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What is Insomnia Disorder?

Insomnia is defined as having difficulty going to sleep or staying asleep. It is the most common sleep complaint. A diagnosis of “insomnia disorder” is based on one or more of the following symptoms:

  • Difficulty falling asleep.
  • Difficulty maintaining sleep, characterized by frequent awakenings or problems return to sleep.
  • Early-morning awakening with inability to return to sleep.

A diagnosis of insomnia disorder requires the following factors:

  • The sleep problems cause significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning.
  • The sleep difficulty occurs at least 3 nights per week and is present for at least 3 months.
  • The sleep difficulty occurs despite having adequate opportunity for sleep.
  • The insomnia is not better explained by another sleep-wake disorder (e.g., narcolepsy, a breathing-related sleep disorder, a circadian rhythm sleep-wake disorder, or parasomnia disorder).
  • The insomnia is not attributable to the physiological effects of a substance (e.g., a drug of abuse or medication), coexisting mental disorders, or coexisting medical conditions.

What causes Insomnia?

A brief period of insomnia is most often associated with anxiety, either in response to an anxious experience or in anticipation of an anxiety-provoking experience. In some persons, transient insomnia may be related to grief, loss, or almost any life change or stress.

Persistent insomnia involves anxiety that manifests as physical tension (somatization), apprehensive feelings, and/or ruminating thoughts.

Idiopathic insomnia, according to the American Sleep Association, is a form of chronic insomnia that lacks clear causes. It is theorized as being the result of neurochemical imbalances in the brain’s sleep system.

What are the treatments for Insomnia?

Pharmacological treatment
Primary insomnia is commonly treated with benzodiazepines, zolpidem, eszopiclone (Lunesta), zaleplon (Sonata) and other hypnotic medications. A variety of over-the-counter sleep aids are also available. Nonprescription formulas include sedating antihistamines, protein precursors, and other substances. Melatonin is a leader among self-administered supplements believed by some to alleviate sleeplessness. Melatonin is an endogenous hormone produced by the pineal gland, which is linked to the regulation of sleep.
Cognitive-Behavioral Therapy
Cognitive-behavioral therapy (CBT) as a treatment for insomnia uses a combination of behavioral and cognitive techniques to treat dysfunctional sleep behaviors, misperceptions, and distorted, disruptive thoughts about sleep. Behavioral techniques include universal sleep hygiene, stimulus control therapy, sleep restriction therapy, relaxation therapies.

Mental Health Library Sources:

Information included in all topics of the Mental Health Library comes from the Desk Reference to the Diagnostic Criteria From DSM-5 and Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry. Complete diagnostic and treatment information may be found within these publications.


Information within the Mental Health Library is not intended to be used for self-diagnosis purposes. Rather, it is provided as a public educational service to make people aware of mental health conditions. Please consult a qualified mental health professional for a diagnosis of any suspected mental health illness.

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