All About Insomnia

An Introduction to This Common Sleep Disorder

man sitting on edge of bed
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Insomnia (in-SOM-ne-ah), is a common sleep disorder that involves difficulty falling, or staying asleep, or both.  It can lead to other symptoms that include fatigue, low energy levels, anxiety, depression, and a weakened immune system. While not considered to be a serious medical disorder, insomnia can make life difficult, or even unmanageable.

The Two Types of Insomnia

There are two types of insomnia: primary and secondary.

They can be either acute, or short-term, or chronic, and ongoing. Cases of acute insomnia typically last from one night to a few weeks. Chronic insomnia is diagnosed if the problem lasts for one month or longer. More women than men are at risk for insomnia due to their hormonal cycles. 

Primary insomnia occurs on its own, without any other medical condition. In many cases of primary insomnia, psychological or environmental issues are usually part of the cause. These causes may include the following:

  • Stress – at home, school, or in the workplace
  • Psychological trauma – divorce, illness, or death
  • Post-traumatic stress (PTSD)
  • Depression
  • Changes in your regular schedule
  • Caffeine, nicotine, alcohol
  • Overeating before bedtime
  • Poor sleep habits
  • Aging

Working odd hours or changing shifts at work can also lead to insomnia.

Secondary insomnia is caused by another medical condition or medication. Medical conditions that can result in secondary insomnia include:

  • Arthritis pain
  • Cancer
  • Respiratory disease
  • Hyperthyroidism
  • Gastroesophageal reflux disease (GERD)
  • Blood pressure medication
  • Decongestants
  • Weight-loss products

The need to urinate frequently also interferes with normal sleep patterns.

Symptoms of Insomnia

The most obvious symptom of insomnia is the inability to fall asleep or remain asleep.

Other symptoms of insomnia include:

  • Daytime fatigue or sleepiness
  • Irritability or depression
  • Difficulty concentrating
  • Headaches

Most people require between seven to eight hours of sleep in order to function. Patients with insomnia typically get less than six hours of sleep per night.

Diagnosis of Insomnia

Before diagnosing insomnia and the type of insomnia you have, your doctor will need to complete a physical examination with a full medical history. Blood tests, to rule out underlying illnesses, may be performed. You may be asked to start a sleep diary to keep track of your activities, diet and other information. 

If you have another sleep disorder, like sleep apnea, you may be referred to a sleep clinic for an evaluation and further testing. 

Treatment of Insomnia

Treatment of insomnia will depend upon its cause. If it is secondary insomnia, the cause of the medical condition must be resolved. This may include changing your medication, the time you take it, or treating the disease or its condition.


If it is primary insomnia, you will be encouraged to practice relaxation techniques, engage in cognitive behavioral therapy, and address your anxiety or depression with therapy. Other changes you can make include limiting your bedtime activities and to refrain from watching television while you are in bed.

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