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Insomnia - Causes, Risk Factors, Symptoms, and Management

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4 min read


Insomnia is a sleep disorder affecting numerous people worldwide. Read more about insomnia and its effective treatments below.

Written by

Dr. K. Shobana

Medically reviewed by

Dr. Kaushal Bhavsar

Published At September 5, 2022
Reviewed AtMarch 13, 2023

What Is Insomnia?

Insomnia is a sleep disorder affecting numerous people worldwide. People affected with insomnia face difficulty falling asleep and waking up earlier than they go to bed. Insomnia can cause daytime sleepiness, a general feeling of being unwell physically and mentally, mood changes, irritability, and anxiety. Along with these symptoms, insomnia increases the risk of developing chronic diseases like obesity, diabetes, cardiovascular disease, and depression.

What Are the Causes of Insomnia?

Various physical and psychological factors cause insomnia. The common causes are,

1) Getting too little physical exercise.

2) Having bad dreams during sleep.

3) Using recreational drugs.

4) The sleeping room being too hot or cold or the bed being uncomfortable.

5) Stress.

Some health disorders may also disturb sleep. The health disorders that disrupt sleep are,

  1. Sleep apnea.

  2. Gastrointestinal reflux disease.

  3. Chronic obstructive pulmonary disease.

  4. Restless leg syndrome.

  5. Overactive thyroid.

  6. Alzheimer’s disease.

Some medications such as Corticosteroids, Statins, Alpha-blockers, Selective serotonin reuptake inhibitors (SSRI), and Angiotensin-converting enzyme (ACE) inhibitors can cause insomnia in older people. Using devices with screens before bed also causes insomnia in young people.

What Are the Risk Factors of Insomnia?

Insomnia can occur at any age. The common risk factors are,

  1. Traveling across time zones.

  2. Working in shifts.

  3. Being older.

  4. Use of caffeine and medications.

  5. Having a family history of insomnia.

  6. Being pregnant or going through menopause.

  7. Having other health conditions.

What Are the Types of Insomnia?

Insomnia is classified based on the duration as transient insomnia, short-term insomnia, and chronic insomnia.

Transient insomnia lasts less than a month and does not recur. Short-term insomnia is otherwise known as acute insomnia or adjustment insomnia. Short-term insomnia is caused by a stressful event such as losing a loved one, a pandemic or rebounding from the cessation of a drug.

Short-term insomnia lasts less than three months, and symptoms may fade on their own as time passes. The affected person copes up with the stressful event that gives rise to sleeping problems.

In some cases, short-term insomnia remains persistent and results in chronic insomnia. Insomnia is considered chronic if people face difficulty sleeping for three nights per week for three months or longer.

Doctors classify insomnia as primary and secondary insomnia or comorbid insomnia based on the cause. Primary insomnia is a condition that occurs without any co-existing disease. Secondary insomnia occurs in conjunction with other medical conditions.

Based on the severity, insomnia is classified as mild, moderate, and severe. Mild insomnia occurs when the lack of sleep results in tiredness. Moderate insomnia and severe insomnia affect a person’s daily functioning.

Insomnia is also classified as sleep-onset insomnia, sleep maintenance insomnia, and early morning awakening insomnia based on the way insomnia is experienced.

Sleep onset insomnia occurs when a person faces difficulty falling asleep at the beginning of the night. Most people with this insomnia can't fall asleep even after spending 20 to 30 minutes in bed. A person with this insomnia has reduced total sleep time and can feel the effects of lack of sleep the next day.

Sleep maintenance insomnia describes the inability to stay asleep through the night. In this insomnia, the affected person wakes up at least once during the night and struggles to get back to sleep for 20 to 30 minutes. Both sleep quantity and quality are affected and create a high chance of developing daytime sleepiness. Early morning awakening insomnia occurs when a person wakes up in the morning before the planned time of waking.

What Are the Symptoms of Insomnia?

Apart from disturbed sleep, insomnia may also cause gastrointestinal problems, low energy, poor concentration, lack of coordination, worry or anxiety about sleep, tension headaches, difficulty in working and studying.

How to Diagnose Insomnia?

