Insomnia: Key Q&A

What is insomnia?

Insomnia is difficulty falling asleep or staying asleep, resulting in inadequate length of sleep, poor quality of sleep or both. The disturbances caused by insomnia affect people during their waking hours by making them feel tired, drained, and lacking in energy. People with insomnia may wake frequently during the night and have difficulty falling back asleep or may wake up too early in the morning.

How common is insomnia?

Insomnia is the most common type of sleep disorder. According to the National Center on Sleep Disorders Research, about 30 to 40 percent of adults experience insomnia in a given year. About 10 to 15 percent experience insomnia that is chronic or severe. Insomnia is more common among women, especially after menopause, and the elderly. About half of people over age 65 have frequent sleep problems.

What causes insomnia?

Many conditions can cause insomnia. Some possible causes of insomnia include lifestyle factors, such as drinking caffeine or alcohol before bedtime, medical conditions, psychiatric conditions, medications and other sleep disorders. For example, heartburn, depression and antidepressants can all lead to insomnia. Examples of other sleep disorders which may cause insomnia include sleep apnea and restless legs syndrome. For many people, a combination of these factors causes insomnia. For example, after a stressful day at work, you may eat or drink later in the evening, resulting in insomnia.

In some cases, the cause of insomnia cannot be determined. This is called idiopathic insomnia. People with idiopathic insomnia often have trouble falling or staying asleep their entire lives. Doctors believe it may be caused by imbalances of certain chemicals in the brain. People with idiopathic insomnia often have family members with the condition.

What are the signs and symptoms of insomnia?

Common signs and symptoms of insomnia may include difficulty falling asleep, difficulty staying asleep or waking up too early. You may wake up feeling tired, even after a full night's sleep and experience excessive daytime fatigue or sleepiness. You may suffer from an inability to concentrate, irritability, anxiety or depression. Finally, you may find that it is harder to remember things because your brain has not had adequate rest.

How is insomnia diagnosed?

It's usually easy to tell if you have insomnia, even without an official diagnosis. However, it can be more difficult to determine the cause or any related problems, such as other sleep disorders. A review of your medical history, a physical examination and details of medications and lifestyle may help pinpoint the cause of your insomnia. You may also be evaluated for psychiatric conditions or be asked to keep a sleep diary to document sleep patterns and behaviors. In some cases, you may be referred to a sleep center where sleep is analyzed by sleep disorder professionals. This is usually done to rule out other sleep disorders.

What is involved in the treatment and prevention of insomnia?

Several approaches may be used to treat insomnia, depending on its cause. When insomnia is caused by a medical or psychological condition, such as heartburn or depression, it will typically go away when the underlying cause is treated. Lifestyle changes, such as increased exercise or elimination of alcohol or caffeine, may help treat or prevent insomnia. Medications may also be prescribed, although they are not a long-term solution. Some forms of therapy, such as relaxation therapy, may help some people.