Insomnia Symptoms, Causes, and Treatments

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If you have difficulty falling or staying asleep, or your sleep is not refreshing, you may be suffering from insomnia. The condition also includes sleep that is of poor quality resulting in excessive daytime sleepiness. It is the most common sleep disorder, affecting nearly everyone at some point in our lives. There may be identifiable factors that interfere with sleep, such as poor sleep environment, pain, stress, or getting up to urinate (nocturia). Insomnia may be episodic, for instance, only occurring during periods of stress, but if it persists chronically at least three nights per week for at least three months, it may require treatment.

Man sitting on edge of bed

Frederic Cirou / PhotoAlto Agency / Getty Images


There are two types of insomnia: acute (short-term) or chronic (ongoing). Other sleep disorders may have insomnia as a component, including:

No matter the type of insomnia that you may be experiencing, you can discover solutions and effective treatments.


Insomnia is one of the most common medical complaints. It is estimated that approximately 20% of US adults experience insomnia.

Women tend to report more insomnia complaints. Insomnia becomes more common as we get older. Individuals who are unemployed, live alone, and are of lower socioeconomic status also have more complaints of insomnia.


Insomnia is characterized by difficulty falling or staying asleep or by sleep that is of poor quality. It may be associated with early morning awakenings. There are, however, other symptoms that may be associated with insomnia. These symptoms include:

  • Excessive daytime sleepiness
  • Fatigue
  • Malaise (feeling unwell)
  • Difficulty concentrating or paying attention
  • Mood problems (anxiety or depression)
  • Headache
  • Decreased energy
  • Difficulties at work, school, or in social activities
  • Upset stomach

It is no surprise that if we don't sleep well, we don't feel well while awake.


Most acute insomnia is brought on by stress, while most cases of chronic insomnia are secondary, or a symptom or side effect of some other problem. Insomnia may occur in the context of other sleep disorders (most commonly sleep apnea and restless legs syndrome), general medical conditions (especially those that cause pain), or illnesses. The triggers may be temporary or persistent.

Insomnia may be the result of stress. The loss of a job with financial problems, the death of a loved one, or a divorce may trigger stress that in turn causes insomnia. It may be associated with other psychiatric problems, such as anxiety or depression, post-traumatic stress disorder (PTSD), or even neurological disorders like dementia.

Insomnia may result from the use of certain prescription or over-the-counter medications or street drugs. It can also occur during withdrawal from certain substances. Insomnia may arise due to shift work or travel (such as with jet lag). It may temporarily occur if caffeine or cigarettes are used too close to bedtime or as the result of other poor sleep habits. People with insomnia often spend too much time in bed while awake. By limiting time spent in bed, a consistent sleep schedule can be reestablished.

While it's unlikely that insomnia will occur because of a vitamin deficiency, it frequently happens when the sleep environment is disrupted, such as when pets, television or other devices are present.

Insomnia may have no recognized cause.


Most individuals with insomnia can be diagnosed after a brief discussion with their doctor. However, there are multiple tests available to diagnose insomnia if they are needed. Some of these include:

Additional testing is often needed if another disorder is suspected, such as sleep apnea, narcolepsy, or circadian rhythm disorders.



If insomnia results in disrupted daytime function, especially if it persists chronically, it may require treatment. There are many effective medications that can be helpful for short-term use. Two major classes include benzodiazepine and nonbenzodiazepine medications. Some of these prescription and over-the-counter medications include:


There are also alternatives to treatment with medications, including making changes in behaviors or sleep habits. Some of the more common alternative therapies for insomnia include:

A Word From Verywell

Insomnia is the most common sleep complaint, affecting nearly everyone at some point in our lives. It can exist in multiple subtypes or even as part of other sleep disorders or medical conditions. There may be associated symptoms such as difficulties with memory, concentration, and mood. Insomnia may be caused by many things, and a careful evaluation by a doctor is usually sufficient to establish a diagnosis.

Occasionally further tests may be indicated. Fortunately, there are effective treatments for insomnia, including many prescription and over-the-counter sleeping pills as well as alternative therapies, such as improving sleep habits or the sleep environment.

If it persists, cognitive behavioral therapy for insomnia (CBTI) may be the most effective treatment option. Our Doctor Discussion Guide below can help you start that conversation with a doctor to find the best treatment option.

Insomnia Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Heart, Lung, and Blood Institute. Insomnia.

  2. Walsh JK, Coulouvrat C, Hajak G, et al. Nighttime insomnia symptoms and perceived health in the America Insomnia Survey (AIS). Sleep. 2011;34(8):997-1011. doi:10.5665/SLEEP.1150

  3. Bollu PC, Kaur H. Sleep Medicine: Insomnia and Sleep. Mo Med. 2019;116(1):68-75.

  4. Sleep Foundation. Cognitive behavioral therapy for insomnia (CBT-I).

  5. Pharmacy Times. FDA approves daridorexant for treatment of insomnia.

  6. Merck Manual Consumer Version. Insomnia and Excessive Daytime Sleepiness (EDS). Reviewed May 2019.

Additional Reading
  • American Academy of Sleep Medicine. "International classification of sleep disorders: Diagnostic and coding manual." 2nd ed. 2005.
  • Ohayon, MM. "Epidemiology of insomnia: what we know and what we still need to learn." Sleep Med Rev. 202; 6:97.
  • Shochat, T et al. "Insomnia in primary care patients." Sleep. 1999; 22 Suppl 2:S359.

By Brandon Peters, MD
Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist.