Insomnia can involve:

  • trouble getting to sleep
  • staying asleep
  • waking up too early

The Centers for Disease Control and Prevention (CDC) advises that most adults need at least 7 hours of sleep each night. But 1 in 3 American adults are not getting the recommended amount of sleep.

It leaves you tired and makes it difficult to function well during the day. Insomnia can be the cause or the result of other health problems, and it can affect anyone.

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Infographic by Alyssa Kiefer

Insomnia is a common problem. The American Academy of Sleep Medicine (AASM) reports that when it comes to insomnia among adults:

  • 30 to 35 percent have brief symptoms of insomnia
  • 15 to 20 percent have short-term insomnia lasting less than 3 months
  • 10 percent have a chronic insomnia disorder, which occurs at least 3 times per week for at least 3 months

A 2019 review article suggests that as many as 75 percent of adults ages 65 and older have symptoms of insomnia.

Research from 2014 demonstrated that about one-fifth of young and preadolescent children have symptoms of insomnia. Prevalence was highest among girls ages 11 and 12 years old.

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Infographic by Alyssa Kiefer

The National Institutes of Health (NIH) list these risk factors for insomnia:

  • Age. You’re more likely to have insomnia as you grow older.
  • Family history and genetics. Certain genes may affect sleep patterns.
  • Environment. Shift work, night work, and jet lag can affect the sleep-wake cycle as well as nighttime noise or light and uncomfortably high or low temperatures.
  • Stress. Worry raises the risk of insomnia. Worrying about not getting enough sleep can make it worse.
  • Sex. More women than men get insomnia, possibly due to hormonal changes. Pregnancy and menopause can also play a role.

Other lifestyle factors that increase the risk for insomnia include:

  • Changing your sleep routine often.
  • Being interrupted during sleep.
  • Taking long naps during the day.
  • Not getting enough exercise.
  • Using caffeine, alcohol, nicotine, or certain drugs.
  • Using electronic devices too close to bedtime.

In 2019, an AASM survey found that a primary culprit of sleep restriction is binge-watching TV. Of the 2,003 adults who answered the survey:

  • 88 percent lost sleep to watch multiple episodes of a TV or streaming series
  • 72 percent of adults ages 18 to 34 and 35 percent of those age 35 and older lost sleep to play video games
  • 66 percent lost sleep due to reading
  • 60 percent missed sleep to watch sports

Sleep disturbances can occur in response to major stressful events, such as natural disasters and violence or war.

The COVID-19 pandemic sparked a worldwide crisis that appears to have affected our sleep. A February 2020 study involving 5,641 adults living in China looked at the impact of the pandemic on sleep. Researchers found a 37 percent increase in clinical insomnia from before the pandemic to its peak.

In 2020, an observational study found that post-9/11 veterans are especially vulnerable to insomnia, with 57.2 percent screening positive for insomnia disorder.

There’s also a two-way relationship between sleep disorders and depression. About 90 percent of people with depression have sleep complaints such as insomnia, hypersomnia, sleep disordered breathing, or restless leg syndrome.

Lack of sleep, even in the short term, can negatively affect:

  • energy
  • mood
  • work or school performance
  • memory, concentration, and decision-making
  • safety

Per the NIH, insomnia can worsen health problems or raise the risk of developing conditions such as:

  • asthma
  • chronic pain
  • decreased immune response
  • heart problems
  • high blood pressure
  • mental health disorders such as anxiety and depression
  • metabolic syndrome, diabetes
  • overweight, obesity
  • pregnancy complications
  • substance use disorders

Research from 2019 suggests that insomnia in older adults increases the risk of cognitive decline and dementia.

A 2017 comparative analysis on the link between sleep duration and mortality found that when compared with someone who sleeps between 7 and 9 hours per night:

  • A person who sleeps on average less than 6 hours per night has a 13 percent higher mortality risk.
  • A person who sleeps between 6 and 7 hours per night has a 7 percent higher mortality risk.

These stats include all causes of death, including car accidents, strokes, cancer, and cardiovascular disease.

A recent study involving 487,200 people in China looked at insomnia risk over a period of about 10 years. Participants were an average age of 51 at the start of the study and had no history of stroke or heart disease.

Those who had three common insomnia symptoms (trouble falling asleep or staying asleep, waking too early, or trouble focusing during the day) were 18 percent more likely to develop stroke, heart attack, and similar diseases than those who didn’t have insomnia symptoms.

A 2011 survey involving 7,428 employed adults in the United States suggested an annual $63 billion lost in work performance due to insomnia.

A 2017 study projected the overall cost of insufficient sleep in United States at:

  • $299 billion to $434 billion in 2020
  • $330 billion to $467 billion in 2030

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Infographic by Alyssa Kiefer

Research from 2019 found that one-fifth of older adults are prescribed sleep medications.

Data from the CDC shows that about 4 percent of people ages 20 and over use prescription sleep aids, including 5 percent of women and 3.1 percent of men. Prescription medications for insomnia include:

  • benzodiazepine receptor agonists, such as:
    • estazolam
    • lorazepam
    • temazepam
    • triazolam
  • nonbenzodiazepine receptor agonists, including:
    • eszopiclone (Lunesta)
    • zaleplon (Sonata)
    • zolpidem (Ambien)
  • melatonin receptor agonists, such as ramelteon (Rozerem)
  • histamine receptor agonists, such as doxepin (Silenor)
  • orexin receptor agonists, including suvorexant (Belsomra) and lemborexant (Dayvigo)

Other medications, such as antidepressants, are sometimes prescribed off-label for treatment of insomnia.

That means a doctor prescribes a drug for a use that’s not approved by the Food and Drug Administration (FDA) because they judge that it is medically appropriate for their patient. And some nonprescription antihistamines and supplements, like melatonin, are used as sleep aids.

Prescription and nonprescription sleep aids and supplements can cause side effects and interact with other medications. Most are intended for short-term use.

Always speak with your doctor before taking them.

Cognitive behavioral therapy (CBT) is an effective first-line treatment for insomnia. CBT is a short-term therapy that can help you learn how to change your thoughts and behaviors to make sleep easier.

Other therapies for insomnia are:

  • talk therapy
  • relaxation or meditation
  • sleep education
  • sleep restriction therapy
  • stimulus control therapy
  • light therapy

Some healthy habits can make it easier to get to sleep and stay asleep. These include:

  • Going to bed at the same time every night and getting up at the same time every morning, if possible.
  • Keeping the bedroom cool, quiet, and free from artificial light sources, such as electronic devices.
  • Avoiding caffeine, alcohol, and tobacco in the evening and not eating a heavy meal in the hours before bedtime.
  • Getting regular exercise during the day but not within 5 or 6 hours of bedtime.
  • Avoiding afternoon naps.
  • Taking an hour before bedtime to wind down and relax.

If you have had symptoms of insomnia for 2 weeks and cannot get back on track, consider making an appointment with a primary care physician.

Insomnia can be both a symptom of and a cause of a variety of serious health conditions. Depending on your symptoms and physical examination, your doctor may refer you to a specialist to help get you the right treatment for your needs.