Insomnia means having persistent trouble sleeping, either falling asleep, staying asleep, or waking up too early. It’s more than just a rough night – it can become a long-term problem. In fact, about one in three adults worldwide report insomnia symptoms at least sometimes, and roughly 10% meet the criteria for chronic insomnia. When sleep is poor, people often feel tired, unfocused, or moody during the day. Over time, chronic insomnia can affect memory, concentration, mood, and even long-term health. Understanding insomnia helps you spot the signs and find solutions that work.
Symptoms of Insomnia
Insomnia shows up in several ways. The main sign is difficulty sleeping, which can look like:
- Trouble falling asleep at bedtime (lying awake for a long time before sleep comes).
- Waking up often during the night and having trouble getting back to sleep.
- Waking up too early in the morning and being unable to fall back asleep.
These are sleep symptoms at night. During the day, insomnia can cause symptoms such as:
- Feeling tired, sluggish, or sleepy even after a full night in bed.
- Trouble concentrating, remembering things, or thinking clearly (“brain fog”).
- Mood changes like irritability, anxiety, or feeling easily annoyed.
- Lower performance at work or school, or trouble enjoying normal activities.
If these sleep problems happen three or more nights a week and last for months, that is called chronic insomnia. Even shorter episodes can be very disruptive. In many cases, people cycle through different patterns: some nights it’s hard to fall asleep, other nights they wake in the middle, and sometimes they wake up too early. All of these are common patterns of insomnia.
Causes of Insomnia
Insomnia often has multiple triggers. Common causes include:
- Stress and emotions. Worry, anxiety, or intense thoughts can keep your mind active when it should be winding down. Major life events (job changes, family issues, grief) often lead to temporary insomnia.
- Health issues. Physical pain or discomfort (like chronic pain, acid reflux, or arthritis) can interrupt sleep. Many illnesses – including colds, flu, thyroid problems, or neurological conditions – affect sleep. Mental health conditions such as depression, anxiety, or PTSD frequently go hand-in-hand with insomnia.
- Medications and substances. Some prescription drugs, over-the-counter medicines, or herbal supplements can have side effects that disrupt sleep. Caffeine, nicotine, alcohol, and certain stimulants are classic culprits that interfere with falling asleep or reduce sleep quality.
- Environment and habits. Noisy neighbors, an uncomfortable mattress, or a light in the bedroom make it hard to sleep. Shift work or frequent travel (jet lag) can throw off your natural sleep-wake cycle. Irregular schedules, late-night screen use, or napping too much can also contribute.
- Hormonal changes. Hormone levels affect sleep. For example, women may experience insomnia related to menstrual cycles, pregnancy, or menopause. Changes in estrogen, progesterone, and other hormones can disturb the body’s internal clock and how you feel at night.
- As people get older, sleep often becomes lighter and shorter. Older adults may have more awakenings or find it harder to fall back asleep. Children and teenagers also have their own sleep patterns and sometimes experience insomnia due to school stress or screens.
In many cases, insomnia starts as a reaction to one factor (like a stressful event) but then becomes a habit that persists even after the original cause is gone. That’s why treatments often focus not just on the trigger but also on changing habits and thoughts around sleep. If you’re unsure whether you’re experiencing true insomnia, read our guide on the top symptoms of insomnia disorder and how to recognize them to better understand what to look for.
Insomnia During Period
Hormone changes around the menstrual cycle can trigger sleep problems. Many who menstruate notice period insomnia in the week or two before their period. This is often tied to premenstrual syndrome (PMS) or its more severe form, premenstrual dysphoric disorder (PMDD). Up to 90% of people who menstruate experience some PMS symptoms, and several of these (like mood swings, cramps, or headaches) can make sleep harder. In PMS/PMDD, levels of sleep-regulating hormones change: for example, melatonin (the sleep hormone) may dip, while fluctuations in progesterone can disrupt sleep cycles.
