Insomnia Disorder

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Insomnia Disorder

Medically reviewed · Ratel Health editorial team · Sunday, 16 August 2026

A condition involving persistent difficulty falling asleep, staying asleep, or achieving restful sleep, causing distress or impairment.

Overview

Insomnia disorder involves persistent difficulty initiating or maintaining sleep, or non-restorative sleep, occurring at least three nights per week for at least three months, along with daytime distress or impairment.

Signs and Symptoms

Symptoms can include difficulty falling asleep, frequent nighttime awakenings, waking too early, and daytime effects such as fatigue, irritability, or difficulty concentrating. Experiencing one or more of these symptoms does not necessarily mean that a person has this condition. Diagnosis requires an appropriate clinical evaluation.

Causes and Risk Factors

The exact cause is not fully understood. Stress, irregular sleep schedules, certain medical or mental health conditions, and learned sleep-related habits are each associated with insomnia.

Diagnosis

A diagnosis should be made by a qualified healthcare professional following a comprehensive clinical assessment. Clinicians may use established diagnostic frameworks such as DSM-5-TR and/or ICD-11 as part of a comprehensive assessment.

Treatment

Treatment depends on the individual’s symptoms, clinical history, severity, age, co-occurring conditions, and other relevant factors.

Psychotherapy

Cognitive behavioral therapy for insomnia (CBT-I) has strong evidence supporting its use and is generally considered a first-line treatment.

Medication

Certain medications are FDA-approved for insomnia and may be considered for short-term use or when other approaches have not been sufficient. Medication decisions should be made with a qualified prescribing healthcare professional. Do not start, stop, or change a prescribed medication based solely on information on this page.

Living With Insomnia Disorder

Consistent sleep and wake times, limiting screens before bed, and avoiding caffeine or alcohol close to bedtime can support better sleep.

When to Seek Professional Help

Professional evaluation may be appropriate if symptoms persist, worsen, cause significant distress, or interfere with work, school, or relationships.

Outlook

Insomnia often improves significantly with behavioral treatment, particularly CBT-I, though some people experience recurring episodes during periods of stress.

Related Conditions

Circadian Rhythm Sleep-Wake Disorders

A group of sleep disorders involving a mismatch between a person’s internal sleep-wake rhythm and their desired or required schedule.

Hypersomnolence Disorder

A sleep disorder involving excessive sleepiness despite a main sleep period lasting at least seven hours.

Nightmare Disorder

A sleep disorder involving repeated occurrences of extended, extremely dysphoric, well-remembered dreams that cause significant distress or impairment.

Medical Information Disclaimer

Ratel Health provides general educational information and does not provide medical diagnosis, treatment, or individualized medical advice. Information on this page is not a substitute for evaluation or care from a qualified healthcare professional. Do not use this information to diagnose yourself or another person, or to start, stop, or change treatment or medication without consulting an appropriately qualified healthcare professional.

References

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
  • National Institute of Mental Health.
  • U.S. Food and Drug Administration.
  • World Health Organization. International Classification of Diseases, 11th Revision.