Few experiences are more frustrating than lying awake at night while desperately wanting to fall asleep. Your body feels exhausted, but your mind refuses to settle. As the minutes tick by, it's easy to become increasingly anxious about how little sleep you're getting − and how much harder tomorrow is going to be as a result. That growing anxiety can then make it even harder to fall asleep, creating a vicious cycle in which poor sleep fuels even more sleeplessness.
As discouraging as insomnia like this can be, it may be helpful to know you're far from alone. In fact, "insomnia is the most common sleep disorder, with roughly 10% to 15% of adults experiencing chronic insomnia and up to 40% to 50% experiencing occasional symptoms," says Wendy Troxel,
a senior behavioral sleep scientist at the RAND Corporation.
Here's what insomnia is, what causes it and how it's typically treated.
What is insomnia?
Insomnia is a sleep disorder "that makes it difficult to fall asleep or stay asleep throughout the night, wake up too early or get good quality sleep despite having the opportunity to do so," explains Dr. Raj Dasgupta, a pulmonary and sleep specialist at Huntington Memorial Hospital in California.
He explains that the defining feature isn't simply getting too little sleep − it's that those nighttime difficulties lead to daytime consequences such as fatigue, trouble concentrating and reduced productivity and performance at school or work.
Over time, "chronic insomnia can also affect mood, memory, focus, energy, relationships and overall health," he adds. "People with chronic insomnia also have a twofold increased risk of depression and an increased risk of cardiovascular disease," Troxel notes.
While "a random bad night of rest is normal for most people," Dasgupta explains, chronic insomnia is generally diagnosed when symptoms occur at least three nights a week for three months or longer. He adds that diagnosis is usually "based on your sleep history, symptoms, medical history and how the sleep problem affects you during the day."
What causes insomnia?
Insomnia rarely has a single cause. Instead, it usually develops from a combination of biological, psychological and lifestyle factors.
Stress is among the most common triggers, Troxel says, whether it's related to work, finances, relationships or major life changes. "Anxiety and depression are also closely linked to insomnia," she adds, with each capable of worsening the other.
Physical conditions such as chronic pain, asthma, acid reflux, neurological disorders, sleep apnea and thyroid disease can also interfere with healthy sleep. "And perimenopause and menopause are significantly underrecognized triggers in women," Troxel says. She adds that medications such as certain antidepressants, stimulants, decongestants and corticosteroids can sometimes contribute as well.
Lifestyle habits also frequently play a role. For instance, Dasgupta says that consuming caffeine or alcohol too late in the day, keeping an irregular sleep schedule, working overnight shifts, taking frequent naps or spending time on phones and other bright screens before bed can all disrupt the body's natural sleep-wake cycle.
How is insomnia treated?
Regardless of the cause, the most effective long-term treatment for chronic insomnia isn't medication − "it's cognitive behavioral therapy for insomnia, or CBT-I," Dasgupta says. CBT-I is a structured program that helps people identify and replace the thoughts and behaviors that interfere with sleep while building healthier sleep habits and routines. It's so effective, in fact, that major sleep organizations usually recommend CBT-I as the first-line treatment because research consistently shows it produces lasting improvements without the risks associated with long-term use of sleep medications.
Other insomnia treatments and recommendations may include improving sleep habits such as maintaining a consistent bedtime and wake time, limiting caffeine and alcohol intake (especially later in the day), exercising regularly (though not immediately before bed), creating a cool, dark, quiet sleep environment and avoiding prolonged screen use before bedtime, Dasgupta notes.
Health care providers may also recommend sleep medications for short-term relief, but these are generally viewed as temporary tools rather than permanent solutions, explains Troxel.
Anyone whose sleep difficulties significantly affect daytime functioning, occur several nights a week for extended periods or are accompanied by unusual nighttime behaviors should seek medical evaluation rather than trying to manage the problem alone, advises Troxel.
"And," she adds, "you should also talk to a doctor if you have loud snoring, gasping in the night, restless legs, morning headaches or unexplained mood changes."
This article originally appeared on USA TODAY: Can't sleep? Here's what causes insomnia and how to treat it
