Insomnia: What It Is, Why It Happens, and What to Do About It
Insomnia is more than just "bad sleep." It's a disorder with various types and causes. Here's how to recognize insomnia and when you need professional help.
It's three in the morning. You've been lying in bed for an hour. Your eyes are closed, but sleep won't come. Thoughts race. You look at the clock, count how many hours are left until you have to get up, and realize tomorrow will be tough. It's been like this every night for several weeks.
This is insomnia. Not just "poor sleep" – but a specific disorder with diagnostic criteria, causes, and treatment methods.
1. Diagnostic Criteria for Insomnia
Insomnia is diagnosed when there is:
- Difficulty falling asleep (>30 minutes), nocturnal awakenings, or early morning awakening without being able to fall back asleep
- This occurs at least 3 nights per week
- This interferes with daytime functioning (fatigue, reduced concentration, mood)
Acute insomnia: less than 3 months. Often linked to a specific stressor.
Chronic insomnia: more than 3 months. Often takes on "a life of its own" regardless of the initial trigger.
2. Types of Insomnia by Disturbance
- Difficulty falling asleep (sleep onset insomnia): you lie down — but don't fall asleep for a long time
- Nocturnal awakenings (sleep maintenance insomnia): you fall asleep, but wake up in the middle of the night
- Early morning awakening (early morning awakening): you wake up at 3–5 AM and can't fall back asleep
- Mixed: a combination of several forms
3. Causes of Insomnia
Insomnia rarely has a single cause. A common model is the "3 Ps":
- Predisposing factors: anxiety, tendency towards nervous system hyperarousal
- Precipitating factors: stress, illness, change in routine
- Perpetuating factors: dysfunctional beliefs about sleep, poor sleep hygiene, anxiety about insomnia
Chronic insomnia is primarily maintained by the third group of factors – even after the initial stressor has passed.
4. How Insomnia is Treated
CBT-I (Cognitive Behavioral Therapy for Insomnia) — the gold standard. More effective than sleeping pills in the long term. Includes:
- Sleep restriction
- Stimulus control
- Working with beliefs about sleep
- Relaxation techniques
Sleeping pills — for short-term relief in acute insomnia. For chronic insomnia, they are not recommended as primary treatment.
5. When to See a Doctor
If insomnia lasts longer than 3 weeks and interferes with your life, it's a reason to consult a specialist. Start with a general practitioner or a sleep specialist. Discuss your situation with our AI psychologist psybot.app. Read also: CBT for Insomnia.