Everyone has a poor night of sleep from time to time. But if you have trouble falling or staying asleep on a regular basis, you may have insomnia.
At UPMC, we offer the latest treatments for insomnia, helping you get a good night's rest.
On this page:
What Is Insomnia?
Insomnia is a sleep disorder that occurs when you have trouble getting to sleep or staying asleep. It can cause short-term or long-lasting sleep problems that affect your ability to perform everyday activities.
What are the types of insomnia?
There are two types of insomnia, including:
- Chronic insomnia — Occurs when you have trouble sleeping at least three days per week for more than three months.
- Short-term insomnia — Occurs when you have trouble sleeping for less than three months, and often less than three times a week.
What causes insomnia?
Insomnia can have many causes, including:
Short-term insomnia causes
Stressful life events that may trigger a bout of short-term insomnia include:
- A divorce.
- An illness.
- The death of a loved one.
- The loss of a job.
Chronic insomnia causes
Stress and anxiety about not sleeping can further create a cycle of being unable to sleep, leading to chronic insomnia.
Other common causes of chronic insomnia include:
- An irregular sleep schedule — This includes shift work or travel.
- Poor sleep habits — Using electronics or drinking alcohol before bedtime.
- Mental health issues — Anxiety, depression, and bipolar disorder.
- Physical illness and pain — Either can disrupt sleep.
- Side effects from medicine — Blood pressure drugs, antidepressants, and stimulants may cause sleeplessness.
- Neurological problems — Alzheimer's disease may throw off the body's wake-sleep cycle.
- Other sleep disorders — Obstructive sleep apnea (OSA) and restless legs syndrome (RLS) often impact sleep.
Insomnia risk factors
Certain factors may increase your risk of insomnia, including:
- Age — The risk of insomnia rises with age.
- Genetics — If you have a family history of insomnia, you're more likely to have it.
- Sex — Women are at higher risk than men.
- Lifestyle — Factors such as shift work, drinking caffeine or alcohol near bedtime, or using electronics at night may increase your risk.
- Stress or worry — May cause racing thoughts that make it hard to fall or stay asleep.
- Medical and mental health disorders — Disorders such as, heart disease, asthma, depression, and anxiety raise the risk.
Complications of insomnia
Insomnia can cause other health problems and may affect your:
- Ability to concentrate.
- Memory.
- Mood.
- Motivation.
- Productivity.
Lack of sleep can also affect your reaction time, alertness, and movements, which can lead to accidents at home, work, school, or on the road.
How can I prevent insomnia?
You may not be able to prevent all causes of insomnia. However, you can take steps to reduce your risk by:
- Avoiding large meals, caffeine, nicotine, and alcohol at night.
- Creating a comfortable sleep environment.
- Establishing a relaxing bedtime routine.
- Following a sleep schedule.
- Incorporating exercise in your day.
- Limiting screen time before bed.
What Are the Signs and Symptoms of Insomnia?
Insomnia symptoms and signs include:
- Feeling grouchy or sleepy during the day.
- Feeling irritable or depressed.
- Having trouble focusing or paying attention during the day.
- Lack of motivation or initiative.
- Lacking energy throughout the day.
- Lying awake for a long time before you fall asleep.
- Memory lapses.
- Waking up often or being awake for much of the night.
- Waking up too early in the morning and not being able to get back to sleep.
- Worrying about not being able to sleep.
When should I see a doctor about my insomnia symptoms?
People with insomnia may have different degrees of symptoms. However, if sleepless nights are causing problems in your daily life, you should schedule an appointment with your doctor.
How Do You Diagnose Insomnia?
Your doctor may ask you to keep a sleep log for a week or two before your appointment. You'll need to keep track of what times you:
- Go to sleep and wake up.
- Drink caffeine or alcohol.
- Work out.
What to expect during your visit
During your appointment, your doctor will:
- Ask about your insomnia symptoms and how long you've had them.
- Talk about your sleep habits and lifestyle.
- Do a physical exam.
