Insomnia is a common sleep disorder characterized by persistent difficulty falling asleep, staying asleep, or waking too early and being unable to return to sleep. People with insomnia often feel that their sleep is unrefreshing or insufficient, even when they have had adequate opportunity and time for rest. The condition can be short-term (acute), lasting days or weeks, or long-term (chronic), persisting for three months or more.

The core nighttime symptoms of insomnia include:

• Sleep onset difficulty: Taking 30 minutes or longer to fall asleep after getting into bed.
• Sleep maintenance difficulty: Waking up one or more times during the night and struggling to fall back asleep.
• Early morning awakening: Waking up significantly earlier than planned with no ability to resume sleep.
• Resistance to sleep: Dreading bedtime or feeling anxious about the prospect of another poor night of sleep.

Insomnia also produces a range of daytime consequences. These commonly include fatigue, low energy, difficulty concentrating or remembering, mood disturbances such as irritability or sadness, and reduced motivation. Some people notice increased errors at work, difficulty maintaining social commitments, or strained relationships. Physical symptoms like tension headaches and gastrointestinal discomfort can also accompany chronic sleep loss.

A hallmark of insomnia that separates it from other sleep disorders is heightened cognitive and physiological arousal around sleep. Many individuals report a racing mind at bedtime, a sense of physical tension, or an inability to "shut off" despite feeling tired. Over time, the bedroom itself can become associated with wakefulness and frustration rather than rest.

Insomnia is diagnosed primarily through a clinical interview. A healthcare provider will ask about your sleep history, daily habits, medical history, and emotional health. According to the DSM-5, insomnia disorder is diagnosed when sleep difficulty occurs at least three nights per week for at least three months, causes significant distress or impairment, and is not better explained by another sleep disorder, medical condition, or substance use. Sleep diaries, in which you record bedtimes, wake times, and sleep quality over one to two weeks, are often used to identify patterns and contributing factors.

In some cases, a provider may recommend actigraphy (a wrist-worn movement sensor) or an overnight sleep study (polysomnography) to rule out other conditions such as sleep apnea or restless legs syndrome. Blood tests may also be ordered to check for thyroid problems or other medical issues that can interfere with sleep.

Cognitive Behavioral Therapy for Insomnia (CBT-I) is the gold-standard treatment recommended by the American Academy of Sleep Medicine and other leading organizations. CBT-I is a structured program, typically lasting four to eight sessions, that addresses the thoughts and behaviors maintaining insomnia. Key components include:

• Sleep restriction: Limiting time in bed to match actual sleep time, then gradually extending it as sleep efficiency improves.
• Stimulus control: Re-establishing the bed as a cue for sleep by getting out of bed when unable to sleep and using the bed only for sleep.
• Cognitive restructuring: Identifying and challenging unhelpful beliefs about sleep, such as catastrophizing about the consequences of a poor night.
• Sleep hygiene education: Guidance on environmental factors, caffeine intake, light exposure, and exercise timing.
• Relaxation training: Techniques such as progressive muscle relaxation, deep breathing, and guided imagery.

CBT-I has been shown to produce durable improvements that are maintained long after treatment ends. It is effective for insomnia that occurs on its own and for insomnia that accompanies other conditions like depression or chronic pain.

You should consider seeking professional help if your sleep problems have persisted for more than a few weeks, if they are affecting your ability to function at work or school, or if they are contributing to mood changes or relationship difficulties. Chronic insomnia rarely resolves on its own, and waiting often allows unhelpful sleep habits and negative thought patterns to become more entrenched.

It is especially important to consult a provider if you experience excessive daytime sleepiness that puts you at risk for accidents, if you snore loudly or have been told you stop breathing during sleep, or if you notice symptoms of depression or anxiety alongside your sleep difficulties. These signs may indicate co-occurring conditions that require their own evaluation and care.

The good news is that insomnia is highly treatable. Evidence-based approaches like CBT-I have strong success rates, and many people see meaningful improvement within a few weeks of starting treatment. Your primary care doctor, a sleep specialist, or a psychologist trained in behavioral sleep medicine can guide you toward the right next steps. For more information, consult the following resources:

• National Heart, Lung, and Blood Institute: Insomnia
• American Psychological Association: Insomnia
• Mayo Clinic: Insomnia Overview