What are the symptoms of insomnia?

Insomnia has several potential symptoms, which fall into a few categories:

• When you have trouble sleeping.
• Daytime effects.
• Chronic insomnia characteristics.

When you have trouble sleeping

When you have trouble sleeping is an important symptom of insomnia. There are three main ways this happens, and people commonly shift between them over time:

• Initial (sleep onset) insomnia: This means you have trouble falling asleep.
• Middle (maintenance) insomnia: This form makes you wake up in the middle of the night but you fall back asleep. It’s the most common form, affecting almost two-thirds of people with insomnia.
• Late (early waking) insomnia: This form means you wake up too early in the morning and don’t fall back asleep.

Daytime effects

Because you need sleep to be your best, disruptions like insomnia commonly cause symptoms that affect you while you’re awake. These include:

• Feeling tired, unwell or sleepy.
• Delayed responses, such as reacting too slowly when you’re driving.
• Trouble remembering things.
• Slowed thought processes, confusion or trouble concentrating.
• Mood disruptions, especially anxiety, depression and irritability.
• Other disruptions in your work, social activities, hobbies or other routine activities.

Chronic insomnia characteristics

The characteristics of insomnia symptoms are also important. If your symptoms have certain characteristics, you may have chronic insomnia. The characteristics include:

• Circumstances: A chronic insomnia diagnosis requires insomnia without circumstances that would interfere with your ability to sleep (such as changes in work schedule, life events, etc.). Diagnosing insomnia requires having sleep difficulties despite having time and the right environment to do so.
• Frequency: Chronic insomnia requires you to have insomnia frequently, at least three times per week.
• Duration: Chronic insomnia lasts for at least three months.
• Explanation: The insomnia isn’t happening because of substances or medications (including both medical and nonmedical drugs) or other sleep disorders. Other medical or mental health conditions also can’t fully explain why you’re not sleeping.

What causes Insomnia?

Experts don’t fully know why insomnia happens, but the current understanding is that this condition can involve many factors. Some of these factors could be causes or they could simply contribute to it.

The factors that could cause or contribute include (but aren’t limited to) the following:

• Family history (genetics): Sleep traits and conditions, including insomnia, seem to run in families.
• Brain activity differences: People with insomnia may have more active brains or brain chemistry differences that affect their ability to sleep.
• Medical conditions: Your physical health can affect your ability to sleep. This includes temporary illnesses like minor infections or injuries, or chronic conditions like acid reflux or Parkinson’s disease. Conditions that affect your circadian rhythm, your body’s natural sleep/wake clock, are also factors.
• Mental health conditions: About half the people with chronic insomnia also have at least one other mental health condition, like anxiety or depression.
• Life circumstances: Stressful or difficult life circumstances may not necessarily cause insomnia, but it’s very common for them to contribute to it.
• Life changes: Brief or temporary changes are often factors, including jet lag, sleeping in an unfamiliar place or adjusting to a new work schedule (especially shift work). Long-term changes, like moving to a new home, can also affect sleep.
• Your habits and routine: Your sleep habits (also known as sleep hygiene) can contribute to insomnia. That includes whether or not you take naps, when you go to sleep, if and when you consume caffeine, and other habits.

What are the risk factors for insomnia?

Insomnia is also more likely to happen in people with the following characteristics or circumstances:

• Light sleepers.
• People who use alcohol.
• People who don’t feel safe in their homes (such as situations involving repeated violence or abuse).
• People with fear or anxiety about sleep, such as those with disruptive sleep issues like nocturnal panic attacks or nightmare disorder.

Management and Treatment