Insomnia is one of the most common sleep disorders and leads to difficulty falling asleep, staying asleep, or getting back to sleep after waking, even when you have adequate sleep opportunity. There are several factors that can contribute to insomnia, and often more than one is involved.
Insomnia can be acute, meaning it lasts for a few days or weeks, or chronic, which occurs at least three nights a week for three months or longer.
When looking at what causes insomnia, we typically break it down into three categories: predisposing, precipitating, and perpetuating factors.
Predisposing factors are characteristics that make someone more likely to develop insomnia, such as being a woman or having a family history of insomnia. These factors increase risk but don’t necessarily mean someone will experience insomnia.
Precipitating factors are events or circumstances that initially trigger insomnia, such as significant stress, anxiety, illness, or major life changes.
Perpetuating factors are the habits and behaviors that keep insomnia going, even after the initial trigger has resolved. These can include spending excessive amounts of time in bed trying to sleep, maintaining an inconsistent sleep schedule, or regularly staying in bed awake for long periods.
Over time, people may also develop anxiety around sleep itself, worrying about whether they’ll fall asleep or how they’ll function the next day. This increases alertness and can make it even more difficult to sleep, creating a cycle of ongoing insomnia.
Maintaining a consistent wake time, establishing a relaxing bedtime routine, and avoiding spending excessive time awake in bed can all help improve sleep. However, for chronic insomnia, cognitive behavioral therapy for insomnia (CBT-I) is considered the first-line treatment. This structured therapy addresses the thoughts and behaviors that perpetuate insomnia and helps retrain the brain to associate the bed with sleep.
Dr. Angela Holliday-Bell, member of
Mattress Firm's Sleep Health PanelCitations:
https://www.nhlbi.nih.gov/health/insomnia/diagnosishttps://pmc.ncbi.nlm.nih.gov/articles/PMC7853203/https://pubmed.ncbi.nlm.nih.gov/27136449/