Typically, sleep during the luteal (pre-period) phase becomes lighter and more restless. Some report trouble falling asleep, frequent awakenings, or vivid dreams. Others may feel extra tired during the day. Good sleep hygiene is key: winding down before bed, keeping a regular bedtime, and managing PMS symptoms (like pain or mood) can help. Relaxation exercises, gentle stretching, or a warm bath before bed can also improve sleep quality. In severe cases, doctors may recommend treatments for PMS/PMDD that include sleep counseling or medication.
Read our detailed blog on “Insomnia During Period” to explore causes, symptoms, and proven ways to improve your sleep during the menstrual cycle.
Insomnia in Pregnancy
Sleep issues are very common in pregnancy. In fact, most pregnant people will experience sleep problems at some point. Early in pregnancy, hormone surges (like rising estrogen and progesterone) can disrupt sleep patterns. Later on, the growing baby can cause discomfort: a large belly, back pain, or the need to use the bathroom frequently. By the third trimester, around three-quarters of women say they have insomnia symptoms.
Typical sleep challenges in pregnancy include:
- Physical discomfort. It may be hard to find a comfortable position. Leg cramps or restless legs are common, making it tough to stay asleep. Nausea (morning sickness) can occur at night, too.
- Frequent bathroom trips. As the uterus grows, it presses on the bladder, so many pregnant people wake up to pee one or more times a night.
- Heartburn and indigestion. Pregnancy hormones relax the muscle between the stomach and esophagus, so acid reflux can wake you up.
- Shortness of breath. In later pregnancy, it’s normal to breathe faster and feel short of breath, even during sleep.
- Anxiety and mind racing. Worries about health, labor, or being a parent can increase stress hormones (like cortisol), making it hard to fall asleep.
Managing insomnia in pregnancy involves good sleep habits and addressing these causes. Using extra pillows to support the belly or between the knees can relieve discomfort. Light exercise during the day and a consistent bedtime routine help set your body’s clock. Reducing fluid intake an hour before bed may cut down on nighttime trips. Importantly, getting enough total sleep is vital: doctors usually recommend about 8–10 hours for pregnant people. When pregnancy insomnia is severe, talking to a healthcare provider can help rule out other sleep disorders (like sleep apnea or restless legs, which can worsen during pregnancy) and suggest safe treatments.
Read our blog on”What Causes Insomnia in Pregnancy?” to learn about common sleep challenges during pregnancy and how to manage them for better rest.
What Vitamin Deficiency Causes Insomnia
No single vitamin deficiency is the sole cause of insomnia, but some nutritional gaps are linked to sleep problems. In particular, Vitamin D deficiency has been associated with a higher risk of insomnia. Vitamin D helps regulate the sleep-wake cycle, and low levels may lead to shorter or restless sleep. Likewise, B vitamins play key roles in sleep. For example, Vitamin B12 is involved in making melatonin (the sleep hormone), and a lack of B12 or other B vitamins (like B6) can contribute to difficulty sleeping. In fact, people with low B1 or B2 often report fatigue and trouble sleeping.
Other nutrients can also matter: insufficient magnesium or iron (though not vitamins) can cause leg cramps or restless legs, which disrupt sleep. Vitamin C, an antioxidant, might indirectly affect sleep by managing stress hormones. In general, a balanced diet that meets all vitamin and mineral needs supports healthy sleep. If you suspect a deficiency (for example, you rarely get sun and feel tired all the time), a doctor can check your levels. Supplements may help only if a deficiency is confirmed; otherwise, they won’t necessarily cure insomnia.
Read our detailed blog on “What Vitamin Deficiency Causes Insomnia?”
Cognitive Behavioral Therapy for Insomnia
Cognitive Behavioral Therapy for Insomnia (CBT-I) is a top-recommended treatment that teaches skills and habits to improve sleep. Rather than using medication, CBT-I focuses on changing thoughts and behaviors that keep you awake. It’s usually done with a trained therapist, but self-help books and online programs are also effective.
Key parts of CBT-I include:
- Stimulus Control. This means using your bed only for sleep (and sex). If you can’t sleep, you get out of bed and do something quiet until you feel sleepy again. Over time, your brain learns to associate bed strictly with sleep, making it easier to fall asleep when you lie down.
