Insomnia

Insomnia is more than occasionally having a bad night. It means regularly having difficulty falling asleep, staying asleep, or getting back to sleep after waking, along with problems during the day.

Chronic insomnia generally means these problems occur at least three nights a week for three months or longer.

Waking During the Night

Waking up during the night does not necessarily mean something is wrong. Sleep tends to become lighter and more interrupted as we get older, and older adults commonly wake several times during the night.

The problem is often not waking up—it is being unable to get back to sleep or becoming anxious about being awake.

What Causes Insomnia?

Many things can interfere with sleep, including stress, pain, medications, caffeine, alcohol, depression or anxiety, restless legs, and sleep apnea.

Sometimes the original cause disappears but the insomnia continues.

A person may begin worrying about whether they will sleep, watching the clock, going to bed earlier, or spending more time in bed trying to catch up. Ironically, these efforts can make sleep more difficult.

The Insomnia Cycle

After several poor nights, bedtime itself can become associated with frustration and being awake rather than sleeping.

Thoughts such as “I have to get eight hours” or “Tomorrow will be terrible if I don't fall asleep soon” can increase alertness at exactly the time the brain needs to settle down.

Breaking this cycle is an important part of treating chronic insomnia.

CBT-I: The First-Line Treatment

Cognitive Behavioral Therapy for Insomnia (CBT-I) is recommended as the first treatment for chronic insomnia.

CBT-I does more than teach good sleep habits. It helps people change behaviors and thoughts that may be perpetuating insomnia and rebuild the association between bed and sleep.

Treatment may include adjusting the amount of time spent in bed, getting up when unable to sleep, maintaining a consistent wake time, and learning to worry less about occasional poor nights.

Sleeping pills can sometimes be useful, particularly for short periods, but they are generally not considered the best long-term solution for chronic insomnia.

The encouraging part is that insomnia is often treatable—even when someone has struggled with it for years.

Learn More

Videos

How Much Sleep Do You Really Need? - 19 Minutes

Dr. Nick Norwitz explains why sleep needs differ from person to person, how they change with age, and why how you feel and function during the day may be as important as the number of hours you sleep.

How to Fall Back Asleep in the Middle of the Night - 5 Minutes

Sleep specialist Michael Breus explains why waking during the night is common and offers practical techniques for settling the mind and getting back to sleep.

Organizations & Information