What Is Insomnia?

Jun 13, 2024
Fact Checked
Insomnia is a sleep disorder that affects nearly 30% of Americans. Learn the causes and treatment options for insomnia.
Written by: Emily Breaux
Medically Reviewed by: Suzanne Gorovoy, PhD

Key takeaways

Lori B., age 63, lay in bed, ready to go to sleep. It was 10:30 p.m., her regular bedtime, but she couldn’t relax. The Metairie, Louisiana, resident tossed and turned for hours but didn’t fall asleep until almost 3 a.m. “I was exhausted, but I couldn’t sleep,” she said. “I would lie there thinking, Should I do something? Should I get up? But I didn’t have the energy. It was very aggravating.” 

Lori explained that she began experiencing insomnia episodes in her 50s, and the episodes had always been the same. “Whenever I have insomnia, I can’t fall asleep,” she said. “I know some people wake up in the middle of the night and can’t go back to sleep, but for me, I can’t fall asleep.” 

Insomnia is a common sleep disorder, affecting nearly 30% [1] Roth T. Insomnia: Definition, Prevalence, Etiology, and Consequences. Journal of Clinical Sleep Medicine. Nov. 14, 2019. Found on the internet at https://jcsm.aasm.org/doi/10.5664/jcsm.26929 of the world’s population and up to an estimated 75% of older adults [2] Nguyen V., et al. Insomnia in Older Adults. Current Geriatrics Reports. Oct. 22, 2019. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731454/ in the United States. Because sleep significantly impacts our health, sleep disruptions can put us at risk for a number of health issues. 

“Sleep accomplishes many essential biological functions in the brain and body that do not occur effectively while we’re awake,” said Chelsie Rohrscheib, a neuroscientist and head sleep expert with the sleep testing platform Wesper. 

“The damage from sleep loss compounds over time and impacts health,” said Rohrscheib. “Sleep loss is associated with increased stress and directly impacts the areas of the brain that control emotion, making us prone to depression and anxiety.”. 

What is insomnia?

Insomnia is a broad term that refers to trouble falling asleep, staying asleep, or waking up too early and being unable to get back to sleep. Insomnia doesn’t have one main cause. Instead, many health and lifestyle factors can cause insomnia

Insomnia is common, with multiple studies showing 10–30% of people worldwide experiencing the sleep disorder [3] Bhaskar S., et al. Prevalence of Chronic Insomnia in Adult Patients and Its Correlation with Medical Comorbidities. Journal of Family Medicine and Primary Care. Oct.-Dec. 2016. Found on the internet at https://journals.lww.com/jfmpc/fulltext/2016/050 . And older adults have even higher rates of insomnia. If we have occasional sleepless nights, it doesn’t automatically mean we have insomnia. Having trouble falling or staying asleep is classified as insomnia when it occurs consecutively, whether it’s occasional short-term insomnia or chronic insomnia. The National Institute of Health defines short-term and chronic insomnia as the following [4] What Is Insomnia? National Heart, Lung, and Blood Institute. March 2022. Found on the internet www.nhlbi.nih.gov/health/insomnia

Fortunately, nearly 72% of people who experience short-term insomnia recover without developing long-term insomnia [5] Vargas I., et al. Acute and Chronic Insomnia: What Has Time and/or Hyperarousal Got to Do With It? Brain Sciences. Jan. 29, 2020. Found on the internet at https://www.mdpi.com/2076-3425/10/2/71 , but without treatment, it can worsen [6] Yale Medicine. Insomnia. Found on the internet at https://www.yalemedicine.org/conditions/insomnia . Early treatment is the key to preventing it from becoming a chronic condition.

What are the causes of insomnia? 

Insomnia can be triggered by our health, environment, and lifestyle—there isn’t one specific cause.

Health risks for insomnia

Certain health characteristics can increase your risk of insomnia. Some causes can’t be prevented, such as age and genetics, but that doesn’t mean you’re guaranteed to develop insomnia.

Here are common physical conditions that may increase your risk of insomnia: 

Lifestyle risks for insomnia 

Your daily choices and experiences can also disrupt your sleep at night. The following lifestyle and environmental factors may result in insomnia: 

What are the symptoms of insomnia? 

Insomnia episodes can vary for each person, but the effects of poor, disrupted sleep generally look the same for everyone. Typical symptoms include: 

“Chronic insomnia causes chronic sleep deprivation,” said Rohrscheib. “This has many negative effects on health, including an increased risk for many dangerous diseases, such as cardiovascular disease, stroke, diabetes, dementia, cancer, and mental health disorders.” 

 Insomnia in older adults

We’re more likely to develop insomnia as we age, but why is that? A strong relationship can be seen between sleep and aging, with biological and lifestyle changes influencing our sleep patterns. 

“The area of the brain that controls sleep declines as we age, which affects our ability to fall asleep and stay asleep,” Rohrscheib explained. “It also impacts our circadian rhythm, our 24-hour internal biological clock that controls the time of day you are awake and asleep.” 

According to Rohrscheib, other reasons insomnia is more prominent in older adults include:

“Frequent nighttime urination is another common sleep disruptor for older adults,” said Suzanne Gorovoy, PhD, EdM, clinical psychologist and behavioral sleep medicine specialist with the University of Arizona College of Medicine. “This is especially prevalent in older adult males due to prostate enlargement.”

