Insomnia is a common sleep disorder. With insomnia, you may have trouble falling asleep, staying asleep, or getting good quality sleep. This happens even though you have the time and the right environment to sleep well. Insomnia interferes with your daily activities, and may make you feel unrested or sleepy during the day.
Short-term insomnia may be caused by stress or changes in your schedule or environment. It can last for a few days or weeks. Chronic (long-term) insomnia occurs three or more nights a week, lasts more than three months, and cannot be fully explained by another health problem or a medicine.
To diagnose insomnia, your doctor may ask about your sleep habits and ask you to keep a sleep diary. Your doctor may recommend healthy lifestyle habits such as a regular sleep schedule, cognitive behavioral therapy for insomnia, and medicines to help you manage your insomnia.
Explore this Health Topic to learn more about insomnia, our role in research and clinical trials, and where to find more information.
You may have a higher risk of insomnia because of your age, family history and genetics, environment or occupation (work), lifestyle, stress or worrying about sleep, or your sex.
Insomnia can occur at any age but your chances of having it increase as you get older.
Your genes may raise your risk of insomnia, as insomnia sometimes runs in families. Your genes may also affect whether you are a deep or light sleeper.
The following can disturb your sleep–wake cycle:
Lifestyle habits can raise your risk of sleep problems.
Stress or worrying about school or work, relationships, money, or the death of a loved one raises the risk of insomnia.
Worrying about whether you will get enough sleep and monitoring the clock can also raise your risk of insomnia or make it worse.
Insomnia is more common in women than in men. Feeling uncomfortable and experiencing hormone changes during pregnancy and menopause can cause problems with sleep.
To screen for insomnia, your doctor will ask how you are sleeping and ask about your risk factors.
Your doctor may talk to you about steps you can take to help you sleep better and prevent chronic insomnia.
Go to treatment to learn more about healthy sleep habits that may help prevent or manage insomnia.
The main symptom of insomnia is trouble falling or staying asleep, even if you have enough time and the right conditions for good sleep. Over time, untreated insomnia may raise your risk of certain health problems or workplace or road accidents.
If you have insomnia, you may:
In the short term, insomnia can make it hard to concentrate or think clearly. You may feel irritable, sad, and unrested or have headaches. Insomnia raises your risk of falling, having a road accident, or missing work.
In addition, chronic insomnia can affect how well your brain, heart, and other parts of your body work. It can raise your risk of certain health problems or make existing problems worse. These conditions include:
If lack of sleep is affecting your daily activities, talk to your doctor. You may be diagnosed with insomnia if you have difficulty falling or staying asleep for at least 3 nights a week. Short-term insomnia lasts less than 3 months. Chronic insomnia lasts for 3 months or more. Your doctor may do more tests to see whether your insomnia has caused any complications.
It may be helpful to keep a sleep diary for 1 to 2 weeks before seeing your doctor. A sleep diary can help your doctor understand your sleep problem and whether certain activities are affecting your sleep. Write down when you go to sleep, wake up, and take naps each day. Also write down how sleepy you feel throughout the day, when you drink caffeine or alcohol, and when you exercise.
You can print and use the NHLBI’s sleep diary.
Your doctor will want to learn about your signs and symptoms, risk factors, health history, and family health history. To better understand your sleep problem, your doctor may have you fill out a questionnaire or ask you for details such as these about your sleep habits:
To find the cause of your sleep problems, your doctor may ask whether you:
Your doctor will do a physical exam to rule out other medical problems that might affect your sleep. He or she will listen to your heart and lungs and look for risk factors for sleep apnea, such as large tonsils or a large neck circumference.
In addition to finding out your medical history, your doctor may have you take the following tests.
Lifestyle changes can often help improve short-term insomnia. A type of counseling called cognitive behavioral therapy for insomnia is usually the first treatment recommended for chronic insomnia. Several medicines can also help manage insomnia and help you have a regular sleep schedule. You may need to visit a doctor who specializes in treating sleep problems.
In addition to following a heart-healthy lifestyle, try to adopt the following bedtime habits. These habits can make it easier for you to fall asleep and stay asleep.
CBT-I is a 6- to 8-week detailed treatment plan to help you learn how to fall asleep faster and stay asleep longer. This is usually recommended as the first treatment option for long-term insomnia and can be very effective if done properly. CBT-I can be done in person by a doctor, nurse, or therapist; by telephone; or online. It involves the following parts:
Many prescription medicines are used to treat insomnia. Some are meant for short-term use while others are meant for longer-term use. Some insomnia medicines can be habit-forming and all of these medicines may cause dizziness, drowsiness, or worsening of depression or suicidal thoughts. All of the medicines listed below may cause insomnia. Talk to your doctor about the benefits and side effects of insomnia medicines.
In some special cases healthcare providers may prescribe medicines that are commonly used for other health conditions but are not yet approved by the FDA to treat insomnia. Some of these medicines may include antidepressants, antipsychotics, and anticonvulsants.
Over-the-counter medicines and supplements
Some over-the-counter (OTC) products that contain antihistamines are sold as sleep aids. Although these products might make you sleepy, talk to your doctor before taking them. Antihistamines can be unsafe for some people. Also, these products may not be the best treatment for your insomnia. Your doctor can advise you whether these products will help you.
Melatonin supplements are lab-made versions of the sleep hormone melatonin. Many people take melatonin supplements to improve their sleep. However, research has not proven that melatonin is an effective treatment for insomnia. Talk to your doctor before using these supplements. Dietary supplements can be beneficial to your health, but they can also have health risks.
The U.S. Food and Drug Administration regulates dietary supplements under a different set of regulations than those covering "conventional" foods and medicines. It does not have the authority to review dietary supplement products for safety and effectiveness before they are marketed.
Side effects of melatonin may include daytime sleepiness, headaches, upset stomach, and worsening depression. It can also affect your body's control of blood pressure, causing high or low blood pressure.
Your doctor may also prescribe medicines to treat other diseases that you may have in addition to your insomnia.
Your doctor may recommend that you use light therapy to set and maintain your sleep-wake cycle. With this treatment, you plan time each day to sit in front of a light box, which produces bright light similar to sunlight.
Talk with your doctor about how often to schedule follow-up visits. Between visits, tell your doctor if you have any new or worsening symptoms or if you have side effects from your medicines. He or she might prescribe a different medicine or treatment.
Your doctor may ask you to keep a sleep diary to help you keep track of how well you are sleeping during and after your treatment.
Even when your sleep improves, you may need to keep a regular daily schedule, take your medicines regularly, and continue cognitive behavioral therapy for insomnia (CBT-I).
Often, people who have insomnia have other conditions that can affect sleep, such as:
Insomnia may also make these conditions or their symptoms worse. It is important to manage these conditions to prevent your insomnia from returning or getting worse. In addition, some medicines that are used to treat these conditions can also increase your risk of insomnia. Talk to your doctor about your medicines as there may be other options for treating your condition.
Learn about the following ways the NHLBI continues to translate current research into improved health for people who have insomnia. Research on this topic is part of the NHLBI’s broader commitment to advancing Sleep Science and Sleep Disorders scientific discovery.
Learn about some of the pioneering research contributions we have made over the years that have improved clinical care.
Another NHLBI-supported study, using fruit flies, showed that genes may explain sleep variations and may help to identify ways to treat insomnia. View To Sleep or Not: Researchers explore complex genetic network behind sleep duration for more information.
In support of our mission, we are committed to advancing insomnia research in part through the following ways.
Learn about exciting research areas the NHLBI is exploring about insomnia.
We lead or sponsor many studies relevant to insomnia. See whether you or someone you know is eligible to participate in our clinical trials