Insomnia: Symptoms, types, causes, effects, and treatments

Reviewed by Brooks Baer, LCPC, CMHP

Written by

therapist.com team

Last updated: 05/31/2024

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What is insomnia?

Insomnia is a sleep disorder characterized by trouble falling asleep, staying asleep, and/or getting restful sleep. You may spend hours trying to fall asleep, or you may stay awake the entire night.

You may even fall asleep easily, but wake up after a few hours and struggle to fall asleep again. When you do fall asleep, the quality of your sleep may be poor, leaving you feeling unrested.

Symptoms of insomnia

The most common signs of insomnia include fatigue, irritability, and difficulty concentrating. And insomnia itself may be a predictor or symptom of stress, grief, or mental health concerns such as:¹

• Anxiety
• Depression
• Addiction recovery
• Bipolar disorder
• Eating disorders
• Posttraumatic stress disorder (PTSD)

How long does insomnia last?

Insomnia is discussed as being “acute” or “chronic.” In general, acute insomnia occurs over a brief period of time (perhaps a few days or weeks), whereas chronic insomnia may last for months or longer.

Various studies have attempted to give a more specific distinction between the two forms.² In general, if you’ve noticed a pattern in your struggle to sleep, and it’s affecting your ability to function, it’s time to see a doctor.

Types of insomnia

Not everyone experiences insomnia the same way. It comes in various forms, and your insomnia may be distinct based on several features:

1. Duration: Acute insomnia could be the result of one specific stressor and pass relatively quickly. Chronic insomnia will likely persist even when stressors pass.
2. Cause: If your insomnia is “primary,” it seems to occur on its own, rather than as the result of a health problem. “Secondary” insomnia, also called “comorbid” insomnia, occurs alongside another medical problem, like depression or acid reflux disease.
3. Severity: You may suffer from mild insomnia that simply leaves you fatigued for a day or two. Or you might have a more moderate case that affects your ability to function. A severe case of insomnia results in serious limitations on your life and may endanger your health.
4. Timing: In “onset” insomnia, you have trouble falling asleep. In “maintenance” insomnia, you have trouble staying asleep. With “terminal” insomnia, you wake up early without meaning to and cannot return to sleep.

It’s possible to have more than one type of insomnia at the same time. Consider speaking with your doctor or a mental health professional if you’re experiencing insomnia symptoms.

What causes insomnia?

Anyone can develop insomnia. If you have a family history of sleep disorders, you may be at a greater risk for it. Age also increases your risk, with older adults being more susceptible.³ And many people struggle with insomnia because of changeable factors like stress or poor sleep habits.

Insomnia has multiple causes—some you can address, and some you can’t. Common causes include: 

• Stress: Stress affects our physical and mental well-being, and insomnia is a common side effect.⁴
• Medications: Certain medications can cause insomnia.⁵ Your doctor may switch you to a different medication if your current prescription affects your sleep. However, it’s important that you don’t stop taking your medication without consulting your doctor first.
• Travel: The stress of travel can lead to acute insomnia.⁶ Flying across two or more time zones in particular can disturb your sleep schedule. Jet lag may trigger a few days of disrupted sleep.
• Stimulants: Caffeine, nicotine, and other stimulants can make it hard to fall asleep.⁷ If you have them later in the day, they may keep you awake most of the night.
• Alcohol or drug use: Although alcohol is a depressant and may cause you to fall asleep faster, it interferes with sleep quality.⁸ Drug or alcohol use can also disrupt your sleep schedule.
• Poor sleep habits: It’s important to create a dark, quiet, calm environment to sleep in. Habits like using your phone in bed or eating right before bed could alter your sleep.^9,10
• Certain mental health disorders: Insomnia may be attributed to mental health disorders such as anxiety or depression.¹¹
• Hormonal changes: People who menstruate may have insomnia at the same time in their cycle each month.¹² Insomnia during pregnancy is also common, with rates as high as 80%.¹³
• Other health conditions: Secondary insomnia can be caused by physical health problems in addition to mental health ones.¹⁴

Effects of insomnia

Lack of sleep affects your physical, mental, and emotional health. Chronic insomnia’s effects can build up over time and put your health at risk. 

Physical health risks

Over time, insomnia can increase your risk of:¹⁵

• Stroke
• High blood pressure
• Heart disease
• Diabetes
• Obesity

Mental health risks

Some studies suggest that insomnia can impact your mental health and cognitive abilities, negatively impacting your ability to:¹⁶ 

• Pay attention
• Use your working memory
• Complete tasks using executive function
• Concentrate

How to treat insomnia

Insomnia treatments may help you overcome the sleep disorder, and a variety of treatment options are available. Several of them are below.

Insomnia therapy

Cognitive behavioral therapy for insomnia (CBT-I) is one of the most effective insomnia therapies.¹⁷ It specifically addresses thoughts, feelings, and behaviors that make it hard to sleep.

CBT-I retrains your brain, teaching you to associate your bed with sleeping and not other activities (like eating, working, or watching TV). It also helps you create healthy habits that promote restful sleep.

If you’re interested in learning and practicing healthy sleep habits, help is available. Browse our therapist directory to find a licensed therapist near you.

Medications for insomnia

Insomnia medication can provide help if you’re struggling with acute insomnia. However, it’s less effective against chronic insomnia. Ask your doctor about possible side effects before trying over-the-counter sleeping pills—and don’t take medication for other conditions (such as Benadryl or other antihistamines) just because it also makes you sleepy. 

Improve your sleep habits

You may be able to stop acute insomnia by practicing these healthy sleep habits: 

• If you’ve tried to fall asleep for more than 10 minutes, get out of bed until you feel tired enough to sleep.
• Avoid using your phone or engaging with screens at night.
• Practice deep breathing.
• Avoid napping during the day.
• Follow a regular sleep schedule, even on weekends.
• Don’t eat within two hours of going to bed.
• Avoid caffeine, drugs, or alcohol before bed.
• Create a dark, quiet, cool sleeping environment.
• Practice relaxation techniques such as meditation to prepare yourself for sleep.
• Keep a sleep diary to track what helps and harms your sleep.

Natural remedies for insomnia

Several natural remedies are commonly suggested for those struggling with insomnia. These include:

Herbal teas, which some people may find beneficial to drink before bed. Chamomile is known for its relaxing properties and is often recommended as a sleep aid.¹⁸

Aromatherapy, which uses the soothing properties of essential oils to calm the mind and body. Lavender essential oil is associated with improved sleep quality, though it may not be enough to help with insomnia.¹⁹

Supplementing with melatonin, which may help if you have trouble sleeping. But sleep supplements’ effectiveness is debatable.²⁰ Be sure to speak with your doctor before trying any over-the-counter supplements.