Understand what insomnia is
If you often lie awake wondering why you cannot sleep, you might have asked yourself, “What is insomnia, exactly?” Insomnia is more than just a bad night here and there. It is a common sleep disorder that makes it hard for you to fall asleep, stay asleep, or get back to sleep when you wake up too early. Over time, it can affect your mood, energy, focus, and overall health (Mayo Clinic).
Most adults need about 7 to 9 hours of sleep each night to feel rested. If you regularly get much less than that because you cannot sleep, and it affects your daily life, insomnia might be the reason (Mayo Clinic).
Recognize common insomnia symptoms
Insomnia can look a little different from person to person, but it usually includes one or more of these problems (Mayo Clinic, Cleveland Clinic):
- Trouble falling asleep at night
- Waking up often during the night
- Waking up too early and not being able to fall back asleep
- Feeling tired or unrefreshed when you wake up
- Daytime sleepiness or low energy
- Trouble concentrating, remembering things, or staying productive
- Feeling irritable, anxious, or low in mood
- Making more mistakes at work, school, or when driving
Insomnia is not only about how long you sleep. It is also about how you feel and function during the day. If poor sleep regularly leaves you feeling unwell or unable to do what you need to do, that is a key sign.
Learn how insomnia is defined
Medical organizations use specific criteria to define insomnia. This helps doctors decide when your sleep trouble is more than just an occasional rough night.
According to the United States National Heart, Lung, and Blood Institute (NHLBI), insomnia is typically defined as (NHLBI):
- Difficulty falling or staying asleep
- Occurring at least 3 nights per week
- Lasting long enough to affect your daily activities
You might also see these two main types of insomnia:
Short term (acute) insomnia
Short term insomnia:
- Lasts for days or weeks
- Is often linked to stress or a specific event, such as a work deadline, travel, illness, or a major life change
- Usually improves once the stressful situation passes
Long term (chronic) insomnia
Chronic insomnia:
- Happens at least 3 nights per week
- Lasts for 3 months or longer (NHLBI)
- Often connects to another health condition, medication, or ongoing stress
Both short term and chronic insomnia are common. About one in three adults has insomnia symptoms, and around 10 percent meet the criteria for an insomnia disorder that affects daily life (Cleveland Clinic).
Understand what causes insomnia
If you are wondering what is behind your sleepless nights, you are not alone. Experts agree that the exact causes of insomnia are not completely understood, and often more than one factor is involved. According to the Cleveland Clinic, insomnia can be influenced by mental health, physical health, and lifestyle factors, and research is still ongoing to clarify these causes (Cleveland Clinic).
Common contributors include:
Mental and emotional factors
- Stress about work, school, finances, or family
- Anxiety or worry that keeps your mind active at night
- Depression or other mood changes
- Grief or major life changes
Physical health conditions
- Chronic pain
- Breathing problems, including sleep apnea
- Heart or lung issues
- Digestive problems like reflux
- Hormone changes
- Neurologic conditions
Some of these issues may not only disturb your sleep directly but can also cause you to wake up gasping or uncomfortable. That is why doctors often check for other medical problems when you describe insomnia symptoms (NHLBI).
Medications and substances
Certain medications and substances can interfere with sleep, such as:
- Stimulants or some antidepressants
- Some medications for asthma or blood pressure
- Caffeine, especially later in the day
- Nicotine
- Alcohol, which might make you feel sleepy at first but can disrupt sleep later in the night
Lifestyle and daily habits
Your daily routine can make it easier or harder to sleep well. Insomnia may be linked to:
- Irregular bedtimes or wake times
- Napping for long periods late in the day
- Screen time or bright light close to bedtime
- Heavy meals, spicy food, or a lot of fluids in the evening
The Mayo Clinic notes that changes in daily routines and bedtime habits are crucial for treating insomnia and that lifestyle adjustments are often the key to better sleep at any age (Mayo Clinic).
Aging and insomnia
Insomnia becomes more common as you get older. Older adults often experience changes that can make sleep harder, such as:
- Shifts in your internal body clock
- More medical conditions and medications
- Less physical activity
- More nighttime awakenings (Mayo Clinic)
Even though insomnia is more common with age, it is not something you have to simply accept.
Know how insomnia is diagnosed
If you think you might have insomnia, it helps to know what to expect from an evaluation. A health care provider will usually:
Review your sleep history
You might be asked about:
- How long it takes you to fall asleep
- How often you wake up at night
- What time you go to bed and wake up
- How you feel and function during the day
- Caffeine, alcohol, or nicotine use
- Exercise habits and naps
Doctors may recommend that you keep a sleep diary for 1 to 2 weeks. In it you record your bedtimes, wake times, naps, and how rested you feel. This simple tool helps you and your doctor see patterns and possible triggers for insomnia (NHLBI).
Check your medical and family history
Your provider will also review:
- Your current health conditions
- Medications and supplements you take
- Any family history of sleep problems
This helps identify whether another health issue may be driving your insomnia (NHLBI).
Do a physical exam
A physical exam might include:
- Listening to your heart and lungs
- Checking your throat and neck
- Looking for risk factors like large tonsils or a large neck circumference that could suggest sleep apnea (NHLBI)
Sometimes you may be referred for further sleep testing if your doctor suspects another sleep disorder.
Explore treatment options for insomnia
The good news is that insomnia is treatable. You are not stuck with sleepless nights forever. Treatment usually combines changes in your daily habits with strategies that target your thoughts and behaviors around sleep.
Cognitive behavioral therapy for insomnia (CBT I)
Cognitive behavioral therapy, often called CBT or CBT I when tailored to sleep, is recommended as the first line treatment for insomnia (Mayo Clinic).
CBT for insomnia helps you:
- Identify thoughts that keep you awake
- Replace unhelpful beliefs, such as “I will never sleep”
- Adjust habits that interfere with sleep
- Build a consistent sleep schedule
Research shows CBT can be as effective, or even more effective, than medication for many people, and the benefits often last longer (Mayo Clinic).
Sleep medications and aids
Medications can sometimes help you get through a rough patch of insomnia, but they are usually not meant as a long term solution.
Prescription sleeping pills
Prescription sleep medicines may help you fall asleep or stay asleep. However, the Mayo Clinic notes that they are generally recommended only for short term use because they can cause side effects like:
- Daytime grogginess
- Impaired balance and increased risk of falls
- Habit formation or dependence (Mayo Clinic)
Your doctor can help you decide if this option is right for you, at the lowest effective dose and for the shortest needed time.
Over the counter sleep aids
Many over the counter sleep aids contain antihistamines. These can cause:
- Daytime sleepiness
- Dizziness
- Confusion, especially in older adults
Because of these risks, over the counter sleep aids are not recommended for regular or long term use (Mayo Clinic).
If you already take a sleep aid frequently, it is worth talking to your doctor about safer options and a step down plan if needed.
Lifestyle and habit changes
You have more control over your sleep than it might feel like when you are wide awake at 3 a.m. Simple, consistent shifts can support other treatments and sometimes are enough on their own. Experts highlight that changes in daily routines and bedtime habits are crucial for treating insomnia (Mayo Clinic).
Helpful changes might include:
- Going to bed and waking up at the same time every day, even on weekends
- Creating a wind down routine, such as reading or taking a warm shower
- Limiting screen time and bright light at least an hour before bed
- Avoiding caffeine and large meals in the evening
- Getting regular daytime movement or gentle exercise, earlier in the day if possible
- Keeping your bedroom cool, dark, and quiet
You can start with one small change, notice how it affects your sleep, and build from there.
Understand why insomnia matters
Insomnia is not just about feeling tired. When it becomes ongoing, it can affect many parts of your life.
The Cleveland Clinic notes that insomnia can range from a minor inconvenience to a major disruption in daily life, and about 10 percent of people experience it as a medical condition that changes how they feel or function (Cleveland Clinic).
According to the Mayo Clinic, chronic insomnia can:
- Reduce your overall quality of life
- Affect your mood and increase the risk of mental health issues
- Lower your work or school performance
- Impair alertness and safety, including while driving
- Increase the risk of other health conditions (Mayo Clinic, Cleveland Clinic)
If you often feel sleepy during the day, notice your attention drifting while driving, or feel that lack of sleep is harming your health or relationships, it is important to take that seriously.
Decide when to seek help
You do not need to wait for your sleep to feel completely out of control before you talk with a health care provider. It is a good idea to seek help if:
- You struggle to fall asleep or stay asleep at least 3 nights a week
- Your sleep problems last longer than a month
- You feel tired, unwell, or unfocused most days
- You rely on alcohol, over the counter products, or prescription pills to sleep
- A bed partner notices loud snoring, pauses in breathing, or gasping in your sleep
Bringing a short sleep diary, even for a week, can make your conversation with a provider more helpful.
Key takeaways about insomnia
To wrap up your main question, “What is insomnia?” here are the essentials:
- Insomnia is a sleep disorder that makes it hard for you to fall asleep, stay asleep, or return to sleep, and it affects how you feel and function during the day (Mayo Clinic).
- Short term insomnia can last days or weeks, often after stress or a life event, while chronic insomnia happens at least 3 nights a week for 3 months or more (NHLBI).
- Many factors can play a role, including stress, mental health, medical conditions, medications, age, and daily habits (Cleveland Clinic).
- Diagnosis usually involves a review of your sleep patterns, health history, and sometimes a physical exam, with tools like a sleep diary to spot patterns (NHLBI).
- Effective treatments exist, especially cognitive behavioral therapy for insomnia, supported by lifestyle changes. Medications and over the counter aids can help in the short term but come with side effects and are not meant for regular use (Mayo Clinic).
If your nights feel long and your days feel slow, you do not have to simply push through. Understanding what insomnia is, why it shows up, and how it can be treated is the first step toward more restful nights and clearer days. Starting with one small change today and considering a conversation with a health care provider can put you on a better path to sleep.
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