Insomnia
Insomnia (PDF, 146 KB)
Insomnia (PDF, 146 KB)
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Insomnia is one of the most commonly reported sleep problems. One in four women has some insomnia symptoms, such as trouble falling asleep, trouble staying asleep, or both.1 About one in seven adults has chronic (long-term) insomnia.2 Chronic insomnia can affect your ability to do daily tasks like working, going to school, or caring for yourself. Insomnia is more common in women, especially older women, than in men.
Insomnia is a common sleep disorder. It is defined as an inability to go to sleep, waking up too early, or feeling unrested after sleep for at least three nights a week for at least three months. Most adult women need to get seven or more hours of sleep a night to feel rested.3
Chronic or long-term insomnia makes it difficult to accomplish routine tasks like going to work or school and taking care of yourself. Insomnia can lead to or contribute to the development of other health problems, such as depression, heart disease, and stroke.
There are two types of insomnia:
The exact cause of primary insomnia is unknown. It may be lifelong, or it can happen because of changes in your routine during travel or stressful life events.
Conditions that may trigger or happen at the same time as secondary insomnia include:
Talk to your doctor or nurse if you think another health problem could be causing insomnia.
Other things that can keep you from getting enough sleep include:
Anyone can get insomnia, but it affects more women than men. More than one in four women in the United States experience insomnia, compared with fewer than one in five men.1 In one study, women of all ages reported worse sleep quality than men, including taking longer to fall asleep, sleeping for shorter periods of time, and feeling sleepier when awake.7,8
Older women are at a higher risk of insomnia. Other people at risk for insomnia include those who:9,10
Women may be more likely to have insomnia than men because women experience unique hormonal changes that can cause insomnia symptoms. These include hormonal changes during:
Also, some health problems that can cause secondary insomnia are more common in women than in men. These include:
It depends. Insomnia can be acute (short-term) or chronic (long-term). While acute insomnia may last for only a few days or weeks, chronic insomnia can last for three months or more.16
The most common symptom of insomnia is difficulty sleeping — either going to sleep, staying asleep, or waking up too early. If you have insomnia, you may:
Lack of sleep may cause other symptoms during the daytime. For example, you may wake up feeling tired, and you may have low energy during the day. It can also cause you to feel anxious, depressed, or irritable, and you may have a hard time concentrating or remembering things.
Insomnia can cause you to feel tired, anxious, or irritable in the short term. Over time, lack of sleep may increase your risk for more serious problems, including:
Women who have long-term insomnia may be more at risk than men with long-term insomnia for mood problems, heart disease and stroke, and obesity.18
To find out if you have insomnia, your doctor will do a physical exam and ask you about your symptoms, daily habits, and stress levels.
Your doctor may also:
You can also get a diagnosis from a doctor who specializes in sleep medicine. Find a sleep medicine doctor near you.
If your insomnia is caused by a short-term change in your sleep/wake schedule, such as with jet lag, your sleep schedule will probably return to normal on its own.
Chronic or long-term insomnia can be treated with steps you can try at home to sleep better, cognitive behavioral therapy (CBT), and prescription medicines.
If insomnia is a symptom or side effect of another health problem, your doctor may recommend treating the other health problem at the same time. When the other health problem is treated, secondary insomnia often goes away on its own. For example, if menopause symptoms, such as hot flashes, are keeping you awake, your doctor might try treating your hot flashes first. Research suggests that older women who use hormone replacement therapy, eat healthy foods based on a Mediterranean diet, and limit how much caffeine and alcohol they drink may have fewer sleep problems than women who did not do those things.20
Talk to your doctor or nurse if you have symptoms of insomnia, and ask about the best ways to treat insomnia.
Research shows that cognitive behavioral therapy (CBT) works as well as prescription medicine for many people who have chronic or long-term insomnia.21 CBT helps you change thoughts and actions that may get in the way of sleep.
This type of therapy is also used to treat conditions such as depression, anxiety disorders, and eating disorders. For success with CBT, you may need to see a therapist weekly for two months or more.21 CBT may involve:
Prescription medicines can help treat short-term or long-term insomnia.2 But your doctor or nurse may have you try cognitive behavioral therapy first rather than medicine to treat insomnia.2
The types of prescription medicines used to treat insomnia include sedatives and certain kinds of antidepressants.22 Prescription sleep medicines can have serious side effects, including sleepiness during the daytime and increased risk of falls for older adults.2,17 They can also affect women differently than men. In 2013, the Food and Drug Administration (FDA) required drug companies to lower the recommended dose for women of certain prescription sleep medicines with zolpidem, because women's bodies do not break down the medicine as quickly as men's bodies do.23
If you decide to use a prescription sleep medicine:
When taking sleep medicine, make sure to give yourself enough time to get a full night of sleep. A full night of sleep is usually at least seven hours. Ask your doctor or pharmacist to tell you about any side effects of taking sleep medicine, such as grogginess that may make it difficult to drive. Talk to your doctor or nurse if your insomnia symptoms continue longer than four weeks.
OTC medicines, or sleep aids, may help some people with insomnia symptoms, but they are not meant for regular or long-term use. Many OTC sleep medicines contain antihistamines that are usually used to treat allergies.
If you decide to use an OTC sleep medicine:
Some dietary supplements also claim to help people sleep. Manufacturers may label dietary supplements like melatonin as "natural" products.
The Food and Drug Administration (FDA) does not regulate dietary supplements in the same way it regulates medicines. The FDA does not test supplements for safety or effectiveness (to see if the supplement is safe for humans and works in the way it's supposed to). The FDA can remove supplements from the market if they are found to be unsafe.
There isn't enough scientific evidence to say whether most complementary and alternative sleep aids help treat insomnia.24
The Food and Drug Administration (FDA) does not regulate dietary supplements like vitamins, minerals, and herbs in the same way it regulates medicines. Use this Understanding Drug-Supplement Interactions tool to learn how dietary supplements may interact with the prescription and over-the-counter medicines you take.
Sleep is essential for good health. During sleep, our bodies and brains repair themselves. Some research suggests our brains use the time during sleep to clear away toxins that build up during the day.25 Sleep is also important to our ability to learn and form memories. Not getting enough sleep puts people at risk for health problems, including high blood pressure, obesity, and depression.
It can be difficult to change everyday habits, but if you can stick with some of these changes, you might be able to improve your sleep. You may need to try these tips for several days in a row to improve sleep.
Try these tips at home to improve sleep:
For more information on insomnia, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:
Insomnia (PDF, 146 KB)
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The Office on Women's Health is grateful for the medical review in 2017 by:
Michael Twery, Ph.D., Director, National Center on Sleep Disorders Research, Division of Lung Diseases, National Heart, Lung, and Blood Institute
Sara Nowakowski, Ph.D., M.S., Assistant Professor, Department of Obstetrics & Gynecology, Department of Psychiatry & Behavioral Sciences, University of Texas Medical Branch
All material contained on these pages are free of copyright restrictions and may be copied, reproduced, or duplicated without permission of the Office on Women’s Health in the U.S. Department of Health and Human Services. Citation of the source is appreciated.
Page last updated: March 20, 2018.
A federal government website managed by the Office on Women's Health in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services.
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