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Insomnia - Symptoms, Diagnosis, Treatment, and Prevention


Insomnia is defined as a difficulty sleeping, which can affect one's life, especially on a socio-professional level. Insomnia may be caused by difficulty falling asleep or staying asleep, with frequent waking throughout the night or too early in the morning. Insomnia can also refer to cases in which sleep is not restful.

Insomnia can be primary (i.e. occurring unexpectedly with no real trigger) or secondary (i.e. a result of diseases that can be of a mental or physical order). Thus, insomnia can sometimes last only a few days, under unusual stress caused by a concern or due to a change of pace, e.g. jet lag. Acute insomnia can also be secondary to isolated pain or acute illness, and disappear once the triggering factor is removed. Insomnia is, however, sometimes more chronic and may form as part of a psychiatric disorder, such as depression, with early awakening, anxiety, difficulty falling asleep, or a manic syndrome where the patient almost never rests.

Pathologies, such as restless legs, may also be responsible for these sleep problems. Additionally, insomnia can be caused by sleep apnea syndrome, causing pauses in breathing during the night. Drugs or toxic substances may also be responsible for insomnia. In some cases, insomnia is chronic, with no cause being found.


Symptoms of insomnia can take the form of: difficulty falling asleep; too-frequent awakenings; difficulty in maintaining sleep; and non-restful sleep. These symptoms can, themselves, trigger: headache; fatigue; a significant decrease in attention; sleepiness; and some irritability accompanied by mood disorders.


A diagnosis of insomnia is made through an examination in which a doctor will try to determine the habits and lifestyle of a patient: his or her bedtime, activities before going to bed, average time of sleep, number of awakenings per night, wake-up time in the morning, profession, smoking, and/or the consumption of coffee and alcohol. A interview of a patient's partner is also important, so that the doctor is able to determine if there is snoring, pauses in breathing, movements, etcetera during sleep. Blood tests may also be performed. A clinical observation during which the patient sleeps overnight with electrodes placed on the body is also possible; it is called polysomnography.


The treatment of insomnia depends on the cause(s). The lifestyle of the patient may need to be modified, by reducing the amount of coffee consumed, avoiding large meals at night, sleeping at fixed hours, and by focusing on relaxing activities before bedtime. If insomnia is caused by a psychological disorder, such as anxiety or depression, a doctor may consider the possibility of prescribing an appropriate medical treatment for these issues. If other conditions are discovered, their support will be necessary. In the absence of an identified pathology or improvement in quality of sleep despite following the recommended instructions, treatment can be implemented for the shortest period possible.


To prevent insomnia, it is better to sleep at regular hours; perform physical activity; sleep in a quiet environment; avoid large meals and exciting substances, such as coffee or tea, especially before bedtime; reduce consumption of cigarettes; and engage in a quiet activity before bedtime.

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