The diagnosis of insomnia is made by searching the cause through physical examination, sleep study, and sleep habits review.

1) Physical Examination:

When the cause of insomnia is unknown, the doctor may do a physical examination to look for other medical problems that may cause insomnia.

2) Sleep Habits Review:

The doctor documents a person’s sleep patterns, waking episodes, alcohol and caffeine intake in a sleep diary for one to two weeks before the next appointment to diagnose insomnia.

3) Sleep Study:

If the affected person experiences signs of another sleep disorder, the doctor recommends a sleep study to rule out the cause. Several tests monitor and record various body activities while a person sleeps.

What Are the Effective Methods to Treat Insomnia?

Behavior and lifestyle changes improve a person’s overall sleep quality. These changes do not cause any side effects as medications, and the improvement lasts longer.

1) Cognitive Behavior Therapy:

Cognitive behavior therapy controls negative thoughts and actions that make a person awake, so this therapy is considered the first line of treatment for people affected with insomnia. This therapy often focuses on pinpointing the anxieties of these people about sleep and replacing them with healthier beliefs and attitudes. This therapy also includes one or more of the following components.

2) Sleep Education and Hygiene:

The psychologist educates the patient about healthy sleep patterns and lifestyle habits. It also helps the patient to understand why they experience insomnia symptoms. Specifically, sleep hygiene focuses on improving sleep quality and quantity behaviors and eliminating behaviors that cause sleep problems.

3) Stimulus Control:

This method removes factors that condition the mind to resist sleep. For example, the affected person is trained to set a consistent bedtime and wake time. Using their bed only for rest, leaving the bed when they cannot sleep within 20 minutes and returning to bed when they feel tired.

4) Relaxation Techniques:

Muscle relaxation, biofeedback, meditation, and breathing exercise are some effective relaxation techniques that help in reducing insomnia. Practicing these techniques controls the breathing, heart rate, muscle tension, and mood of a person.

5) Sleep Restriction:

This therapy decreases the time spent in bed and avoids daytime naps, causing partial sleep deprivation. It makes a person feel tired the next night. Once the sleep improves, the time spent on the bed gradually increases.

Medications Prescribed for Insomnia:

Medications serve as the last resort for people affected with insomnia. The medicines prescribed are,

  1. Benzodiazepines.

  2. Nonbenzodiazepines.

  3. Melatonin agonists.

  4. Orexin receptor agonists.

  5. Antidepressants.

  6. Antipsychotics.

  7. Over-the-counter antihistamines.

Home Remedies for Insomnia:

Few home remedies help to manage insomnia.

a) Go to bed and wake up at the same time, every day,

b) Avoid using devices with screens before bedtime,

c) Avoid naps,

d) Avoid taking large meals and beverages before bed,

e) Make sure that the room is at a comfortable temperature before bedtime,

f) Find ways to relax,

g) Limit caffeine and alcohol intake at night time.


Sleep is a state of rest where an individual becomes physically inactive, unaware of the surrounding environment and other body functions. Sleep helps a person to maintain a healthy weight, lowers the risk of developing diabetes and heart disease, reduces stress, improves mood and coordination. People facing insomnia are unable to get these benefits of sleep. Diagnosing and treating insomnia early by consulting a psychologist helps manage insomnia soon to have a good sleep every day.

Frequently Asked Questions


What Is the Treatment for Insomnia?

The doctor can treat insomnia with lifestyle and behavioral changes to improve a person's sleep quality. These changes include relaxation techniques, cognitive behavior therapy, stimulus control, and sleep education given by an expert. In addition, the doctor prescribes certain medications like Benzodiazepines, antidepressants, antipsychotics, and antihistamines to treat severe insomnia patients.


How to Manage Insomnia Naturally?

Insomnia can be treated naturally with various behavior change therapies and home remedies. Psychologists provide behavior and lifestyle change therapies to educate the affected person about lifestyle changes and healthy sleep patterns. In addition, specific home remedies like waking up and sleeping at regular times, avoiding naps, and limiting alcohol and caffeine intake at night can also help treat insomnia naturally.


