What Is Insomnia

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Insomnia is a sleep disorder in which a person has persistent difficulty falling asleep, staying asleep, or waking too early and being unable to get back to sleep, despite having the opportunity to sleep. It affects daytime life, causing fatigue, low mood, irritability, or trouble concentrating. Short-term insomnia is very common during stress, illness, or change. When sleep problems occur at least three nights a week for three months or longer, it is called chronic insomnia. Insomnia is highly treatable, most effectively with cognitive behavioural therapy for insomnia (CBT-I).

What Insomnia Looks Like

• Lying awake for a long time before falling asleep.
• Waking during the night and struggling to return to sleep.
• Waking much earlier than planned.
• Feeling unrefreshed even after spending enough time in bed.
• Being unable to sleep even when exhausted.
• Worrying about sleep during the day and dreading bedtime.
• Daytime tiredness, low mood, irritability, or poor focus.

Many people with insomnia describe feeling tired but wired: physically exhausted yet mentally alert, especially once their head hits the pillow.

Why It Happens

Sleep researchers often describe insomnia using three kinds of factors. Predisposing factors make someone more vulnerable, such as a tendency to worry, a sensitive stress response, or family history. Precipitating factors trigger the sleep problem, such as a stressful event, illness, pain, a new baby, shift work, or grief. Perpetuating factors keep insomnia going long after the trigger has passed. These include spending extra time in bed to catch up, napping, irregular schedules, using screens in bed, and worrying about not sleeping.

Over time, the bed can become linked with frustration and alertness rather than rest, a process called conditioned arousal. Efforts to force sleep tend to backfire, because sleep comes more easily when the mind and body are relaxed rather than striving. Insomnia also often occurs alongside anxiety, depression, chronic pain, and other conditions, and each can worsen the other. The page on how sleep and mental health affect each other explores this link.

What It Is Not

• Not simply poor sleep habits. Habits play a role, but insomnia involves the nervous system and learned patterns.
• Not the same as short sleep by choice. Insomnia means sleep does not come even with the chance to sleep.
• Not sleep apnea, though the two can co-occur. Loud snoring, gasping, or pauses in breathing need medical assessment.
• Not a delayed body clock alone. Some people fall asleep late but sleep well once they do. That pattern is a circadian rhythm issue, which is treated differently.
• Not best treated long term with sleeping pills. Medications may help briefly but do not address the underlying patterns.

How It Is Assessed and Treated

Assessment usually involves a sleep history and a sleep diary kept for one to two weeks, recording bedtime, wake time, time awake, and daytime effects. A physician may check for medical causes, medications, or other sleep disorders. CBT-I is the recommended first treatment for chronic insomnia. It combines stimulus control, which means using the bed only for sleep and getting up when unable to sleep, with sleep restriction, which temporarily limits time in bed to strengthen sleep drive. It also includes consistent wake times, relaxation, and changing unhelpful thoughts about sleep. Most people see improvement within six to eight sessions, and gains tend to last.

Getting Support at Pacific Maple Psych Centre

If you have been struggling to sleep for weeks or months, CBT-I can help you reset your sleep and feel more rested, often without relying on medication.