Insomnia – Symptoms and Causes

A person sitting on a bed


A baby lying on a bed

Insomnia is a sleep disorder where people have difficulty falling or staying asleep. It can be caused by many things, including stress, anxiety, medications, and health problems. Symptoms of insomnia include difficulty falling asleep, frequent wake-ups during the night, and feeling tired the next day. There are many treatments for insomnia, including Behavioral Therapy, Cognitive Behavioral Therapy, and medications.


A woman sitting on a bed

Insomnia is caused by many things. Some causes include stress, anxiety, depression, medications, caffeine, health problems such as sleep apnea or restless leg syndrome. Hormone changes in women can also cause insomnia. For children under 11 years old, the most common cause of insomnia is not being able to separate themselves from their parents to fall asleep. This kind of insomnia is called Separation Anxiety Disorder and typically goes away on its own when they get older. Other sleep disorders can arise from various neurological or cardiovascular diseases that may result in disturbed sleep patterns through either excessive somnolence or difficulty initiating and maintaining sleep.

Hormone deficiencies such as low thyroid hormone, high cortisol levels, increased progesterone levels, or low testosterone can cause insomnia because these hormones affect our ability to fall asleep at night. Thyroid hormone is necessary for regulating our body temperature which is needed for initiating sleep at night. Cortisol is responsible for managing stress and anxiety levels in the body which both can be disrupted if this hormone level drops off during the day or night time. Testosterone deficiency in men adversely affects sexual libido and physiological functions that can reduce the quality of sleep at night which can lead to a lack of sex drive, erectile dysfunction, and insomnia.

Psychophysiologic Insomnia:

One form of insomnia is psychophysiologic insomnia where has difficulty falling asleep due to tension or stress. This is typically treated by relaxation or cognitive therapy to reduce the body’s anxiety response and thus allow for a longer period of deep sleep.


Some symptoms of Insomnia are trouble falling asleep, waking up frequently during the night with difficulty falling back asleep, and sleeping less than desired.

Other symptoms can include:

An individual averagely spends 25% of their life in bed trying to fall asleep, but most people only spend 6-10 years asleep throughout their lifetime. The recommended hours of sleep an adult should get is between 7-9 hours daily, adults need more sleep than children and adolescents because they engage in more mental and physical activities throughout the day which requires rest during the night time when cellular restoration occurs.

Last for Days or Weeks:

Insomnia can last a few days to a few months in most cases and goes away on its own when an individual returns to a normal sleeping schedule even without treatment. People with chronic insomnia have difficulty falling asleep at night for longer than 30 days which is typically caused by a serious underlying health problem causing them to lose a large amount of sleep. Chronic insomnia is typically treated by behavioral therapy and medication to improve the individual’s sleeping patterns.


The most common treatments for insomnia are:

  • Behavioral Therapy
  • Medication

Behavioral therapies:

Behavioral therapies include the following: stimulus control therapy, sleep restriction therapy, relaxation techniques, and cognitive therapies. These therapies focus on changing people’s bedtime routines to promote better sleep at night and waking up earlier in the morning. Stimulus control therapy focuses on staying away from electronic devices before bedtime as their wavelengths of light suppress melatonin production resulting in poor sleep quality. Sleep restriction Therapy limits time spent in bed to reduce frustration with not being able to fall asleep quickly which improves sleep quality eventually if done correctly. Relaxation techniques include deep breathing exercises, progressive muscle relaxation exercises, yoga Nidra meditation, or guided imagery sessions. Cognitive therapies aim to change how people perceive the necessity of sleep and help them understand what factors influence their sleep quality.


Medications can also be used to treat insomnia depending on the intensity of symptoms as well as other conditions that may arise from it, especially if stress or anxiety is a factor. These medications include benzodiazepines, non-benzodiazepine hypnotics, melatonin receptor agonists, and off-label use of anticonvulsants such as gabapentin or pregabalin.


Insomnia can be a very frustrating experience and it is estimated that people spend 25% of their lives trying to fall asleep. The good news is that most cases of insomnia resolve themselves without any treatment within a few days or months. If insomnia persists for longer than 30 days, then it is classified as chronic and typically requires behavioral therapy and medication to improve sleep quality.

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