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Amish Patel - NowPatientGreen tick
Updated on 5 Jun 2024

Insomnia (sleeplessness) is a common sleep disorder affecting millions of people around the world. Symptoms include trouble falling asleep, staying asleep, or a combination of both. Here, we will take a closer look at the causes, symptoms, diagnosis, and treatments available.

What is Insomnia?

Insomnia is when you find it difficult to fall asleep, stay asleep, or have restless sleep. Insomnia is a symptom rather than the disease itself. Symptoms of insomnia may range from mild to severe and include a lack of sleep leading to daytime sleepiness, tiredness, changes in mood and an impaired quality of life.

Types of Insomnia

Insomnia can be classified into two main types:

  • Acute insomnia (short-term insomnia) is temporary and lasts for a few days or weeks. It is often caused by stress, illness, or a change in sleep patterns
  • Chronic insomnia (long-term insomnia) may continue for at least 3 nights each week for 3 months or more

Primary and Secondary causes of Insomnia

Primary insomnia is associated with sleep problems not directly linked to other underlying medical or psychiatric conditions. Primary insomnia is often associated with stress, poor sleep hygiene, or other psychological factors. Secondary insomnia on the other hand occurs because of other health problems or factors that disrupt your sleep-wake cycle.

Diagnostic process and sleep study

Diagnosis involves a medical review, an assessment of your sleep patterns, and an evaluation of any underlying causes that may be causing your insomnia. A study to monitor your breathing and brain activity during the night may be considered in some cases.

Causes of Insomnia

Several risk factors can increase your risk of developing insomnia and prevent a good night’s sleep.

  • Mental disorders can greatly affect sleep quality
  • Other sleep disorders such as sleep apnea or restless legs syndrome
  • Medical conditions such as neurological conditions, chronic pain, or hormonal imbalances
  • Antidepressants or medication for asthma or high blood pressure
  • Over-the-counter treatments containing stimulants
  • Excessive consumption of caffeine, alcohol or substance abuse
  • Irregular sleep schedules due to jet lag, affecting your circadian rhythm
  • Poor sleep hygiene, which can also contribute to trouble sleeping
  • Hormonal changes during pregnancy, menopause, and the menstrual cycle
  • Age-related changes in underlying health conditions, especially in older adults
  • Family history of insomnia
  • High levels of stress
  • Shift work

Impact on physical and mental health conditions

Chronic sleep deprivation increases the risk of developing conditions such as diabetes, obesity, and cardiovascular disease. Depression and anxiety, are often linked to insomnia making symptoms worse. Insomnia can also affect memory, thought processes, and your overall quality of life. Therapy, medication, and lifestyle modifications can all help manage insomnia and mental health disorders.

Treatments for Insomnia

Sleep aids should be taken as prescribed by a healthcare professional, as they can cause side effects and be addictive. Some over-the-counter medications such as antihistamines may also cause drowsiness as a side effect, but treatment with these should only be short-term

Herbal supplements or homeopathic treatments include melatonin, valerian root, and lavender. Speak to a healthcare professional before starting these treatments, especially if you have other medical conditions or are taking other medications.

Sleep hygiene and lifestyle changes

Good sleep hygiene and making lifestyle changes can help regulate your sleep-wake cycle and promote restful sleep. These include:

  • Keeping to a sleep schedule
  • Creating a relaxing bedtime routine
  • Optimizing the sleep environment
  • Avoiding caffeine and nicotine close to bedtime
  • Getting regular exercise

Cognitive behavioral therapy for Insomnia

Cognitive behavioral therapy for insomnia (CBT-I) aims to identify and modify thoughts and behaviour, that contribute to sleep difficulties.

CBT-I may include various types of therapy, including sleep restriction therapy, relaxation training, stimulus control therapy, and cognitive restructuring.

Relaxation and mindfulness

Deep breathing exercises, progressive muscle relaxation, and meditation, can all help to calm your mind and prepare you for sleep.

Insomnia in certain age groups

Common causes of insomnia in children include stress, anxiety, irregular sleep, and the use of electronic devices at night. Healthy bedtime routines and sleep habits will help to improve quality of sleep.

We may experience changes in our sleep patterns as we get older. Medical conditions, medication, changes in hormone levels, and lifestyle can all affect the sleep cycle of older adults. Healthy bedtime routines and sleep habits will help to improve quality of sleep.

Preventing Insomnia

  • Promote good sleep habits from an early age
  • Create an optimal sleep environment. Maintain a comfortable temperature, reduce noise and light, use good quality bedding, and ensure the bedroom is used only for sleep
  • Manage stress and self-care. Exercise, hobbies and mindfulness can help manage stress and promote better sleep

Sleep schedules

Going to bed and waking at the same time every day will help regulate your internal body clock and achieve better sleep quality. This will train your brain to associate sleep with certain times, making it easier to fall asleep.

Regular exercise

Regular exercise will help to reduce stress, relax, and improve your overall physical health. 30 minutes of moderate exercise each day of the week should be the goal, but avoid exercising too vigorously near bedtime as this will interfere with your sleep.

Dietary choices

Avoid caffeine, nicotine, or alcohol close to bedtime, as these may affect your sleep patterns. Also, add foods into your diet that promote sleep, such as foods high in tryptophan, such as turkey, nuts, or seeds and those that contain melatonin, such as tart cherries and kiwi fruit.

When to consult a healthcare provider

Consult a healthcare provider if insomnia continues to affect your daily life, or if you have chronic insomnia or other health conditions. They may prescribe sleeping pills for a short time.

Finding a sleep specialist or therapist

Sleep therapists can offer cognitive behavioral therapy and other medications when necessary for insomnia. You may be asked to keep a sleep diary to track your sleep patterns. Online directories or referrals from primary care can help find suitably qualified professionals.


Understanding the causes, symptoms, and treatments available for is essential to manage sleep insomnia. Having healthy sleep habits and managing underlying factors can improve the quality of your sleep and help you regain control.


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