Tests to diagnose insomnia
There are no special tests to diagnose chronic insomnia. However, your doctor may order blood tests to rule out health issues that could affect your sleep.
Your doctor may also order a sleep study to make sure you don't have another sleep disorder such as:
- Sleep apnea.
- Leg movements.
- Rare behaviors while asleep, such as sleepwalking or hallucinations.
Insomnia prognosis
Insomnia is a treatable condition. Your health care provider can help you understand the cause of your insomnia and provide you with lifestyle recommendations and treatments to improve your sleep.
How Do You Treat Insomnia?
Our UPMC sleep medicine experts treat people with insomnia every day. We use the latest techniques and therapies to help you get quality sleep. With the right treatment, you can start getting restful sleep and feel like yourself again.
Your doctor will likely start with the most conservative treatment. Treatment options include lifestyle changes, therapy, and medications.
Lifestyle changes
Lifestyle changes to treat insomnia may include:
- Avoiding large meals, caffeine, nicotine, and alcohol at night.
- Creating a comfortable sleep environment.
- Establishing a relaxing bedtime routine.
- Following a sleep schedule.
- Incorporating exercise into your day.
- Limiting screen time before bed.
Cognitive behavioral therapy (CBT) for insomnia
Your doctor may suggest a six- to eight-week CBT plan to address unwarranted thoughts and beliefs about your sleep. CBT teaches you ways to:
- Adjust your sleep timing to your body's clock.
- Cope with stress about not being able to sleep.
- Increase your body’s natural need to sleep by staying awake longer, exercising, and getting more natural sunlight exposure.
Your CBT sessions may involve:
- Sleep restriction and compression — You and your doctor will figure out how much sleep you need and the best time to sleep. Then you work to reduce the time you spend in bed. The goal is not to restrict sleep, but to lessen the time you lie in bed awake.
- Sleep education and sleep hygiene — Your doctor may talk to you about how lifestyle choices affect sleep.
- Stimulus control — You may learn steps you can take to reduce anxiety about sleep. For instance, if you don't fall asleep after 20 minutes in bed, get up. Go read, meditate, or do another quiet activity. This will decrease your thoughts about not being able to sleep while in bed.
- Relaxation therapy — This can also help decrease anxiety surrounding sleep. You may learn breathing techniques, muscle relaxation, or meditation.
- Relapse prevention — Learning about triggers for recurrence of insomnia and how to cope/address triggers.
UPMC is the only adult sleep center in western Pennsylvania that offers CBT for insomnia. It's a novel alternative to sleeping pills with fewer side effects.
Medication to treat insomnia
Your doctor might prescribe medicines in addition to or as an alternative to CBT. Medications that may help your insomnia include:
- Benzodiazepines (BZDs) — FDA-approved psychoactive drugs for insomnia. Doctors usually don't prescribe BZDs long-term because they have a high potential for abuse.
- Nonbenzodiazepines — These drugs (Zolpidem is one) have less abuse potential than BZDs, but still require a prescription.
- Melatonin agonists — These medicines stimulate melatonin production, which helps you feel sleepy at night.
- Orexin receptor antagonists —These drugs help manage feelings of sleepiness and wakefulness.
- Antidepressants — Low doses of sedatives like trazodone and doxepin can be helpful.
Your UPMC sleep doctor will tailor your medication for your sleep problem based on:
- Drug costs.
- Potential side effects.
- The cause of your insomnia.
- Your medical history.
- Your preferences.
Why Choose UPMC for Insomnia Care?
When you choose UPMC for insomnia care, you will receive:
- Access to board-certified specialists — Our sleep medicine specialists are experienced in caring for people with all types of sleep disorders, including insomnia.
- Expert diagnosis and personalized care — Our team will develop a customized treatment plan to reduce your risk of side effects and improve your quality of life.
- A full range of treatment options — UPMC is the only adult sleep center in western Pennsylvania that offers CBT for insomnia. It's a novel treatment that can be used as an alternative to or alongside sleeping pills to improve sleep quality.
