A Few Bad Nights or Insomnia?

From the WebMD Archives

Have you been tossing and turning at night? Perhaps you're having trouble falling asleep because you're lying in bed worrying about work and finances. Or, you wake up in the middle of the night and can't fall back asleep. Or, you wake up feeling more tired, not refreshed, in the morning and are excessively tired during the day.

You're certainly not alone if you're suffering from any of these symptoms of insomnia. More than 25 percent of Americans report not getting enough sleep occasionally. And 10%, according to the CDC, experience insomnia almost every night.

So, how do you tell if you've simply hit a rough patch that will pass, or if you have a chronic sleep problem?

There isn't a hard number, says Tracey Marks, MD, psychiatrist in Atlanta and author of Master Your Sleep. A good marker is to look at a week or month and add up whether you've had trouble sleeping more nights than not.

Acute insomnia, which lasts for a few days, can be connected to a particular event like a work deadline or examination.


Sleep usually gets better when the stressor goes away, says Deirdre Conroy, PhD, clinical assistant professor of psychiatry and clinical director of the Behavioral Sleep Medicine Program at the University of Michigan.

It's common to have temporary insomnia, says William Kohler, MD, medical director of the Florida Sleep Institute in Spring Hill, Florida. You don't need to be overly concerned about a couple nights of restless sleep. But if insomnia persists and interferes with your functioning, then it's time to evaluate the nature of the problem.

Chronic insomnia, which occurs at least 3 times a week for 3 months or more, can affect your daytime functioning. You may notice changes in your mood, difficulty concentrating, or decreased productivity.

Identifying a Probable Cause

A lot of times sleep problems are related to mood problems, says Conroy. So you should ask yourself: Has my mood changed? Do I feel more depressed? Am I more irritable than usual?

If you're prone to worry, anxiety can be making your sleep worse. But sleep problems also develop without any associated mood problems.


Sometimes you can point to a primary stressor like losing a job or worrying about the mortgage. But there doesn't have to be a particular stressor associated with insomnia. Just worrying about sleep can snowball over time, says Conroy.

Other reasons for insomnia include an underlying medical condition, pain, medications, sleep disorders, and poor sleep habits.

What You Can Do

If you've noticed signs of insomnia and the problem has been going on for a few weeks, set up an appointment with your doctor to discuss your sleep concerns. The doctor can assess your medical condition and make any needed changes to your meds if they're possibly causing the problem. If your doctor suspects an underlying sleep disorder like sleep apnea or restless legs syndrome, they may refer you to a sleep specialist.

Keep a sleep log to see if you can identify any patterns to discuss with your doctor. Track when you go to bed, how long it takes you to fall asleep, how many times you awake at night, what time you get up, how you feel when you wake up, and if you take a nap during the day.


Depending on the cause of insomnia, your doctor may prescribe a sleep medication to provide short-term relief. they may also refer you to a mental health professional who practices cognitive behavioral techniques and other strategies to improve your sleep hygiene.

Sleep is important for your overall health and lack of sleep has been shown to contribute to illness, including heart disease and diabetes.

"We hear so much about diet and exercise," says Conroy. "Sleep is as important as your nutrition."

Boost Your Sleep Hygiene

Many Americans have poor sleep habits. Marks, the Atlanta psychiatrist,shares tips for getting a good night's sleep:

  • Keep your bedtime the same each night (even on the weekend) for consistency's sake.
  • Cut out caffeine, cigarettes, and alcohol 4-6 hours before bedtime.
  • Don't exercise right before bed.
  • Only use your bed for sleep and sex. Don't bring work or gadgets into bed.
  • Adjust your thermostat to a comfortable temperature, usually 68-74 degrees.
  • Turn the lights off and use eye covers to keep the room dark.
  • If it's taking more than 30 minutes to fall asleep, don't stay in bed. Go to another quiet room and engage in relaxing activity until you feel drowsy.
  • If your mind is busy, write down your thoughts on a problem-solving worksheet.
WebMD Feature Reviewed by Lisa Bernstein, MD on May 22, 2015



Tracey Marks, MD, author of Master Your Sleep.

Deirdre Conroy, PhD, clinical assistant professor of psychiatry and clinical director of the Behavioral Sleep Medicine Program, University of Michigan, Ann Arbor.

William Kohler, MD, medical director of the Florida Sleep Institute in Spring Hill, Fla.

Yaggi, HK. Diabetes Care, March 2006.

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