What Are the Symptoms of Insomnia?

Physical and Mental Effects May Occur

What are the common symptoms of insomnia? If you have difficulty falling or staying asleep, you may wonder what other symptoms might occur with this condition. You may also be interested to learn about some of the consequences of these symptoms.

To better understand the most common symptoms of insomnia, let’s review a short excerpt from UpToDate -- a trusted electronic medical reference used by health care providers and patients alike.

Then, after the passage, read further for additional information about what all of this may mean for you.

"Common symptoms of insomnia include:
  • Difficulty falling asleep or staying asleep
  • Variable sleep, such as several nights of poor sleep followed by a night of better sleep.
  • Daytime fatigue or sleepiness
  • Forgetfulness
  • Poor concentration
  • Irritability
  • Anxiety
  • Depression
  • Reduced motivation or energy
  • Increased errors or accidents
  • Ongoing worry about sleep

"For many people, the symptoms of insomnia interfere with personal relationships and job performance. In one survey, people who experienced chronic insomnia had a two-fold increased risk of automobile accidents compared to people who were fatigued for other reasons.

"[Some] people with insomnia have an impaired sense of sleep. You may feel that you have not slept, even if testing shows that you have. You may also feel more fatigued than individuals without insomnia, even if testing indicates that you are less sleepy. This impaired sense of sleep may be related to a problem with the body's sleep-arousal system, which normally helps you feel awake after sleeping and feel tired before going to bed.

"One result of poor sleep is that you may become concerned that you will be sleep-deprived and will suffer from serious consequences of lost sleep. This concern may grow as you are unable to sleep, which in turn makes it increasingly difficult to fall asleep. It is important that you not get caught in this cycle and understand that you are sleeping more than it seems."

The defining symptoms of insomnia are difficulty falling or staying asleep or sleep that is simply not refreshing. Normally, most people fall asleep in about 10 minutes. If you lie down and have trouble falling asleep, you are said to have a prolonged sleep latency. Many people with insomnia lie awake for many minutes or even hours trying to fall asleep.

In addition, their sleep may be fragmented with periods of light sleep or wakefulness. Insomniacs may spend much of the night lying awake. This may be actually happening, or it might instead be only their perception of their sleep.

It is not uncommon for insomniacs to have great variation in their sleep. There may be periods of relatively good sleep interspersed with problematic nights. In the case of acute insomnia, the difficulty sleeping does resolve with time, especially when the inciting cause is relieved. For however long insomnia occurs, though, it often results in symptoms of sleep deprivation.

When we do not obtain the sleep that we need, there are numerous consequences. Not only do we begin to feel sleepy, but there may be important physical and mental symptoms. As described above, people with insomnia may have trouble with concentration, memory, and mood. Anxiety and depression as well as the risk of suicide are strongly linked to insomnia. In addition, sleep deprivation in insomnia may result in job errors, accidents, and other unforeseen problems.

Traffic accidents are a frequent side effect of sleep deprivation, especially in insomnia. In fact, the degree of impairment can be equivalent to that which occurs in alcohol intoxication. Slowed reaction times, compromised visual tracking, and impaired hand-eye coordination may increase the risk of serious accidents.

One of the most serious adverse effects of insomnia is how it affects our ability to interact with others. Even setting aside mood issues, there seems to be an element of dysfunction that occurs in the frontal lobe of the brain in sleep deprivation. The frontal lobe is key for helping us to think at a higher level, making decisions and judgments, and observing social cues. When the frontal lobe does not work well, we may be more likely to make poor choices, get into fights, or alienate those around us. This has significant social implications and affects our relationships as well as our ability to work and thrive.

It is interesting to consider that people with insomnia have an impaired sense or perception of sleep. Someone with insomnia might say, "I only slept 3 hours last night" even when objective sleep testing like polysomnography or actigraphy suggest otherwise. For some reason, even when sleep is obtained, it is not registered in the brains of insomniacs in the proper way. Sleep does not refresh. Therefore, even after sleep is obtained, the person with insomnia may feel as if it has not been. Moreover, the regulation of sleep is disrupted, so that people with insomnia do not feel tired when they are supposed to be.

Finally, people with insomnia often become caught in a psychological tailspin. They may believe that they are not sleeping enough. As the night slips away, moment by moment, the anxiety of what this could mean escalates. Questions and worries compound: “Will I be able to get up in the morning? What if I oversleep? I won’t be able to function at my job now. What if I get fired?” This is called catastrophization. It means that your thinking goes to an extreme outcome -- a catastrophe -- even if it may not be rational, or even plausible. This phenomenon often occurs in insomnia, and it can be greatly distressing.

It is important to break this cycle, to realize that you are probably sleeping more than you may be aware. Although the consequences of sleep deprivation are real, the anxiety that might accompany a small difficulty sleeping may escalate the problem exponentially. Fortunately, there are many treatment options available for insomnia and, in particular, therapy may provide you a sense of comfort in your moment of need.

Want to learn more? See UpToDate's topic, "Insomnia," for additional in-depth medical information.


Bonnet, Michael et al. "Insomnia." UpToDate. Accessed: December 2011.

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