- A life crisis or stress, including the loss of a life partner, divorce, or loss of a job
- Environmental noise
- Extreme temperatures, such as a room that is too hot or too cold
- Change in the surrounding environment
- Sleep/wake schedule problems, such as those due to jet lag
- Heart disease
- Asthma or chronic obstructive pulmonary disease (COPD)
- Sleep apnea
- Gastroesophageal reflux disease (GERD) or ulcer
- Behavioral factors, including:
Certain medications such as:
- Allergy medication
- Blood pressure medication
- Psychiatric medication
- Difficulty falling asleep
- Waking up frequently during the night with difficulty returning to sleep
- Waking up too early
- Not feeling refreshed after sleep
- Daytime sleepiness
- Irritability, anxiety , and inability to concentrate
When Should I Call My Doctor?
|Monitored Breathing During Polysomnography|
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Treat Underlying Medical Conditions
Identify and Modify Behaviors That Worsen Insomnia
- Reduce or avoid caffeine, especially late in the day.
- Reduce or avoid alcohol and avoid drug use.
- Quit smoking. If you smoke, avoid doing so near bedtime.
- Avoid eating or drinking close to bedtime.
- Go to bed and wake up at the same time each day.
- If you must take naps, keep them short.
- Only use the bedroom for sleep or sex. Avoid watching TV or worrying in bed.
- Keep your bedroom at a comfortable temperature and dark. Minimize disruptions, such as pets.
- If you work at night and sleep during the day, make sure to block daylight from the room. Decrease the amount of noise. Use a fan to block out noise.
Herbal Therapies and Supplements
Cognitive Behavioral Therapy
- Minimize intake of caffeinated food and drinks after lunch.
- Avoid drinking alcohol.
- Avoid eating too fast or too much. Do not eat too close to bedtime.
- Avoid drinking fluids before bedtime.
- If you smoke, talk to your doctor about ways to quit.
- Exercise regularly, but not within less than 3 hours of bedtime.
- Use the bedroom only for sleep and sex. Do not use electronics or watch TV while in bed
- Schedule relaxing bedtime routines. Listen to quiet music or soak in warm water.
- Make sure that the bedroom is not too cold or too hot.
- Use a humidifier or dehumidifier as needed.
- Get sunlight during the day.
- Use shades or lined drapes; or wear an eye mask to reduce sleep disruption.
- Use earplugs or listen to relaxing music or white noise. This helps reduce the disturbing effects of noise.
- Make sure your mattress is supportive and the bedding is comfortable.
- Avoid "clock watching" after going to bed.
- Keep bedtimes and wake-times consistent throughout the week.
- If you cannot avoid naps, keep them short.
National Center on Sleep Disorders Research http://www.nhlbi.nih.gov
National Sleep Foundation http://www.sleepfoundation.org
Better Sleep Council Canada http://www.bettersleep.ca
Canadian Sleep Society http://www.canadiansleepsociety.ca
Insomnia in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 10, 2015. Accessed June 2, 2015.
Jacobs GD, Pace-Schott EF, et al. Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison. Arch Intern Med . 2004 Sep 27;164(17):1888-96. Available at: http://archinte.jamanetwork.com/article.aspx?articleid=217394. Accessed June 2, 2015.
Insomnia. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/insomnia.html. Updated Apirl 2014. Accessed June 2, 2015.
Morin CM, Vallieres A, et al. Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial. JAMA. 2009;301(19):2005-2015.
Sleep insomnia, lack of sleep. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/inso/. Updated December 13, 2011. Accessed June 2, 2015.
- Reviewer: Marcin Chwistek, MD
- Review Date: 06/2015 -
- Update Date: 05/11/2013 -