By Naomi Carr

Last updated: 08 April 2024 & medically reviewed by Morgan Blair

It is common for people to experience sleep disturbances, such as insomnia, which can be caused by several different health, environmental, and lifestyle factors. Symptoms of insomnia can cause several health complications if they continue long-term and may require professional treatments, such as medications and therapy

Key takeaways:

  • Persistent insomnia can lead to physical and mental health issues and impaired cognitive functioning, so it is important to seek treatment or advice.

  • Insomnia can be acute (lasting less than three months) or chronic (lasting longer than three months).

  • Sleep is restorative; impacting immunity, cognition, and resilience and adults require around 7-9 hours of sleep per night to maintain a healthy level of restoration.

  • Effective treatment approaches for insomnia will aim to manage the factors contributing to the development of symptoms, as this can often alleviate the issue.

Insomnia: Causes, Symptoms, and Treatment

What is insomnia?

Insomnia is a common sleep disorder that causes trouble falling or staying asleep. Symptoms of insomnia affect around a third of adults and can be caused or worsened by several different factors. [1]

Persistent insomnia can lead to physical and mental health issues and impaired cognitive functioning, so it is important to seek treatment or advice. Treatments for insomnia can include medications, therapies, natural remedies, and self-care techniques. [2]

What causes insomnia?

Insomnia can be caused by a variety of factors. Often, several contributing factors will occur in combination. Causes of insomnia can include: [3][4][5]

  • Mental health: It is common for insomnia to occur alongside a mental health condition, each contributing to and exacerbating issues. Mental health conditions commonly associated with insomnia include depression, anxiety, and stress-related conditions.

  • Physical health: Physical health conditions, both acute and chronic, can contribute to insomnia, including pain conditions, breathing conditions, acute illnesses such as cough and cold, and acid reflux.

  • Environment: Sleeping conditions can impact the risk of insomnia symptoms, including noise and light pollution and temperature.

  • Substances: Stimulant medications such as Adderall, illicit substances like cocaine, and legal substances caffeine, nicotine, and alcohol can all impact sleep quality and quantity. 

  • Lifestyle or career: Lifestyle and career choices or requirements can impact sleeping schedules and circadian rhythms. This can include working night shifts, traveling across different time zones, experiencing ongoing stress, frequently sleeping late or napping, and spending a lot of time looking at screens during the day or in the evening. 

  • Age: Age can impact sleep cycles and quality of sleep. For example, adolescents are more likely to be ‘night owls’, going to bed late and waking late, compared to adults. Also, older adults are more likely to experience poor quality of sleep and frequent awakenings in the night. 

  • Hormones: Hormonal changes can contribute to symptoms of insomnia, such as during menstruation, menopause, and pregnancy.

Types of insomnia

Insomnia can be acute (short-term) or chronic (long-term). Acute insomnia lasts for under three months and may involve a few nights of poor sleep per week. It is often caused by a life stressor, such as an upsetting circumstance or acute illness, and can improve without the need for intervention once the stressor has been alleviated. [2]

Chronic insomnia lasts for over three months and may involve several nights per week of sleep disturbances and ongoing daytime sleepiness. Symptoms can be severe and have a significant impact on functioning. Because of this, chronic insomnia can require professional intervention to treat. [6]

Symptoms of insomnia

Symptoms of insomnia can vary from person to person and may depend on the underlying cause. Common symptoms of insomnia include: [1][2][3]

  • Struggling to fall asleep at night 

  • Regularly waking up in the night

  • Waking very early in the morning unable to fall back to sleep

  • Feeling very tired throughout the day

  • Changes in mood, including irritability, low mood, and anxiety

  • Difficulty concentrating

  • Impaired social functioning

  • Poor performance at work

  • Physical pains, such as headaches and stomach pain

Is insomnia dangerous?

