Signs and Symptoms

The primary symptom of insomnia is difficulty initiating or maintaining sleep, or experiencing non-restorative sleep, for at least one month^[4][5]. Other common signs and symptoms include:

• Fatigue, tiredness, or lack of energy during the day
• Impaired attention, concentration, or memory
• Challenges in performing social, work, or caregiving responsibilities
• Increased risk of errors or accidents at work or while driving
• Irritability or low mood
• Physical symptoms like tension headaches or digestive issues
• Excessive daytime sleepiness or feeling “tired and wired”
• Worrying about sleep or daytime functioning

Causes

Insomnia can be triggered by various factors, including^[5][6]:

• Stress and anxiety
• Major life events or changes
• Shift work or alterations in daily routine
• Disruptions in home life

While sleep typically returns to normal once stressful periods pass, insomnia can persist for some individuals. Several health and lifestyle factors may also contribute to sleep problems^[6][7]:

• Caffeine, nicotine, alcohol, certain medications, and recreational drugs
• Environmental disturbances like noise, light, or uncomfortable bedroom temperature
• Comorbid health conditions such as asthma, bronchitis, or chronic pain
• Other sleep disorders like restless leg syndrome or sleep apnea
• Mental health disorders, particularly anxiety and depression

The frustration and worry associated with insomnia can further exacerbate sleep difficulties, creating a vicious cycle of sleep-related stress.

Tips for Improving Sleep Hygiene

Adopting healthy sleep habits, known as sleep hygiene, can significantly improve sleep quality and duration^[8][9][10]. Consider the following tips:

1. Reserve your bed for sleep and intimacy only, avoiding activities like reading or watching TV^[11].
2. Ensure your bedroom is quiet, dark, and maintained at a comfortable temperature^[9][10].
3. Limit use of electronic devices 1-2 hours before bedtime, as the blue light can interfere with sleep^[12].
4. Avoid consuming caffeinated beverages in the afternoon and evening hours^[13][14].
5. Limit alcohol intake, as it can disrupt sleep patterns^[15].
6. If you smoke, work with your healthcare provider on a cessation plan, as nicotine can impair sleep^[16].
7. Engage in regular exercise, but avoid vigorous activity close to bedtime^[17][18].
8. Maintain a consistent wake time, even on days when you’ve slept poorly.
9. Try not to worry excessively about falling asleep or the consequences of sleep loss.
10. Tackle cognitively demanding tasks earlier in the day rather than near bedtime^[17].
11. Practice relaxation techniques like deep breathing or mindfulness when going to bed^[19].

→ READ: How To Sleep Better: 12 Science-Backed Tips for the Best Snooze

Treatment Options

Cognitive Behavioral Therapy for Insomnia (CBT-I) is the gold standard non-pharmacological treatment, combining several evidence-based techniques^{[20][21][22][23]}:

• Stimulus control therapy: Strengthening the association between the bed and sleep by using the bed only for sleep and sex.
• Sleep restriction therapy: Limiting time in bed to the actual amount of time spent sleeping to regulate the sleep-wake cycle.
• Cognitive therapy: Identifying and challenging unhelpful thoughts and beliefs about sleep that perpetuate insomnia.
• Relaxation training: Using techniques like progressive muscle relaxation, breathing exercises, or guided imagery to reduce anxiety and promote relaxation.
• Sleep hygiene education: Teaching habits and practices that optimize the sleep environment and support healthy sleep patterns.

If you are experiencing persistent sleep difficulties, reach out to your healthcare provider or a sleep specialist for personalized guidance and treatment recommendations. With proper care and lifestyle modifications, it is possible to overcome insomnia and restore refreshing, restorative sleep.

References:

1. Medic, G., Wille, M., & Hemels, M. E. (2017). Short- and long-term health consequences of sleep disruption. Nature and Science of Sleep, 9, 151–161.
2. Buysse, D. J. (2013). Insomnia. Journal of the American Medical Association, 309(7), 706-716.
3. Ishak, W. W., Bagot, K., Thomas, S., Magakian, N., Bedwani, D., Larson, D., . . . Zaky, C. (2012). Quality of life in patients suffering from insomnia. Innovations in Clinical Neuroscience, 9(10), 13-26.
4. American Academy of Sleep Medicine. (2014). International Classification of Sleep Disorders, 3rd Edition. Darien, IL: American Academy of Sleep Medicine.
5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
6. Ohayon, M. M. (2002). Epidemiology of insomnia: What we know and what we still need to learn. Sleep Medicine Reviews, 6(2), 97-111.
7. Morin, C. M., & Jarrin, D. C. (2013). Epidemiology of insomnia: Prevalence, course, risk factors, and public health burden. Sleep Medicine Clinics, 8(3), 281–297.
8. Irish, L. A., Kline, C. E., Gunn, H. E., Buysse, D. J., & Hall, M. H. (2015). The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Medicine Reviews, 22, 23-36.
9. Hume, K. I., Brink, M., & Basner, M. (2012). Effects of environmental noise on sleep. Noise & Health, 14(61), 297-302.
10. Raymann, R. J. E. M., Swaab, D. F., & Van Someren, E. J. W. (2008). Skin deep: Enhanced sleep depth by cutaneous temperature manipulation. Brain, 131(2), 500-513.
11. Belanger, L., Savard, J., & Morin, C. M. (2006). Clinical management of insomnia using cognitive therapy. Behavioral Sleep Medicine, 4(3), 179-202.
12. Suganuma, N., Kikuchi, T., Yanagi, K., Yamamura, S., Morishima, H., Adachi, H., . . . Takeda, M. (2007). Using electronic media before sleep can curtail sleep time and result in self-perceived insufficient sleep. Sleep and Biological Rhythms, 5(3), 204-214.
13. Paterson, L. M., Wilson, S. J., Nutt, D. J., Hutson, P. H., & Ivarsson, M. (2009). Characterisation of the effects of caffeine on sleep in the rat: A potential model of sleep disruption. Journal of Psychopharmacology, 23(5), 475-486.
14. Drapeau, C., Hamel-Hébert, I., Robillard, R., Selmaoui, B., Filipini, D., & Carrier, J. (2006). Challenging sleep in aging: The effects of 200 mg of caffeine during the evening in young and middle-aged moderate caffeine consumers. Journal of Sleep Research, 15(2), 133-141.
15. Chaput, J.-P., McNeil, J., Després, J.-P., Bouchard, C., & Tremblay, A. (2012). Short sleep duration is associated with greater alcohol consumption in adults. Appetite, 59(3), 650-655.
16. Jaehne, A., Loessl, B., Barkai, Z., Riemann, D., & Hornyak, M. (2009). Effects of nicotine on sleep during consumption, withdrawal and replacement therapy. Sleep Medicine Reviews, 13(5), 363-377.
17. Passos, G. S., Poyares, D., Sant