How Can a Person Relieve Stress and Insomnia?

People can relieve stress and insomnia by limiting their caffeine and alcohol intake at night. Also, maintaining a proper sleeping environment to cope with stress and avoiding taking frequent naps can treat insomnia. In addition, avoiding beverages and heavy meals at night can also improve sleep quality.


How Does Depression Cause Insomnia?

Depression and insomnia are interlinked. Insomnia is a symptom of depression, and a person suffers from a lack of sleep due to this mental illness. However, sleep disturbances or insomnia are not only caused by depression but can also have other underlying reasons. But depression is one of the reasons a person might suffer from insomnia or sleep deprivation.


How Does Dehydration Cause Insomnia?

Insomnia, or lack of sleep, is caused by dehydration, which can affect the sleep hormone in the body (melatonin). However, excess water does not necessarily promote healthy sleeping in a person. Also, symptoms of dehydration, such as frequent waking up due to thirst, can mainly cause insomnia in a person.


Does Chemical Imbalance Cause Insomnia?

Chemical imbalances can lead to depression, which further causes insomnia. A chemical imbalance occurs in the brain of a person, which causes anxiety and sleep disorders. The melatonin hormone released in the brain mainly causes insomnia.


Which Part of the Human Brain Controls Insomnia?

The hypothalamus is the part of the brain that controls insomnia in a person. It is located deep inside the brain and appears as a small, peanut-sized structure. This part of the brain regulates arousal, alertness, and sleep activity with the help of a group of nerve cells. Damage to the hypothalamus can cause sleep disturbances in a person.


What Happens to the Brain When a Person Has Insomnia?

Insomnia affects the normal functioning of a person’s brain due to sleep deprivation. Lack of sleep makes the person tired and weak and also compromises their ability to focus, thus affecting their mood and behavior. Severe insomnia can also cause mental illnesses such as depression, anxiety, and psychosis.


Which Body System Causes Insomnia?

Insomnia is caused by the central nervous system not getting enough sleep to function correctly. Sleep is essential for the central nervous system to process and send information to the brain. Therefore, sleep disorders or insomnia occur due to a person's mental conditions and poor sleeping habits.


How Does Insomnia Weaken the Immune System of a Person?

Insomnia causes a weakening of the immune system by decreasing the production of cytokines that fight infection. These cytokines usually increase in number during any inflammation or infection in the body. Therefore, insomnia leads to immune compromise in a person by reducing the cells and antibodies needed to fight infections.


How Does Infection Cause Insomnia?

Insomnia can be caused by certain infections in the body that occur due to bacteria,  parasites, and viruses. These agents can affect a person's central nervous system and lead to sleep disorders. The human immune system responds against infections and causes insomnia conditions in a person, or the direct action of these pathogens causes sleep disorders.


How Many Hours Does a Person With Insomnia Sleep?

An insomniac has no fixed hours; timings vary depending on sleep needs. For an average person, sleep hours are recommended to be at least seven to eight hours per day. Insomnia can keep a person awake or make them feel weak and tired. An insomniac finds it challenging to fall asleep even after being in bed for 20 to 30 minutes.


Does the Insomnia Condition Need Hospitalization?

A person is not usually hospitalized for insomnia but can be admitted if there is any underlying condition causing sleep disorders in the person. The expert should treat insomnia with non-pharmacological methods to avoid side effects and drug interactions.  Therefore, a person is only hospitalized if a lack of sleep causes harm to their health.


What Is the Initial Important Treatment for Insomnia?

The first important treatment for insomnia is cognitive behavioral therapy, which helps the person control their harmful actions and thoughts. The treatment is based on identifying the patient's anxieties related to sleep and imparting healthy attitudes and beliefs to them. Cognitive behavior therapy is mainly used to change the lifestyle habits of a person that cause insomnia or sleep-related disorders.


Is Insomnia a Mental Illness?

Insomnia is not a mental illness condition but can be a symptom caused by other medical conditions. However, insomnia is usually caused by mental illnesses that cause sleep disturbances. The medical conditions causing insomnia include schizophrenia, depression, and anxiety.
Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)


sleep disorderinsomnia
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