sleep foundation


The National Sleep Foundation

Medically Reviewed by

The National Sleep Foundation

Written by

The National Sleep Foundation

Insomnia is difficulty falling asleep or staying asleep and is often considered chronic if it happens at least three nights per week for three months or longer.

Most of us have experienced brief periods of insomnia (also called acute insomnia). Almost everyone knows what it feels like to still be awake staring at the ceiling and wishing for sleep—this can happen when you travel and experience jet lag, or when you’re anxious and overwhelmed by life circumstances.

So how do you distinguish a normal, passing sleep problem from a more serious form of insomnia that requires treatment?

Symptoms of Insomnia

According to guidelines from a physician group, people with insomnia have one or more of the following symptoms:

  • Difficulty falling asleep
  • Difficulty staying asleep (waking up during the night and having trouble returning to sleep)
  • Waking up too early in the morning
  • Unrefreshing sleep (also called “non-restorative sleep”)
  • Fatigue or low energy
  • Cognitive impairment, such as difficulty concentrating
  • Mood disturbance, such as irritability
  • Behavior problems, such as feeling impulsive or aggression
  • Difficulty at work or school
  • Difficulty in personal relationships, including family, friends and caregivers

The duration of insomnia is important. Doctors consider insomnia chronic if it occurs at least three nights per week for three months or longer. At this point, your insomnia may be a behavioral pattern (for example, your nighttime routines do not cue your body for sleep, or your sleep schedule is out of sync with your biological clock), or it could be comorbid, meaning it is linked to another medical or psychiatric issue that needs to be addressed. Recently, researchers have begun to think about insomnia as a problem of your brain being unable to stop being awake. Your brain has a sleep cycle and a wake cycle—when one is turned on the other is turned off. Insomnia can be a problem with either part of this cycle: too much wake drive or too little sleep drive. Regardless of its cause, if insomnia has become a regular occurrence, talking to your doctor about treatment may be a good idea.

You may also want to consider whether and to what degree insomnia is affecting your life. If you feel fatigued or have low energy during the day and it gets in the way of your productivity and enjoyment of friends, family, or hobbies, that probably means you could benefit from talking to your doctor. If you’ve tried on your own to make adjustments to your sleep routines and it hasn’t worked, you may want to enlist the help of a sleep specialist.