Insomnia Disorder
A sleep disorder characterized by persistent difficulty falling asleep, staying asleep, or waking too early, despite adequate opportunity, causing daytime impairment.
Prevalence: 10-30% of adults experience insomnia symptoms. Chronic insomnia affects 10% of population. More common in women and older adults.
Common Symptoms
- Difficulty initiating sleep (taking >30 minutes)
- Difficulty maintaining sleep (frequent awakenings)
- Early morning awakening unable to return to sleep
- Daytime fatigue or sleepiness
- Difficulty concentrating or memory problems
- Mood disturbances (irritability, dysphoria, anxiety)
- Decreased performance at work or school
- Worry or distress about sleep
- Physical tension
- Daytime dysfunction
- Headaches
- Gastrointestinal symptoms
- Ongoing concerns and anxiety about sleep
- Low energy
- Behavioral problems from fatigue
- Microsleeps during day
- Reduced motivation
- Increased errors or accidents
Risk Factors
- Female gender
- Older age
- Shift work
- High stress levels
- Mental health disorders (anxiety, depression)
- Medical conditions
- Certain medications
- Low socioeconomic status
- Worry-prone personality
Treatment Approaches
- Cognitive Behavioral Therapy for Insomnia (CBT-I) - FIRST LINE
- Sleep restriction
- Stimulus control
- Sleep hygiene education
- Relaxation training
- Cognitive restructuring of sleep beliefs
- Mindfulness-based therapy
- Short-term medication if needed (Z-drugs, melatonin)
- Avoid long-term benzodiazepines
- Treat underlying conditions
- Light therapy for circadian issues
- Online CBT-I programs available
Self-Help & Natural Approaches
- Cognitive Behavioral Therapy for Insomnia (CBT-I) - GOLD STANDARD
- Sleep restriction therapy
- Stimulus control (bed only for sleep and sex)
- Maintain consistent sleep-wake schedule
- Relaxation techniques before bed
- Mindfulness meditation
- No screens 1-2 hours before bed
- Dark, cool (60-67°F), quiet bedroom
- Avoid caffeine after noon
- Avoid alcohol (disrupts sleep)
- Regular exercise (not within 3 hours of bed)
- Morning light exposure
- Limit naps (or 20-30 min max)
- Get out of bed if can't sleep after 20 min
- Address worries before bed (worry time earlier)
- Relaxing bedtime routine
- No clock-watching
- Paradoxical intention (try to stay awake)
- Progressive muscle relaxation
- 4-7-8 breathing
When to Seek Professional Help
- Insomnia lasting 3+ months
- Significant daytime impairment
- Affecting work, relationships, or health
- Co-occurring depression or anxiety
- Using alcohol or drugs to sleep
- Possible sleep apnea (snoring, gasping)
- Restless legs syndrome suspected
- Medication causing insomnia
- Self-help strategies not working
- Want professional CBT-I treatment
Crisis Resources
- National Sleep Foundation: sleepfoundation.org
- American Academy of Sleep Medicine: aasm.org
- Society of Behavioral Sleep Medicine: behavioralsleep.org
- Primary care doctor
- Sleep medicine specialist
- Find CBT-I therapist
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.