Insomnia is defined as trouble falling asleep or staying asleep. It is very common and affects one in three American adults. Insomnia can occur in people of all ages, usually just for a night or two, but sometimes for weeks, months, or even years. Insomnia is most common among women and older adults.

Types of Insomnia

Transient Insomnia: The inability to sleep well for a period of a few nights, which lasts less than four weeks. This type of insomnia is usually brought on by excitement or stress. Children may experience it before the first day of school or a big test, while adults may sleep poorly before an important meeting or after an argument with a family member or friend. Exercising too close to bedtime can also be a cause for this type of insomnia.

Short-Term Insomnia: Insomnia that lasts from four weeks to six months. Generally this type of insomnia is brought about by periods of ongoing stress, and when the stressful situation gets better, or the person adjusts to the stress, the sleep returns to normal.

Chronic Insomnia: Poor sleep every night or most nights for more than six months. More than 20 million Americans suffer from this insomnia.

Causes of Insomnia

  • Psychological factors such as vulnerability to insomnia and persistent stress can impact your ability to sleep well.
  • Lifestyle habits such as use of stimulants or alcohol during the day, following erratic hours or misusing sleeping pills may cause or worsen insomnia.
  • Environmental factors such as noise and light may be keeping the body from getting a good night's sleep.
  • Other physical or psychiatric illnesses.

What to Do

If you suffer from insomnia, there is help available. See your health care provider or come see one of our board certified sleep specialists who can help you identify the type of insomnia you have as well as help you find the cause. You can also try to follow good sleep habits, including following the guidelines below.

Sleeping Well Guidelines

  • Get up about the same time every day
  • Go to bed only when sleepy
  • Establish relaxing pre-sleep rituals, such as a warm bath, light bedtime snack, or 10 minutes of reading
  • Exercise regularly. Confine vigorous exercise to early hours, at least six hours before bedtime, and do mild exercise at least four hours prior to bedtime.
  • Keep a regular schedule. Regular times for meals, medications, chores, and other activities help keep the inner clock running smoothly.
  • Avoid ingestion of caffeine within six hours of bedtime. Don't drink alcohol, especially when sleepy. Even a small dose of alcohol can have a potent effect when combined with tiredness.
  • Avoid smoking close to bedtime.
  • If you must nap, try to nap at the same time every day; mid-afternoon is the best time for most people.
  • Avoid sleeping pills, or use them conservatively. Most doctors avoid prescribing sleeping pills for periods longer than three weeks.
  • Do not drink alcohol while taking sleeping pills.


It is important to remember that not getting 8 hours of sleep every night does not mean you are putting your health at risk. Different people have different sleep needs. Some people do fine on 6 hours of sleep a night. Others only do well if they get 10 to 11 hours of sleep.

Treatment often begins by reviewing any drugs or medical conditions that may be causing your insomnia or making it worse.

Thinking about any lifestyle and sleep habits that may be affecting your sleep is an important next step. This is called sleep hygiene. Making some changes in your sleep habits may improve or solve your insomnia.

Using medicine to treat insomnia can sometimes be useful, but there can be risks.

  • Antihistamines (the main ingredient in over-the-counter sleeping pills) may cause memory problems over time, especially in the elderly.
  • Only use sedatives under the close care of a doctor, because they can cause tolerance and sometimes dependence. Stopping these medications suddenly can cause rebound insomnia and withdrawal.
  • Lower doses of certain antidepressant medicines may help. These medicines do not carry the same problems with tolerance and dependence as sedatives.

It may help to see a psychiatrist or other mental health provider to test for a mood or anxiety disorder that can cause insomnia.

  • They may use talk therapy, such as cognitive-behavioral therapy, to help you gain control over anxiety or depression.
  • A psychiatrist may also prescribe antidepressants or another medicine to help your sleeping problem and any mood or anxiety disorder you might have.
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