Insomnia

Insomnia, also known as sleeplessness, is a sleep disorder in which people have trouble sleeping.[1] They may have difficulty falling asleep, or staying asleep as long as desired.[9][11] Insomnia is typically followed by daytime sleepiness, low energy, irritability, and a depressed mood.[1] It may result in an increased risk of motor vehicle collisions, as well as problems focusing and learning.[1] Insomnia can be short term, lasting for days or weeks, or long term, lasting more than a month.[1]

Insomnia
Other namesSleeplessness, trouble sleeping
A drawing of someone with insomnia from the 14th century
Pronunciation
SpecialtyPsychiatry, sleep medicine
SymptomsTrouble sleeping, daytime sleepiness, low energy, irritability, depressed mood[1]
ComplicationsMotor vehicle collisions[1]
CausesUnknown, psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, others[2]
Diagnostic methodBased on symptoms, sleep study[3]
Differential diagnosisDelayed sleep phase disorder, restless leg syndrome, sleep apnea, psychiatric disorder[4]
TreatmentSleep hygiene, cognitive behavioral therapy, sleeping pills[5][6][7]
Frequency~20%[8][9][10]

Insomnia can occur independently or as a result of another problem.[2] Conditions that can result in insomnia include psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, menopause, certain medications, and drugs such as caffeine, nicotine, and alcohol.[2][8] Other risk factors include working night shifts and sleep apnea.[9] Diagnosis is based on sleep habits and an examination to look for underlying causes.[3] A sleep study may be done to look for underlying sleep disorders.[3] Screening may be done with two questions: "do you experience difficulty sleeping?" and "do you have difficulty falling or staying asleep?"[9]

Sleep hygiene and lifestyle changes are typically the first treatment for insomnia.[5][7] Sleep hygiene includes a consistent bedtime, a quiet and dark room, exposure to sunlight during the day and regular exercise.[7] Cognitive behavioral therapy may be added to this.[6][12] While sleeping pills may help, they are associated with injuries, dementia, and addiction.[5][6] These medications are not recommended for more than four or five weeks.[6] The effectiveness and safety of alternative medicine is unclear.[5][6]

Between 10% and 30% of adults have insomnia at any given point in time and up to half of people have insomnia in a given year.[8][9][10] About 6% of people have insomnia that is not due to another problem and lasts for more than a month.[9] People over the age of 65 are affected more often than younger people.[7] Females are more often affected than males.[8] Descriptions of insomnia occur at least as far back as ancient Greece.[13]