Acute insomnia, which lasts for under three months, is not usually dangerous. Although it can cause physical discomfort, changes in mental state, and impaired cognitive abilities, these symptoms are unlikely to result in severe or long-lasting effects and may be alleviated with self-care techniques and good sleep hygiene. [3]

However, chronic insomnia, lasting for several months, may increase the risk of several physical and mental health complications, which could be dangerous if left untreated. Adults require around 7-9 hours of sleep per night and sleep is restorative, impacting immunity, cognition, and resilience. Several months of reduced sleep can lead to severe impairments in these areas. [6]

It is important to note, however, that although chronic insomnia may increase health risks, worrying about these complications may in some cases be more harmful. It is important to seek professional advice to resolve sleep disturbances, as ongoing anxieties and stress around losing sleep will often worsen symptoms. [7]

Health complications of insomnia

Insomnia can lead to an increased risk of: [1][6][8]

  • Pain conditions

  • Diabetes

  • Obesity

  • Neurodegenerative diseases

  • Breathing-related conditions

  • Heart conditions

  • Stroke

  • Accidental harm caused by impaired functioning

Insomnia is also likely to worsen mental health issues. It is estimated that around 40% of people with insomnia have a co-occurring mental health condition, suggesting that mental health symptoms and insomnia symptoms can cause or exacerbate one another. [4][6]

Sleep disturbances are a common symptom of many mental health conditions, including depression, anxiety, and stress-related conditions. Similarly, insomnia symptoms can lead to a worsening mental state and increased risk of suicidal ideation. [6]

Diagnosis of insomnia

If insomnia symptoms are persistent and have an impact on professional, social, emotional, or cognitive functioning, it may be necessary to seek professional assessment and treatment. To diagnose insomnia, a doctor or sleep specialist will enquire about [1][5]

  • Physical and mental health history, including recent or current conditions

  • Medications or substances currently or recently being used

  • Lifestyle and current circumstances, such as work and home life, including any stressors or difficulties

  • Recent sleep patterns, how they have changed, what the current issues are, and the duration of sleep

It may be necessary to conduct a sleep study, in which the individual will sleep in a lab overnight where heart rate, movements, and sleeping times can be monitored so ongoing sleep disturbances can be better understood. [5]

These investigations will help the professional determine the severity of insomnia symptoms and what factors might be contributing to these symptoms.

Treatment for insomnia

Treatment for insomnia will vary depending on the underlying causes. Rather than just treating the symptoms of insomnia, effective treatment approaches will aim to manage the factors contributing to the development of these symptoms, as this can often alleviate the issue.[2]

Treatments for insomnia can include:[1][3][5]

  • Medications: Medications, such as sleeping tablets and minor tranquilizers, might be used short-term to help the individual get to sleep at night and restore a healthy sleep schedule. These medications, such as Ambien, Belsomra, and Lunestra are only used for a few days or weeks because they are habit-forming, have the potential for addiction and abuse, and should only be used when symptoms are severe. People currently taking medication might be offered a change in treatment if this is impacting their sleep.

  • Therapies: Behavioral therapies, such as cognitive behavioral therapy (CBT), can be used to help alter thoughts and behaviors around sleep, improving anxieties and harmful habits. Therapies can also be used to treat underlying mental health conditions that contribute to insomnia, such as depression, anxiety, and stress.

  • Physical health treatments: When insomnia is related to a physical health condition, treating these symptoms will likely improve sleep.

  • Sleep disorder clinics: Severe insomnia may require treatment within a sleep disorder clinic, where sleep can be monitored and treated using more intensive interventions, such as mild sleep deprivation, alongside medicinal and behavioral therapies.

Various self-care and sleep hygiene techniques can also be used to improve sleep, such as:[2][3]

  • Having a routine, including going to bed and getting up at the same time every day

  • Ensuring the bedroom is quiet and dark when going to sleep

  • Engaging in relaxing activities before bed, such as reading, meditation, or taking a bath

  • Engaging in physical exercise during the day

  • Avoiding daytime naps

  • Avoiding caffeine and alcohol before bed

  • Avoiding looking at screens (such as televisions and phones) before bed

  • Eating a healthy diet and staying hydrated

  • Utilizing breathing exercises, relaxation exercises, meditation, and yoga to improve symptoms of stress and anxiety