Insomnia
(Sleep Disorder · Trouble Sleeping · Sleep Problems)
In this condition factsheet:
The Facts on Insomnia
Insomnia can refer to difficulty getting to sleep, difficulty staying asleep, waking up early without being able to return to sleep, or a combination of the three. In order to be diagnosed with insomnia, sleep difficulty must occur at least 3 nights per week even though the opportunity for adequate sleep is available. It must also interfere with your life and functioning – for example, if you wake feeling unrefreshed or find yourself dozing during the day.
Insomnia is not defined based on how many hours you've slept, since the amount people need can vary from person to person. It is also normal to sleep less as you age. If you're sleeping less than you did when you were younger, it doesn't necessarily mean you have insomnia.
Insomnia is a very common medical complaint. About 10% of adults in Canada experience persistent insomnia, and an additional 20% to 25% report occasional insomnia. It is more common among women, older adults, shift workers, and people with medical conditions and mental health issues.
Causes of Insomnia
Insomnia usually has an underlying cause. Common causes of insomnia include:
- air travel, especially when travelling from west to east (jet lag)
- environmental disturbances such as noise, light and temperature
- exercise just before going to bed
- illegal drug use
- medical conditions such as gastroesophageal reflux, prostate enlargement, Parkinson's disease, Alzheimer's disease, and stroke
- medications such as decongestants, stimulants (e.g., methylphenidate*) and some antidepressants
- mental health conditions such as anxiety or depression
- nicotine, caffeine, and alcohol
- not being active enough during the day
- other sleep disorders such as sleep apnea and restless leg syndrome
- pain from arthritis or other medical conditions
- poor sleep habits
- shift work
- stress caused by work, family life, death or illness of a family member or friend, or financial difficulties
- watching TV or other screens late at night
Short-term insomnia (insomnia that lasts less than 3 months) is usually caused by temporary stressors such as changes in sleep environment (e.g., noise, light, and temperature), a stressful event (e.g., death or illness of a family member, job loss, surgery, divorce), travelling, and shift work. The insomnia often goes away when the stressor is resolved. Chronic insomnia, which occurs 3 or more nights a week, and lasts at least 3 months, is usually caused by factors such as medical illness, medication and mental health issues. Insomnia can also occur on its own.
Symptoms and Complications of Insomnia
Symptoms of insomnia can include:
- trouble falling asleep
- trouble staying asleep
- waking up too early in the morning and being unable to get back to sleep
- not feeling rested or refreshed when you wake up despite getting enough hours of sleep
- feeling tired and sleepy during the day
- feeling irritable or anxious
- headaches
- difficulty focusing or concentrating during the day
Staying up for several days in a row can produce symptoms like hallucinations, but few people with insomnia reach that stage. However, insomnia can often cause poor concentration, forgetfulness, and fatigue that negatively affects personal relationships as well as job and school performance. It can also result in a higher risk of accidents. People with insomnia are also more likely to suffer from depression and anxiety.
Worrying about not being able to get adequate sleep can often worsen the insomnia. It is important to get help in order to not get caught in this cycle.
