Insomnia: Why You Can’t Sleep and What You Can Do About It

Insomnia

Most people have trouble sleeping once in a while. Stress, schedule changes, illness, pain, medications, caffeine, or anxiety can all affect sleep. But when trouble falling asleep, staying asleep, or waking too early happens often, it may be insomnia.

Insomnia is more than “just being tired.” It can affect your energy, mood, focus, memory, work performance, appetite, and overall health. The good news is that many sleep problems can improve with the right routine, lifestyle changes, and medical guidance when needed.

What Is Insomnia?

Insomnia is a sleep disorder that makes it hard to fall asleep, stay asleep, or get good quality sleep even when you have enough time and the right setting for sleep. It can leave you feeling unrested during the day and may interfere with daily activities.

Insomnia may be short-term, such as during a stressful life event, or it may become chronic. Chronic insomnia is generally when sleep difficulty happens at least 3 nights per week and lasts for 3 months or longer.

Common Symptoms of Insomnia

Insomnia may look different from person to person. Symptoms may include:

• Difficulty falling asleep

• Waking up during the night

• Waking too early and not being able to fall back asleep

• Feeling tired even after sleeping

• Daytime sleepiness

• Trouble concentrating

• Irritability, anxiety, or low mood

• Worrying about sleep before bedtime

Poor sleep can also make anxiety, depression, pain, and stress feel worse. Insomnia can cause daytime sleepiness, trouble focusing, and changes in mood such as anxiety, depression, or irritability.

Common Causes of Poor Sleep

Sleep problems can be caused by many different factors, including:

• Stress or racing thoughts

• Anxiety or depression

• Irregular sleep schedule

• Shift work or night work

• Too much caffeine, especially later in the day

• Alcohol near bedtime

• Heavy meals close to bedtime

• Screen use before bed

• Pain or chronic medical conditions

• Frequent urination overnight

• Certain medications

• Menopause symptoms, such as hot flashes or night sweats

• Sleep apnea or snoring

• Restless legs symptoms

Because there are many possible causes, treatment should be based on the person - not just the symptom.

Is Medication Always Needed?

Not always. Many people improve with sleep routine changes and treatment of the underlying cause.

For long-term insomnia, cognitive behavioral therapy for insomnia, often called CBT-I, is usually recommended as a first treatment option. CBT-I is a structured 6- to 8-week approach that helps people fall asleep faster and stay asleep longer. It can be done in person, by phone, or online.

Sleep medication may be appropriate for some people, but it should be used carefully. Some medications can cause next-day drowsiness, falls, confusion, dependence, medication interactions, or worsening breathing problems in people with sleep apnea.

When to Seek Medical Care

You should consider a medical evaluation if:

• Trouble sleeping lasts more than a few weeks

• Sleep problems are affecting work, driving, mood, or daily function

• You feel anxious, depressed, or overwhelmed

• You wake up gasping, choking, or short of breath

• You snore loudly or someone has noticed pauses in your breathing

• You have restless legs or uncomfortable leg sensations at night

• You are waking frequently to urinate

• Hot flashes, pain, reflux, or medication side effects are disrupting sleep

• You are using alcohol, cannabis, or over-the-counter sleep aids to sleep

• You feel sleepy while driving

When Insomnia May Be an Emergency

Seek urgent help right away if you have:

• Thoughts of harming yourself or someone else

• Severe confusion

• Hallucinations

• Chest pain, severe shortness of breath, or fainting

• Severe depression, mania, or extreme agitation

• No sleep for several days with worsening mood, impulsivity, or unsafe behavior

If you are in crisis or having thoughts of self-harm, call or text 988 for the Suicide & Crisis Lifeline. If there is an immediate medical emergency, call 911 or go to the nearest emergency room.

Can Telehealth Help With Insomnia?

Yes, telehealth may be helpful for many adults with mild to moderate insomnia symptoms. During a virtual visit, your provider may review:

• Your sleep schedule

• Stress, anxiety, or mood symptoms

• Caffeine, alcohol, nicotine, and screen use

• Current medications and supplements

• Medical conditions that may affect sleep

• Snoring or possible sleep apnea symptoms

• Menopause symptoms, pain, reflux, or nighttime urination

• Safe treatment options and when testing or referral may be needed

Telehealth may not be appropriate if symptoms suggest a serious medical emergency, severe psychiatric symptoms, substance withdrawal, severe breathing problems, or another condition that needs immediate in-person care.

What This Means For You

Insomnia is common, but it does not have to be ignored. Better sleep often starts with a consistent routine, a calmer bedtime environment, and identifying what may be disrupting your sleep. If sleep problems are ongoing or affecting your daily life, medical guidance can help determine the next best step.

At Your Best Life Medical eClinic, we provide convenient telehealth visits for adults in Virginia when sleep concerns are appropriate for virtual care.

Having trouble sleeping? Schedule a telehealth visit today to discuss your symptoms and safe next steps.

Click Link to Schedule an Appointment

This information is for educational purposes only and does not replace medical advice, diagnosis, or treatment. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room. If you’re in crisis in the US, call or text 988.