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Can't get to sleep at night? Can't stay asleep? Insomnia is a sleep disorder that prevents people from falling and/or staying asleep. People with insomnia have one or more of these symptoms:

  • Difficulty falling asleep
  • Waking up during the night and having trouble going back to sleep
  • Waking up too early in the morning
  • Feeling tired when you wake up
  • Being sleepy or tired during the day
  • Feeling cranky or irritable
  • Problems with focus or memory

Types

Primary insomnia is not directly linked to any other health condition or problem.

Secondary insomnia comes from something else, like a health condition (such as asthma, depression, arthritis, cancer, or heartburn), pain, a medication, or a substance like alcohol.

Acute vs. Chronic

Insomnia can be short-term (acute), or it can last a long time (chronic). It can also come and go, with periods of time when a person sleeps fine. Acute insomnia can last up to 3 months and often has a cause like stress. Insomnia is chronic when a person has sleep trouble at least 3 nights a week for a month or longer. Insomnia can last for years if you don't treat the cause.

Causes

Causes of acute insomnia can include:

  • Major life stress (job loss or change, death of a loved one, divorce, moving)
  • Illness
  • Emotional or physical discomfort
  • Noise, light, or being too hot or too cold while you're trying to sleep
  • Some medications (such as those for colds, allergies, depression, high blood pressure, and asthma)
  • Changes to a normal sleep schedule (like jet lag or switching from a day shift to night shift, for example)

Causes of chronic insomnia include:

  • Irregular sleep schedules
  • Substances that interfere with sleep (alcohol, caffeine, nicotine)
  • Activities that stimulate the brain (playing video games, watching TV) or the body (exercise) right before bedtime
  • Using the bedroom for activities other than sleep and sex
  • Depression and/or anxiety
  • Chronic stress
  • Pain or discomfort at night
  • Poor sleep habits

Diagnosing the Problem

If you think you have insomnia, talk to your doctor or health care provider. A checkup may include a physical exam and questions about your health and sleep problems. You may be asked to keep a sleep diary for a week or 2, where you keep track of your sleep patterns and how you feel during the day. Your health care provider may want to talk to your bed partner, too, about the amount and quality of your sleep. In some cases, you may be referred to a sleep center for special tests.

Treatment

You may not even need any treatment for acute insomnia. In mild cases, it can be cured with good sleep habits (see below). If your insomnia makes it hard for you to function during the day because you are tired, your doctor may prescribe sleeping pills for a limited time. These quick-working, short-acting drugs can help you avoid next-day drowsiness. But avoid using over-the-counter sleeping pills for insomnia. They may have side effects, and they tend to work less well over time.