Can't Sleep? Discover Symptoms, Causes, and Treatments for Insomnia

Discover Insomnia's Symptoms, Causes, and Cures

Insomnia causes difficulty sleeping and may be helped by the use of treatments like sleeping pills and behavioral changes
Insomnia causes difficulty sleeping and may be helped by the use of treatments like sleeping pills and behavioral changes. Jaris Paul/The Image Bank/Getty Images

If you have difficulty falling or staying asleep or your sleep is not refreshing, you may be suffering from insomnia and be seeking help for trouble sleeping. Learn about the various subtypes of insomnia, the common symptoms, some potential causes, how it is diagnosed, and the treatment options including medications and behavioral changes. If you can't sleep, learn how to get help with tips for fixing insomnia.

What Is Insomnia?

Insomnia is the inability to fall or stay asleep. It may also describe 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 3 nights per week for at least 3 months, it may require treatment.

There are multiple subtypes of insomnia and 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.

How Common Is Insomnia?

Insomnia is one of the most common medical complaints. A survey of patients found that 69 percent had insomnia, with half of these individuals saying it was occasional but 19 percent reporting chronic difficulties. It is estimated that 10 percent of people have chronic insomnia with daytime deficits.

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.

Symptoms 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.

Causes of Insomnia

There are almost innumerable potential causes of insomnia. It 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 triggers insomnia. It may interact with other psychiatric problems such as anxiety or depression, post-traumatic stress disorder (PTSD), or even neurological disorders like dementia.

It may happen with the use of prescription or over-the-counter medications or street drugs. It can also occur in the context of withdrawal from certain substances.

Insomnia may be present in the context of shift work or travel (such as in jet lag).

It may occur temporarily if caffeine or cigarettes are used too close to bedtime or as the result of other poor sleep habits. It can be worsened when the time in bed exceeds the required sleep to meet needs.

It is unlikely to occur because of a vitamin deficiency. It frequently occurs when the sleep environment is disrupted, such as when pets or the television are allowed to disrupt sleep.

Insomnia may even have no recognized cause.

How to Diagnose Insomnia

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.

Treatment of Insomnia

If insomnia results in disrupted daytime function, especially if it persists chronically, it may require treatment. There are many medications that act as sleeping pills that can be effective. 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. Many of these options include changes in behavior or sleep habits. Some of the more common alternative therapies for insomnia include:


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.


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.

Continue Reading