Insomnia: Causes, Risks & Treatments - Cleveland Clinic

People with insomnia can't fall asleep, stay asleep or get enough restful slumber. Insomnia is a common sleep disorder. ComingtoaClevelandCliniclocation?Visitation,maskrequirementsandCOVID-19information Home / HealthLibrary / Disease&Conditions Insomnia Peoplewithinsomniacan’tfallasleep,stayasleeporgetenoughrestfulslumber.Insomniaisacommonsleepdisorder.Overtime,lackofsleepcanleadtohealthproblemslikediabetes,hypertensionandweightgain.Behavioralandlifestylechangescanimproveyourrest.Cognitivebehavioraltherapy(CBT)andsleepingpillsalsohelp. Appointments866.588.2264 Appointments&Locations RequestanAppointment Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment Prevention Outlook/Prognosis LivingWith Insomnia Overview SymptomsandCauses DiagnosisandTests ManagementandTreatment Prevention Outlook/Prognosis LivingWith BackToTop Overview Whatisinsomnia? Insomniaisacommonsleepdisorderthatischaracterizedbydifficulty: Fallingasleepinitially. Wakingupduringthenight. Wakingearlierthandesired. Whatarethesymptomsofinsomnia? Chronicinsomniamaycause: Difficultyfallingasleepand/orwakingupinthemiddleofthenight. Difficultyreturningtosleep. Feelingtired/fatiguedduringthedaytime. Irritabilityordepressedmood. Problemswithconcentrationormemory. Whatarethetypesofinsomnia? Insomniacancomeandgo,oritmaybeanongoing,longstandingissue.Thereisshortterminsomniaandchronicinsomnia: Shortterminsomniatendstolastforafewdaysorweeksandisoftentriggeredbystress. Chronicinsomniaiswhenthesleepdifficultiesoccuratleastthreetimesaweekforthreemonthsorlonger. Howcommonisinsomnia? Sleepdisordersareverycommon.Theyaffectupto70millionAmericanseveryyear. Insomniasymptomsoccurinapproximately33%to50%oftheadultpopulationwhileChronicInsomniadisorderthatisassociatedwithdistressorimpairmentisestimatedat10%to15%. Howmuchsleepdomostpeopleneed? Mostadultsneedaroundseventoninehoursofsleeppernightbuttheamountofsleepneededtofunctionatyourbestvariesbetweenindividuals.Thequalityofyourrestmattersjustasmuchasthequantity.Tossingandturningandrepeatedlyawakeningisasbadforyourhealthasbeingunabletofallasleep. SymptomsandCauses Whatcausesinsomnia? Manythingscancontributetothedevelopmentofinsomniaincludingenvironmental,physiologicalandpsychologicalfactors,including: Lifestressorsincludingyourjob,relationships,financialdifficultiesandmore. Unhealthylifestyleandsleephabits. Anxietydisorders,depressionand/orothermentalhealthproblems. Chronicdiseaseslikecancer. Chronicpainduetoarthritis,fibromyalgiaorotherconditions. Gastrointestinaldisorders,suchasheartburn. Hormonefluctuationsduetomenstruation,menopause,thyroiddiseaseorotherissues. Medicationsandothersubstances. Neurologicaldisorders,suchasAlzheimer’sdiseaseorParkinson’sdisease. Othersleepdisorders,suchassleepapneaandrestlesslegssyndrome. Whataretheriskfactorsforinsomnia? Insomniaoccursmoreofteninwomenthaninmen.Pregnancyandhormonalshiftscandisturbsleep.Otherhormonalchanges,suchaspremenstrualsyndrome(PMS)ormenopause,canalsocanaffectsleep.Insomniabecomesmorecommonovertheageof60.Olderpeoplemaybelesslikelytosleepsoundlybecauseofbodilychangesrelatedtoagingandbecausetheymayhavemedicalconditionsortakemedicationsthatdisturbsleep. Whataretheconsequencesofinsomnia? Whenyoucan’tfallasleeporyourrestisfitful,youmay: Beirritable,anxiousordepressed. Feelfatiguedorlowonenergythroughouttheday. Havememoryproblemsordifficultyconcentrating. Struggleatwork,schoolorinrelationships. DiagnosisandTests Howisinsomniadiagnosed? Thereisnospecifictesttodiagnoseinsomnia.Yourhealthcareproviderwillperformaphysicalexamandaskquestionstolearnmoreaboutyoursleepproblemsandsymptoms.Thekeyinformationforthediagnosisofinsomniaisreviewingyoursleephistorywithyourdoctor.Yourproviderwillalsoreviewyourmedicalhistoryandmedicationsyouaretakingtoseeiftheymaybeaffectingyourabilitytosleep.Youmayalso: Getabloodtest:Yourdoctormaywantyoudoabloodtesttoruleoutcertainmedicalconditionssuchasthyroidproblemsorlowironlevelsthatcannegativelyimpactsleep. Keepasleepdiary:Youmaybeaskedtowritedownyoursleeppatternsforonetotwoweeks(bedtime,waketime,naps,caffeineuse,etc.)Thisinformationcanhelpyourprovideridentifypatternsorbehaviorsthatinterferewithrest. Completeasleepstudy:Sleepstudies(polysomnograms)arenotnecessaryfordiagnosinginsomnia.Ifyourdoctorhasconcernsthatyourinsomniamaybecausedbysleepapneaoranothersleepdisorder,youmaybereferred.Youmaygotoasleepdisorderscenterordothestudyathome. ManagementandTreatment Whatarethecomplicationsofinsomnia? Overtime,lackofsleeporpoorqualitysleepcannegativelyaffectyourphysicalandmentalhealth.Insomniacancontributeto: Diabetes. Drivingaccidents,injuriesandfalls. Highbloodpressure(hypertension),heartdiseaseandstroke. Mooddisorders. Weightgainandobesity. Howisinsomniamanagedortreated? Short-terminsomniaoftengetsbetteronitsown.Forchronicinsomnia,yourhealthcareprovidermayrecommend: CognitiveBehavioralTherapyforInsomnia:Therapy(CBT-I):CBT-Iisabrief,structuredinterventionforinsomniathathelpsyouidentifyandreplacethoughtsandbehaviorsthatcauseorworsensleepproblemswithhabitsthatpromotesoundsleep.Unlikesleepingpills,CBT-Ihelpsyouovercometheunderlyingcausesofyoursleepproblems. Medications:Behaviorandlifestylechangescanbesthelpyouimproveyoursleepoverthelongterm.Insomecases,though,takingsleepingpillsforashorttimecanhelpyousleep.Doctorsrecommendtakingsleepmedicinesonlynowandthenoronlyforashorttime.Theyarenotthefirstchoicefortreatingchronicinsomnia. Canmelatoninhelpmesleep? Yourbodyproducesahormonecalledmelatoninthatpromotessleep.Somepeopletakemelatoninsupplementsasasleepaid.Butthere’snoproofthatthesesupplementswork.BecausetheU.S.FoodandDrugAdministration(FDA)doesn’tregulatesupplementsthesameasmedications,youshouldtalktoyourhealthcareproviderbeforetakingone. Prevention HowcanIpreventinsomnia? Lifestylechangesandimprovementstoyourbedtimeroutineandbedroomsetupcanoftenhelpyousleepbetter: Avoidlargemeals,caffeineandalcoholbeforebed. Bephysicallyactiveduringtheday,outsideifpossible. Cutbackoncaffeine,includingcoffee,sodasandchocolate,throughoutthedayandespeciallyatnight. Gotobedandgetupatthesametimeeachday,includingweekends. Putawaysmartphones,TVs,laptopsorotherscreensatleast30minutesbeforebedtime. Quitsmoking. Turnyourbedroomintoadark,quiet,coolsanctuary. Unwindwithsoothingmusic,agoodbookormeditation. Outlook/Prognosis Whatistheprognosis(outlook)forpeoplewhohaveinsomnia? Somepeoplewithinsomniasleepbetterafterchangingdaytimeandnighttimebehaviors.Whenthesechangesdon’thelp,therapyormedicationscanimproveslumber. LivingWith WhenshouldIcallmyhealthcareprovider? Youshouldcallyourhealthcareproviderifyouexperience: Difficultyconcentratingormemoryproblems. Extremefatigue. Moodproblems,suchasanxiety,depressionorirritability. Morethanthreemonthsofsleepproblems. WhatshouldIaskmyhealthcareprovideraboutinsomnia? Ifyouhaveinsomnia,youmaywanttoaskyourhealthcareprovider: AmItakinganymedicationskeepingmeawake? WhatchangescanImaketosleepbetter? Howdoescognitivebehavioraltherapyimprovesleep? HowdoIfindatherapist? CouldIhaveothersleepdisorderslikesleepapnea? Ifyou'resufferingfrominsomnia,don'thesitatetoreachouttoyourhealthcareproviderforhelp.Theymayoffertipsformanagingissuesthatinterferewithyoursleep.Manypeoplewithinsomniarestbetterafterchangingtheirdiet,lifestyleandnighttimeroutines.Ortheymayalsorecommendmedicationsorcognitivebehavioraltherapy. 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