Insomnia

Insomnia is difficulty falling asleep, staying asleep, or waking earlier than desired, usually with daytime effects such as fatigue, irritability, poor concentration, or worry about sleep.

Sleep-onset insomnia Sleep-maintenance insomnia Early awakening CBT-I focused
Quick overview

What to know first

Insomnia is not simply “not sleeping enough.” It is a pattern of sleep difficulty despite adequate opportunity for sleep, paired with daytime impact.

Common symptoms

  • Trouble falling asleep
  • Frequent awakenings
  • Waking too early
  • Unrefreshing sleep
  • Fatigue, irritability, or poor focus

Common contributors

  • Stress, anxiety, depression, or major life changes
  • Caffeine, alcohol, nicotine, or medications
  • Pain, reflux, urinary symptoms, or chronic illness
  • Sleep apnea, restless legs, or circadian rhythm problems
Self-check

Do your symptoms fit insomnia?

This brief tool is for education only. It does not diagnose insomnia, but it can help organize symptoms.

Sleep difficulty: Do you have trouble falling asleep, staying asleep, or waking too early?

Opportunity: Do you usually have enough time and opportunity to sleep?

Daytime impact: Does poor sleep affect energy, mood, attention, work, driving, or quality of life?

Frequency: Does this happen at least 3 nights per week?

Duration: Has this been going on for 3 months or longer?

Possible sleep apnea: Do you snore loudly, gasp, choke, or have witnessed pauses in breathing?

Your result will appear here

Answer the questions above to see a general educational interpretation.

CBT-I principles

A practical starter framework

Cognitive Behavioral Therapy for Insomnia is a structured approach for chronic insomnia. These principles are educational and do not replace formal care.

Anchor wake time

Keep a consistent wake time daily. A stable wake time helps anchor the body clock.

Protect the bed

Use the bed mainly for sleep. If awake and frustrated, get up briefly and return when sleepy.

Build sleep pressure

Avoid long naps and excessive time in bed. More time in bed does not always mean more sleep.

Practical sleep tips
  • Keep a regular wake time.
  • Get morning light exposure.
  • Avoid caffeine after early afternoon.
  • Avoid using alcohol as a sleep aid.
  • Keep the bedroom cool, dark, quiet, and comfortable.
  • Avoid clock-watching at night.
  • Keep naps short and early, or avoid them if they worsen nighttime sleep.
When to seek medical evaluation
  • Insomnia persists more than a few weeks or causes major daytime impairment.
  • You snore, gasp, choke, or have witnessed pauses in breathing.
  • You feel unsafe driving due to sleepiness.
  • You have restless legs, abnormal sleep behaviors, nightmares, or panic at night.
  • You rely on alcohol, sedatives, or over-the-counter sleep aids regularly.
Sleep diary

Track patterns before changing everything

A sleep diary can help identify patterns in bedtime, wake time, awakenings, naps, caffeine, alcohol, medication use, and sleep quality.

Estimate sleep efficiency

Sleep efficiency is the percentage of time in bed that you spend asleep. One night is only a snapshot; 1–2 weeks of tracking is more useful.

Your sleep diary result will appear here

Enter your times and awakenings to estimate time in bed, sleep time, and sleep efficiency.

Download or use an app

Use a standardized diary if you want to bring a clear record to a clinician.

Download AASM Sleep Diary PDF →
Try the Consensus Sleep Diary →
VA CBT-i Coach app →
Printable diary

Printable 7-day sleep diary

Open a clean, print-friendly sleep diary that prints by itself instead of printing the whole insomnia page.

This information is for general education only and does not replace individualized medical advice. Persistent or severe sleep problems should be discussed with a clinician.