Insomnia is persistent difficulty falling asleep, staying asleep, or obtaining restorative sleep, despite adequate opportunity. The result is daytime fatigue, impaired concentration, and reduced quality of life.

Acute insomnia often follows stress or schedule disruption and resolves when the precipitating factor eases. Chronic insomnia lasts for months or longer and may involve conditioned arousal—the bed itself becomes associated with wakefulness and worry. Contributing factors include anxiety, depression, irregular schedules, caffeine or alcohol use, medical conditions, and poor sleep hygiene. Paradoxically, the effort to force sleep often maintains the problem.

Cognitive-behavioral therapy for insomnia is the first-line treatment. It includes stimulus control (using the bed only for sleep), sleep restriction, cognitive restructuring of sleep-related worries, and relaxation training. Medications can provide short-term relief but carry risks of tolerance and dependence. Addressing underlying medical or psychiatric conditions is essential when they are present.

Insomnia is more than an occasional bad night. It is a self-perpetuating pattern that responds best to systematic change in behavior and thinking about sleep.