Key points
- Insomnia is defined by difficulty sleeping and its effect on your days, not by a number of hours[1].
- Chronic means at least three nights a week, for at least three months[1].
- CBT-I is recommended first, before sleeping pills[1][2].
- In two minutes, the ISI test gives you an idea of how severe your insomnia is[3].
The guides
- Do I have insomnia?The signs, how it differs from a run of bad nights, the ISI test and when to seek help.
- Insomnia in womenMenstrual cycle, pregnancy, after giving birth, menopause: what the studies say.
- Waking up at nightWhat is normal, the common causes, and what to do in the middle of the night.
- How much sleep do you need?The real benchmarks, and the “8 hours” trap.
- Insomnia and stressWhen your thoughts keep you awake, and what helps in the evening.
- Insomnia after 60What changes with age, the risks of sleeping pills, and how well CBT-I works.
- Insomnia and night shiftsShift patterns, daytime sleep, and what adapted CBT-I has to offer.
- What causes insomniaWhat makes you vulnerable, what sets it off, what keeps it going, and what you can change.
- CBT-I explainedThe therapy recommended first for chronic insomnia: its components, how it runs, the studies.
What is insomnia?
Insomnia is when sleep is hard to get or hard to keep (taking a long time to drop off, waking in the night, waking too early) even though you have the time and the right conditions to sleep, and your days suffer for it: tiredness, poor concentration, low mood[1].
So it is not a question of hours. Some people sleep little and feel perfectly well; others sleep seven hours but have broken nights and difficult days.
Short-term or chronic
Short-term insomnia often follows an event: stress, a bereavement, illness, travel. It usually settles as the situation does.
It becomes chronic when the difficulties occur at least three nights a week for at least three months[1]. To work out where you stand, read Do I have insomnia?.
What keeps it going
When insomnia lasts, it is no longer just the original event that sustains it. The things people do to compensate often keep it going:
- staying in bed longer or going to bed earlier “to catch up”, which breaks up your sleep;
- napping, which reduces your drive to sleep in the evening;
- lying awake in bed fighting to sleep, which links your bed with tension;
- worrying about sleep and its consequences, which makes you more alert at bedtime.
These are exactly the mechanisms CBT-I works on. To find out more: what causes insomnia.
How insomnia is treated
For chronic insomnia in adults, European and American guidelines put cognitive behavioural therapy for insomnia (CBT-I) first, whether face to face or in digital form[1][2]. Sleep restriction and stimulus control are among its most effective components[4].
Sleeping medication can help occasionally, for a short time, and is something to discuss with your doctor[1]. If you take it, never stop it on your own.
See where you stand
Three free tools to help you see more clearly, no account needed: