What is insomnia?

Insomnia is being unable to fall asleep or stay asleep. Insomnia can affect not only sleep but also your everyday life. Around one third of Australians experience insomnia at some point in their lives, although only 5% will need professional treatment.

Insomnia usually lasts for a short time, although it can go on for months or even years. Women and elderly people are more likely to suffer from it.

Causes of insomnia

Why do some people sleep soundly no matter what happens and others find it impossible to sleep? Sometimes insomnia can occur for no obvious reason, but there are also several possible causes.

• Poor sleep habits (sleep hygiene) is the most common cause of insomnia. Having a regular sleep routine, pre-bedtime activities and bedroom surroundings can have a big influence on sleep.
• Substances, including caffeine, nicotine, alcohol, amphetamines and some prescription medicines can dramatically affect your ability to sleep.
• Stress, caused by work or financial problems, relationship issues or grief.
• Medical issues in particular conditions causing pain, hormone changes (e.g. hot flushes and night sweats during menopause), breathing, urinary or digestive problems.
• Mental health problems — insomnia can be a symptom of anxiety, depression or other disorders.
• Sleep disorders, including obstructive sleep apnoea, circadian rhythm disorders caused by irregular sleep patterns, restless legs syndrome and periodic limb movement.
• Life stage — elderly people are more likely to have insomnia.
• Shift work — people who work different shifts often don’t sleep as well as those who work set hours during the day.

Types of insomnia

There are several different types of insomnia:

• Acute (short term) insomnia is very common and lasts for a few days or weeks. It may be due to stress or life events and most people recover naturally.
• Chronic (long term) insomnia involves having at least 3 nights of bad sleep a week over a month or longer, and is often due to anxiety, other sleeping problems or even pregnancy.
• Primary insomnia refers to insomnia where no underlying cause can be identified.
• Secondary insomnia is due to an underlying cause such as a general health condition, anxiety, depression or sleep disorder.
• Delayed sleep phase syndrome (DSPS) refers to people who are ‘night owls’ and have long-term problems getting to sleep until the early hours of the morning. This may not be a problem for those who are able to sleep in, but it can cause chronic sleep deprivation in people who need to get up early.

Symptoms of insomnia

Insomnia can include any of the following:

• difficulty getting to sleep
• waking up during the night and having trouble going back to sleep
• waking up too early

Insomnia also causes a range of problems that can occur during the day, and can make it difficult to function normally. They include:

• difficulty waking at a normal time
• daytime sleepiness or fatigue (may not be present)
• poor concentration
• forgetfulness or making errors
• irritable or grumpy mood
• ‘sleep anxiety’ or worrying about lack of sleep
• anxiety or depression (these issues can also cause insomnia)
• tension headaches
• digestive symptoms

Keeping a sleep diary is a good way to track symptoms, which you can share with a healthcare professional.

Being overtired can increase the risk of someone making mistakes or having an accident. Research has shown that severe sleep deprivation can affect driving ability as much as alcohol.