Insomnia: Sleep Better and Feel Better

Guide to insomnia causes, sleep hygiene, cognitive-behavioral treatment, and medication options.

10 min readLast updated: 2026-02-17

Quick Facts

Prevalence
30% of adults experience insomnia symptoms
Chronic
Insomnia occurs 3+ nights weekly for 3+ months
ICD-10
G47.0

Overview: Understanding Insomnia

Insomnia involves persistent difficulty initiating or maintaining sleep despite adequate opportunity, causing daytime consequences. Chronic insomnia affects 10-15% of adults. Sleep deprivation impairs cognitive function, emotional regulation, immune health, and safety .

Effective treatment—particularly cognitive-behavioral approaches—restores healthy sleep without long-term medication dependence.

Key Information
Insomnia includes sleep onset insomnia (difficulty falling asleep), sleep maintenance insomnia (frequent awakening), early morning awakening, and non-restorative sleep. Multiple factors often contribute: stress, anxiety, depression, medical conditions, medications, and poor sleep habits.

Common Causes

Stress, anxiety, and depression commonly trigger insomnia. Medical conditions (chronic pain, acid reflux, sleep apnea, hormonal changes) disrupt sleep. Medications, caffeine, alcohol, and nicotine affect sleep quality. Environmental factors (noise, light, temperature) impair sleep. Irregular sleep schedules and bedroom use for non-sleep activities worsen insomnia.

Cognitive-Behavioral Therapy for Insomnia (CBT-I)

Sleep restriction therapy consolidates fragmented sleep into solid blocks, increasing sleep efficiency. Stimulus control strengthens bed-sleep association. Relaxation training and mindfulness reduce racing thoughts. Cognitive therapy addresses sleep-related worries and beliefs .

Warning
Sleep deprivation impairs judgment, mood, and safety. Untreated insomnia increases depression, anxiety, and cardiovascular disease risk. Sleep apnea requires medical evaluation and specific treatment; insomnia treatment differs.
Clinical Note
Sleep hygiene improvements address modifiable factors: consistent sleep schedule, comfortable sleep environment, avoidance of screens pre-sleep, limiting caffeine/alcohol, and regular exercise. CBT-I is more effective than medications for long-term improvement. Medications provide short-term relief but carry dependence risk; combining with behavioral treatment enables eventual medication discontinuation.

Sleep Hygiene Practices

Maintain consistent sleep-wake times including weekends. Limit bed to sleep and intimacy. Keep bedroom cool, dark, and quiet. Avoid screens 1-2 hours before sleep. Exercise regularly but not close to bedtime. Avoid caffeine after 2 PM. Manage pre-sleep worry through journaling or meditation.

Sources

  1. [1]Riemann D et al.. "Insomnia: Pathophysiology and Clinical Approaches." Lancet, 2015.
  2. [2]Trinder J et al.. "Cognitive Behavioral Therapy for Insomnia: An Effective Alternative." Australian & New Zealand Journal of Psychiatry, 2017.

Medically reviewed by

Medical Review Team, Sleep Medicine

Last updated: 2026-02-17Sources: 2

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