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Warning

Retirement is a celebratory milestone for many older adults, but this major lifestyle change may come with schedule and sleep disruptions. Research shows that no longer having a set work schedule can lead to insomnia for some people [16] Patel D., et al. Insomnia in the Elderly: A Review. Journal of Clinical Sleep Medicine. June 15, 2018. Found on the internet at https://jcsm.aasm.org/doi/10.5664/jcsm.7172 . An unstructured day may throw off mealtime and bedtime routines, which help regulate our circadian rhythm.

Although we’re more likely to develop insomnia with age, it isn’t an inevitable part of aging. Treatment options are available to manage symptoms and help support restorative, healthy sleep. 

 Insomnia treatment options

Possible insomnia treatment options include lifestyle changes, talk therapy, and medication. Not sure where to begin? Start small by establishing healthy sleep habits with these sleep hygiene tips.  

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On top of adopting healthy sleep habits, upgrading to an adjustable bed may help promote better sleep. Adjustable beds can help reduce pain and snoring, as well as relieve symptoms of conditions like acid reflux.

Establishing healthy sleep habits may help curb disruptions for some sleepers, but others may need more guided, structured treatment for insomnia.

 Cognitive behavior therapy for insomnia 

Cognitive behavior therapy for insomnia (CBT-I) is a popular treatment. CBT-I involves both behavioral and cognitive therapy centered on positive changes in both thinking and behavior and is recommended as the first treatment option for sleep disruptions before medical interventions like drugs and sleep aids are prescribed.  

Research shows that older adults with insomnia and depression benefitted from CBT-I and had significantly fewer symptoms at a 20-week follow-up visit [20] Sadler P., et al. Cognitive Behavior Therapy for Older Adults with Insomnia and Depression: A Randomized Controlled Trial in Community Mental Health Services. Sleep. August 2018. Found on the internet at https://academic.oup.com/sleep/article/41/8/zs

CBT-I aims to help patients recognize the root causes of their insomnia. Patients work with a licensed provider who has completed formal training in CBT-I to implement behavioral changes and habits to support better sleep. 

“Cognitive behavioral therapy for insomnia includes psychoeducation on sleep, sleep restriction, stimulus control, and helping people manage their anxiety relating to sleep,” said Shmaya Krinsky, doctor of psychology and founder of Anxiety and Behavioral Health Psychotherapy in New York. “Sleep restriction is a tool that helps increase the client’s sleep efficiency by helping them stay in bed for only times that they can actually sleep, rather than lying in bed for hours not sleeping.”

“Stimulus control is reducing all of the negative behaviors around sleep, such as screen time, exercise, using their bedroom for other activities that may distract from sleep, caffeine in the evening, and others,” said Krinsky.

“Finally, we treat the client’s negative associations related to sleep so that they can become more confident in their ability to sleep and reduce their negative thoughts and emotions that may have developed relating to sleep.”

 Insomnia medication and supplements

Behavioral changes and sleep modifications are popular first-round treatment options for insomnia, but some health care providers may recommend medication or supplements to help manage the problem. Medications and supplements should always be paired with healthy sleep habits—they aren’t a substitution for good sleep practices. While supplements can be helpful for some people, they are not intended to treat long-term sleep problems.

Bottom line

Insomnia can happen to anyone at any stage of life. Still, the typical biological and lifestyle changes associated with aging make it more likely for older adults to develop this sleep disorder. If you experience insomnia for more than three months, it’s considered chronic. 

Because high-quality sleep is crucial for our physical and mental health, we recommend speaking with your health care provider if you have insomnia. Your provider will discuss the best treatment options according to your lifestyle, current health conditions, and preferences. 

Have questions about this article? Email us at reviewsteam@ncoa.org.

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Sources

  1. Roth T. Insomnia: Definition, Prevalence, Etiology, and Consequences. Journal of Clinical Sleep Medicine. Nov. 14, 2019. Found on the internet at https://jcsm.aasm.org/doi/10.5664/jcsm.26929
  1. Nguyen V., et al. Insomnia in Older Adults. Current Geriatrics Reports. Oct. 22, 2019. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731454/
  1. Bhaskar S., et al. Prevalence of Chronic Insomnia in Adult Patients and Its Correlation with Medical Comorbidities. Journal of Family Medicine and Primary Care. October-December 2016. Found on the internet at https://journals.lww.com/jfmpc/fulltext/2016/05040/prevalence_of_chronic_insomnia_in_adult_patients.8.aspx
  1. What Is Insomnia? National Heart, Lung, and Blood Institute. March 2022. Found on the internet www.nhlbi.nih.gov/health/insomnia
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Emily Breaux headshot
Emily Breaux Author
Emily Breaux is a writer with a background in education. She has written on multiple health care and technology topics, as well as for the higher education and hospitality industries. She specializes in medical alert systems and enjoys writing about hearing aids, health insurance, and wellness topics specifically for older adults.
Suzanne Gorovoy Medical Reviewer
Suzanne Gorovoy is a clinical psychologist, behavioral sleep medicine specialist, and member of the Sleep and Health Research Program at the University of Arizona College of Medicine. She received her graduate degree in School Psychology from Teachers College at Columbia University, her PhD in Clinical Psychology from Case Western Reserve University, and completed a postdoctoral fellowship in Behavioral Sleep Medicine at the University of Arizona College of Medicine.
Susan Stiles
Susan Stiles Reviewer
Susan Stiles, PhD, provides leadership in the design and development of consumer products that inspire, educate, and activate older adults. She’s been instrumental in bringing the Aging Mastery Program® to market and scaling it nationwide via strategic alliances and business partnerships. Stiles has 20+ years of experience in design thinking, multimedia, strategic communications, and management consulting.
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