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Conditions InDepth: Insomnia

Insomnia is defined as inadequate or poor-quality sleep despite having adequate time to sleep. Insomnia may take the form of difficulty falling asleep, or middle-of-the-night or early-morning awakening. It may be a short-term problem or occur more often over a long period of time. It becomes more common as you get older.

Over the course of a year, about one third to half of adults experience some level of insomnia. About 10%-15% have more severe or chronic insomnia. It may cause problems during the day, such as tiredness, a lack of energy, difficulty concentrating, and irritability.

Insomnia is not a disease. Instead, it is a result of a behavior or a symptom of an underlying mental or physical problem. There are many causes of insomnia.

Short-term insomnia is often due to temporary situations. It generally occurs in people who are experiencing one or more of the following:

  • A life crisis or stress
  • A change in the sleep environment, including factors such as noise, light, or temperature
  • Sleep/wake schedule problems, such as those due to jet lag or temporary shift work
  • Side effects of medication

Chronic insomnia often results from a medical condition. They may include:

Chronic insomnia may also be due to behavioral factors. These include:

  • Misuse of nicotine, caffeine, alcohol, or other substances
  • Disrupted sleep/wake cycles from shift work or other nighttime activity schedules
  • Chronic stress

For some people, insomnia is aggravated by:

  • Expecting to have difficulty sleeping and worrying about it
  • Excessive napping in the afternoon or evening
What are the risk factors for insomnia?What are the symptoms of insomnia?How is insomnia diagnosed?What are the treatments for insomnia?Are there screening tests for insomnia?How can I reduce my risk of insomnia?What questions should I ask my doctor?What is it like to live with insomnia?Where can I get more information about insomnia?

Revision Information

  • Buysse DJ. Insomnia. JAMA. 2013;309(7):706-716.

  • Can't sleep at night? National Sleep Foundation website. Available at: Accessed March 2, 2016.

  • Insomnia in adults. EBSCO DynaMed website. Available at: Updated January 27, 2016. Accessed March 2, 2016.

  • Merrigan JM, Buysse DJ, Bird JC, Livingston EH. JAMA patient page. Insomnia. JAMA 2013;309(7):733.

  • What is insomnia? National Heart, Lung, and Blood Institute website. Available at: Updated December 13, 2011. Accessed March 2, 2016.