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What is insomnia?

Marked by persistent trouble in staying or falling asleep, insomnia is classified as a sleep disorder. Insomnia is a relatively common ailment, with some studies suggesting up to 30-40% of adults have insomnia at some point in their lives.

Insomnia varies widely from person to person, with some suffering from acute insomnia and others from chronic insomnia. Individuals with insomnia can also be classified into one of two categories, primary insomnia or secondary insomnia, explained below in further detail.

Causes

Why does insomnia happen?

The causes of insomnia vary widely from individual to individual but can be better examined when you understand the two main insomnia categories:

Primary insomnia: Your insomnia is a condition in and of itself. You may be experiencing primary insomnia because of life stressors, such as:

Stress over big life changes
Sensitivity to lights and sounds in your environment
Changes to your regular sleep routine (jet lag, night shift work, etc.).

Secondary insomnia: Your insomnia is triggered by other health conditions, substances such as medication or drugs, or pain. Possible health conditions that may cause secondary insomnia include:

Heartburn
Mental health conditions
Other sleep disorders, such as sleep apnea
Alcohol, caffeine, and tobacco use
General pain or discomfort

While primary and secondary insomnia can have other causes as well, this list is intended to give you a broader understanding of some of the most common causes of insomnia. However, it’s important to keep in mind that your stressors may be different.

Is insomnia genetic?

Genes have been associated with insomnia. However, a wide range of psychological and physiological factors affect a person’s insomnia, so the condition is usually not attributed exclusively to genetics.

What are the risk factors for insomnia?

Several risk factors may place you at a higher risk of developing insomnia. Some factors that researchers have identified include:

Women are more likely than men to experience insomnia.
Older people are at a higher risk than younger people.
Those who work night or rotating shifts.
Young to middle-aged African-Americans.
Anyone suffering from a long-term mental or physical illness.

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Symptoms

What are the symptoms of insomnia?

The symptoms of insomnia may vary from person to person and depend on the type of insomnia. However, some of the most common telltale signs of insomnia are:

Daytime sleepiness
Irritability or grumpiness
Difficulty focusing
General fatigue & lethargy
Struggling in social, work, or other circles
Behavioral issues
Increased risk of mistake

Can insomnia cause other illnesses (sleep apnea, anxiety, high blood pressure, etc.)?

While insomnia can worsen your other illnesses, it can be difficult to determine whether it is a cause or effect of your other illnesses. In fact, several illnesses, such as anxiety, sleep apnea, and diabetes, have been linked to the cause of insomnia. When you are in discomfort or unable to center yourself in a relaxed state of mind, you may find yourself experiencing insomnia.

How does insomnia affect the health of your body and mind?

Insomnia can also serve as a direct cause of certain ailments. During sleep, your body and mind have the opportunity to rest and rejuvenate, so those suffering from a lack of sleep may feel the toll of insomnia. Some things to be on the lookout for are:

Risk of heart disease and high blood pressure
Weakened immune system
Negative impacts on your social life
Depression
Decreased productivity
Obesity

Your body needs rest to repair and relax, and insomnia may be preventing it from carrying out some of these vital functions. That’s why it’s important to seek treatment for chronic insomnia that is negatively impacting your life.

Diagnosis

How is insomnia diagnosed?

In addition to a physical exam, your doctor will ask about your medical and sleep history. You’ll also want to bring along a list of any prescription medications you are taking. Any history of drug, alcohol, or tobacco consumption is also necessary to disclose. Depending on the circumstances, you may be asked to keep a sleep diary for a few weeks to better understand your sleeping habits and patterns. If you must undergo sleep tests, you may be referred to a sleep center or given an at-home testing device.

Treatment

Can insomnia go away?

Insomnia may come and go, depending on its causes and the ongoing events in your life. For those with acute insomnia lasting a few nights to a few weeks, treatment is usually unnecessary. If anything, your doctor may prescribe a few sleeping pills to be used in the short term. For those with chronic insomnia rooted in health conditions, anxiety, or other issues, treatment may need to be sought. Insomnia can go away on its own, depending on your life circumstances.

Can insomnia be prevented?

Fortunately, there are some things you can do to cultivate good sleeping habits. While it may be difficult to get into a good routine, it can save you many future headaches. Some things you can do to prevent insomnia before it occurs include:

Exercise regularly, but not too close to bedtime.
Maintain a good bedtime routine.
Use your bed only for sleeping.
Don’t use electronic devices in bed.
Steer clear of alcohol, nicotine, and caffeine in the hours before bed.
Make sure your room and bed are comfortable and at a good temperature.
Follow the same bedtime routine each evening.

Which doctor to see for insomnia?

In the case of acute insomnia, symptoms often dissipate on their own, and direct treatment is unnecessary. If you suffer from chronic insomnia that is impacting your ability to lead a normal life, you should seek treatment from a trained doctor. Depending on your circumstances, this may be a primary care physician, a clinical psychologist, a sleep disorder expert, and/or a psychiatrist.

How is insomnia treated?

Because chronic insomnia is often a response to secondary conditions, you’ll need to address any other issues to help treat your insomnia. Generally, doctors advise against over-the-counter sleep aids, and if they are used, they must be in moderation.

Your physician can help guide you on the best course of action to treat your insomnia, which may include:

Cognitive-behavioral therapy

Light therapy
Relaxation techniques
Stimulus control therapy

Prescription medications

Through therapy and sometimes with the help of prescription medications, individuals often see improvements in their sleep patterns. Although this progress may be gradual at first, your positive habits will snowball, allowing you to readjust to a healthy sleep schedule free of insomnia.

References

Mayo Foundation for Medical Education and Research. (2016, October 15). Insomnia. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/insomnia/diagnosis-treatment/drc-20355173

Symptoms of Insomnia. Sleep Foundation. (2020, September 18). https://www.sleepfoundation.org/insomnia/symptoms

WebMD. (n.d.). Insomnia: Definition, Symptoms, Causes, Diagnosis, and Treatment. WebMD. https://www.webmd.com/sleep-disorders/insomnia-symptoms-and-causes

Information

Medically reviewed by:

Dr Roy Kedem, MD

Dr Roy Kedem started his premedical studies at Harvard, and research in genetics and gene sequencing at Harvard, Beth Israel. He attended medical school in the UK at the Cambridge Overseas Medical Program in 1998. Dr Kedem then completed his residency in Internal Medicine at Columbia College of Physicians and Surgeons in Stamford, Connecticut and his fellowship in Hospital Medicine at the Cleveland Clinic in Cleveland, Ohio.

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