may recommend over-the-counter (OTC) or prescription medications, including benzodiazepine hypnotics, non-benzodiazepine hypnotics and melatonin receptor agonists.
Don't let your insomnia go untreated
Untreated insomnia can lead to anxiety, depression and irritability, plus trouble with focusing, learning and remembering.
Insomnia also can cause serious problems such as a slowed reaction time while driving and a higher risk of accidents, risk of substance abuse and an increased risk of long-term medical conditions, including high blood pressure and cardiovascular disease.
If you are having sleep problems, your primary care provider can give you a proper diagnosis to help you treat it and avoid any potential future complications.
National Center for Biotechnology Information (NCBI): National Library of Medicine. Insomnia (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1978319/)
Center for Disease Control and Prevention (CDC). Key Sleep Disorders – Sleep and Sleep Disorders (https://www.cdc.gov/sleep/about_sleep/key_disorders.html)