- Sleep Restriction. This sounds odd, but it helps: you temporarily limit time in bed to the hours you actually sleep (tracking it in a diary). For example, if you only sleep 5 hours per night, even though you’re in bed 8 hours, you start by only going to bed 5 hours before your wake-up time. This increases your sleep pressure. As sleep gets more solid, you gradually allow more time in bed. This boosts deep sleep and helps reset your sleep cycle.
- Relaxation and Stress Management. CBT-I teaches relaxation techniques (deep breathing, progressive muscle relaxation, meditation) to quiet the mind before bed. It also addresses negative thoughts about sleep (“I’ll never sleep, tomorrow will be awful”), replacing them with more realistic, calming thoughts. By reducing anxiety about not sleeping, you make it easier to drift off.
- Good Sleep Hygiene. This is about habits. CBT-I reinforces keeping a consistent sleep schedule (same bedtime and wake-up time every day), avoiding caffeine and alcohol late in the day, creating a restful bedroom (cool, dark, quiet), and winding down with a calming pre-sleep routine (no screens, maybe reading or listening to quiet music).
- Cognitive Restructuring. A therapist helps challenge unhelpful beliefs about sleep. For example, correcting the idea that one bad night will ruin your health, or that you must get 8 hours exactly. Seeing sleep in a healthier way can relieve the pressure that often makes insomnia worse.
Research shows CBT-I works for most people, often as well or better than sleeping pills, with no drug side effects. Many notice improvements after a few sessions. The American College of Physicians recommends CBT-I as the first treatment for chronic insomnia because it targets the root causes and is safe long-term. For those without access to a therapist, there are workbooks, online courses, and apps that guide you through CBT-I techniques.
Tips and Other Solutions
In addition to CBT-I, simple lifestyle changes can help many people sleep better. Here are some practical tips:
- Keep a consistent sleep schedule – go to bed and wake up at the same time every day, even on weekends.
- Develop a relaxing bedtime routine – for example, take a warm shower, read a soothing book, or practice gentle yoga before bed. Avoid screens (phones, tablets, TV) for at least an hour before sleeping, as the blue light can trick your brain into thinking it’s daytime.
- Exercise regularly, but not too close to bedtime. Getting 30 minutes of moderate exercise earlier in the day (like walking, swimming, or yoga) can improve sleep quality.
- Make your sleep environment comfortable – keep the room dark, quiet, and cool. A white-noise machine, blackout curtains, or a fan can help block distractions. Use the bed only for sleep (and intimacy), not for work or stressful activities.
- Watch what and when you eat and drink. Avoid caffeine (coffee, tea, cola, energy drinks) in the afternoon and evening. Finish large meals a few hours before bedtime. If you’re thirsty, drink a small glass of water, but avoid overdrinking so you’re not waking to urinate.
- Manage stress through relaxation techniques during the day. Deep breathing, meditation, and mindfulness can reduce overall anxiety and make it easier to unwind at night. Journaling or making a “worry list” earlier in the evening can prevent an active mind at bedtime.
- Consider natural sleep aids only if needed. Some people find melatonin supplements help reset their sleep cycle (for example, when adjusting to jet lag). Herbal remedies like valerian or chamomile tea may be soothing, though their effects are mild. Always discuss supplements or herbs with a doctor first, especially if you take other medications.
- Medications should be a last resort. Prescription sleep drugs or over-the-counter sleep aids can work short-term, but they often lose effectiveness and can have side effects (grogginess, dependency, memory issues). If your insomnia is severe and other methods fail, talk to a healthcare professional about safe options and weighing benefits vs. risks.
If lifestyle changes and therapy haven’t resolved your insomnia, it’s time to consult a doctor. At Aura MD, our sleep specialists offer personalized care tailored to your needs. We provide both in-office and online insomnia treatment, which focuses on building healthier sleep habits and managing sleep-related anxiety.
Insomnia can feel overwhelming, but many people do see significant improvement. By recognizing the causes, whether it’s stress, hormones, vitamin levels, or habits, and using effective strategies like CBT-I and good sleep practices, you can reclaim restful nights. It may take patience and some trial and error, but getting better sleep is possible, and the payoff is feeling much healthier and happier during the day.
