Insomnia

While most people are aware of insomnia, there are still misconceptions of what insomnia is, what causes insomnia and how to treat insomnia.

When considering disorders that affect sleep, insomnia is likely what comes to the forefront of most people’s minds. While most people are aware of insomnia, there are still misconceptions of what insomnia is, what causes insomnia and how to treat it

What Is Insomnia?

Insomnia is a sleep disorder in which people have trouble falling or staying asleep. Individuals with insomnia may also wake up too early in the morning and be unable to fall back to sleep. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) sleep problems associated with insomnia occur at least three nights each week and persist for at least three months

When considering disorders that affect sleep, insomnia is likely what comes to the forefront of most people’s minds. While most people are aware of insomnia, there are still misconceptions of what insomnia is, what causes insomnia and how to treat it. Insomnia consists of one or more of the following symptoms: trouble falling asleep, trouble staying asleep and daytime sleepiness.

Types of Insomnia

Insomnia can be an isolated condition or as a result of something else. Primary insomnia lasts for a month or more and is a result of external stressors in a person’s life.  Secondary insomnia is a symptom or side effect of another health condition such as depression, asthma, menopause or sleep apnea.

In addition, the National Sleep Foundation has identified five types of insomnia.

1. Acute Insomnia. Most people experience acute insomnia at some point in their lives. Acute insomnia refers to a brief period of difficulty sleeping.
2. Chronic Insomnia. Chronic insomnia refers to long-term patterns of difficulty sleeping. To be considered chronic, insomnia must occur at least three nights a week for a minimum of three continuous months.
3. Comorbid Insomnia. Comorbid insomnia is insomnia that is a result of another disorder, most commonly, mental health disorders. Anxiety and depression are both known to cause comorbid insomnia. Medical causes of comorbid insomnia may include physical pain or frequent urination.
4. Onset Insomnia. Onset insomnia refers solely to the difficulty of falling asleep upon getting in bed.
5. Maintenance Insomnia. Maintenance insomnia refers to difficulty staying asleep. A person with maintenance insomnia may have no problems falling asleep but wakes up throughout the night.

Symptoms of Insomnia

Insomnia may affect all area of a person’s life. Symptoms of insomnia include:

• Difficulty falling asleep
• Difficulty staying asleep
• Daytime sleepiness
• Waking excessively early
• Not feeling rested after sleeping
• Low energy
• Difficulty concentrating
• Irritability

Insomnia may be a symptom of other disorders. When looking at insomnia as the disorder, it may be difficult to tease out what are the symptoms of insomnia versus what the symptoms of other disorders are. Insomnia symptoms include the characteristic features of difficulty falling asleep, difficulty staying asleep and daytime sleepiness. Other symptoms of insomnia include waking excessively early, not feeling rested after sleeping, having low energy, mental confusion or difficulty concentrating and irritability. Insomnia may affect all area of a person’s life due to a lowered threshold for frustration tolerance and increased irritability.

What Causes Insomnia?

Insomnia may result from medical, mental health or behavioral difficulties. Common causes of insomnia include:

• Medical conditions: Health issues such as heartburn, restless leg syndrome, sleep apnea and menopause
• Stress: High stress can cause trouble sleeping.
• Major life changes: Life events such as starting a new job or moving can contribute to insomnia.
• Other mental health disorders: Depression, anxiety and PTSD can cause trouble sleeping
• Travel or work schedule: Traveling through various timezones or working night or rotating shifts can disrupt your sleep routine.
• Lifestyle habits: Certain habits including frequent napping, staying up too late, smoking cigarettes or using electronics too close to bedtime can all contribute to unhealthy sleep patterns.

Medical insomnia causes include disorders such as acid reflux, which may flare up when laying down to sleep, or disorders that cause pain such as arthritis. Mental health causes of insomnia include disorders such as depression and anxiety. Most cases of insomnia caused by a person’s behaviors are unintentional, and increasing knowledge of what causes insomnia may help resolve it. Some common behaviors that prevent restful sleep include taking naps, attempting to recover from sleepless nights by sleeping in the following day, working night or rotating shifts and using electronics up until bedtime.

How Is Insomnia Diagnosed?

According to the DSM-5, the criteria for insomnia disorder include:

• Dissatisfaction with the quality or amount of sleep caused by trouble falling asleep, difficulty staying asleep and waking up too early
• Sleep issues create a significant amount of stress that begins to impact aspects of daily life
• Sleep problems occur at least three nights each week and persist for at least three months
• Poor sleep occurs even when there is enough time devoted to sleep and rest

A doctor may check for signs and symptoms of insomnia to rule out other causes of sleeplessness and ensure an accurate insomnia diagnosis. There is no definitive insomnia test but instead a battery of tests to rule out other disorders and focus on the warning signs of insomnia. A doctor may conduct blood tests, perform a sleep study or request a patient to fill out sleep logs and inventories.

At some point in life, nearly everyone will experience at least acute insomnia. Occasional bouts of difficulty sleeping are normal in response to highly stressful and even exciting occasions.

Who is at Risk for Insomnia?

Anyone can experience insomnia in his or her lifetime. People diagnosed with a mood disorder or with a chronic medical condition may be at higher risk of developing chronic insomnia. Stressful life events such as divorce or death of a loved one may lead to the development of acute cases of insomnia.

Insomnia Statistics

Millions of people struggle with insomnia. Statistics indicate that insomnia is the most common sleep disorder, with 30% of adults experiencing short-term insomnia and The American Academy of Sleep Medicine has found that chronic insomnia affects as many as ten percent of adults. 

While most people experience insomnia at some point, only approximately five percent turn to prescription sleep aids. A patient should carefully consider this medication because it can cause dependence.

In some cases, insomnia can co-occur with addiction. If you or a loved one is struggling with co-occurring insomnia and substance use disorder, The Recovery Village can help. Reach out to a representative today for more information.

Editor – Jennifer Kopf

Jennifer Kopf is a Florida-based writer who likes to balance creative writing with helpful and informative pieces. Her passion for helping people has translated into writing about the importance of treatment for substance use and mental health disorders. Read more

Medically Reviewed By – Denise-Marie Griswold, LCAS

Denise-Marie Griswold is a Licensed Clinical Addictions Specialist. She earned her Master's Degree in Substance Abuse and Clinical Counseling from East Carolina University in 2014. Read more