Health blog

Insomnia: Causes, Symptoms and Treatment

Posted on March 4, 2025

Diabetes

Overview

Sleep is vital for all bodily processes. While you rest, your body promotes healthy brain function and preserves physical well-being. For children and teenagers, sleep is essential as it aids in their growth and development. There are over 80 sleep disorders that impact the quality, amount and timing of sleep, affecting both our mental and physical health.It help regulate mood and cognitive performance

What is Insomnia?

Insomnia is one of the common sleep disorders that can make it difficult to fall asleep or remain asleep throughout the night.

It may also lead to waking up too early without the ability to return to sleep, leaving you feeling fatigued upon waking.

Insomnia can sap your energy, impact your mood, and adversely affect your health, work performance, and overall quality of life.

The amount of sleep needed varies among individuals, but most adults require between 7 to 9 hours each night.

Types of Insomnia?

Insomnia can be classified as either short-term or chronic:

  • Short-term insomnia: It is often triggered by stress or changes in your schedule or environment; it typically lasts for a few days or weeks.
  • Chronic insomnia: Occurs at least three nights a week for over three months and cannot be attributed to another health issue.

What Can Cause Insomnia?

causes

There are numerous potential causes of insomnia, including:

  • Stressful thoughts
  • Depression
  • Medications that disrupt sleep
  • Dietary choices & lifestyle (e.g., caffeine intake later during the day)
  • Physical health issues
  • Mental health disorders
  • Poor sleep habits
  • Neurological disorders
  • Pregnancy
  • Other sleep disorders

What are the Symptoms of Insomnia?

causes

Signs or symptoms of insomnia may encompass:

  • Difficulty in falling asleep at night.
  • Waking up multiple times throughout the night
  • Rising too early in the morning
  • Experiencing fatigue or drowsiness during the day
  • Feeling irritable, down, or anxious
  • Struggling to concentrate or focus on tasks
  • Increasing frequency of mistakes or accidents
  • Persistent concerns regarding sleep

Diagnosis of Insomnia

How can we diagnose insomnia?

Insomnia disorder is a clinical diagnosis established by history. The evaluation goals are to characterize the nature and severity of the sleep problem and identify contributing factors and comorbidities relevant to successful treatment. Key elements include:

  • A sleep history is obtained supplemented by 'sleep diary'
  • Symptoms of other sleep disorders are probed
  • Screen for depression and anxiety
  • Review of medications and habits, including caffeine intake, tobacco and alcohol, and substance use.

https://www.nhlbi.nih.gov/health/insomnia/diagnosis

What are the Risks associated with Insomnia?

Insomnia can elevate the risk of various health problems, including

  • High blood pressure
  • Obesity
  • Depression
  • Type 2 diabetes
  • Heart disease
  • Difficulties with memory and concentration

How to Manage/Treat Insomnia?

Non-Pharmacological Treatment

Sleep hygiene is an effective yet often overlooked approach to tackling sleep disturbances. Here are some key recommendations:

  • Waking up and going to bed at same time everyday, including on weekends
  • Avoiding long periods of wakefulness in bed
  • Not using bed for non-sleep activities (reading, TV, work etc.)
  • Avoiding screens, especially smartphones and iPads in the hour before bed
  • Avoiding napping
  • Discontinuing or reducing consumption of alcohol, caffeine, drugs
  • Exercising atleast 3-4x/wk (but not in the evening if this interferes with sleep)

Cognitive Behavioral Therapy for Insomnia (CBT-I) is considered the first-line treatment for chronic insomnia. It is a structured, evidence-based approach that helps individuals identify and change thoughts, behaviors, and habits that contribute to their sleep difficulties. CBT-I has been shown to be more effective than medications in the long term and tends to have fewer side effects. It not only helps with sleep but can also address underlying issues like anxiety or depression that may contribute to insomnia.

Pharmacological Treatment

The FDA has approved an array of prescription medications for the treatment of insomnia, including

  • Benzodiazepine receptor agonists (BZRAs): Which include the nonbenzodiazepine BZRAs (eszopiclone, zaleplon, and zolpidem) and five benzodiazepine hypnotics (estazolam, flurazepam, temazepam, triazolam, and quazepam)
  • Dual orexin receptor antagonists (DORAs): Which include
    • Daridorexant
    • Lemborexant
    • Suvorexant
  • Low-dose doxepin (a histamine receptor antagonist)
  • Ramelteon (a melatonin receptor agonist)

References

https://www.sleepfoundation.org/insomnia/what-causes-insomnia

https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes

https://www.uptodate.com/contents/pharmacotherapy-for-insomnia-in-adults