Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
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Primary insomnia is fairly common, and sometimes it can resolve without treatment. But if you are having persistent insomnia, you may need a diagnostic evaluation, including blood tests or anovernight sleep studyto determine whether there is anunderlying cause.
Managing lifestyle habits is usually effective for the relief of primary insomnia. If that doesn’t work, medical treatment might be necessary.
Primary Insomnia Symptoms
Primary insomnia often means not getting enough sleep. People who have primary insomnia average six hours of sleep per night, while people who don’t have the condition average about eight hours of sleep per night. You might notice that you toss and turn at night or get up out of bed frequently.
Typically, primary insomnia makes it hard to fall asleep and/or stay asleep. You might wake up easily during the night due to triggers like noises, or even without a trigger.
Sleep deprivation can lead to a number of effects during waking hours. Symptoms of insomnia-associated fatigue include:
You might have these symptoms for a few days in a row, and they can resolve the day after a restful night of sleep or after a nap. Sometimes fatigue can actually lead to falling asleep, with resolution of insomnia.
Recognizing Insomnia
Complications
You can develop a lot of anxiety and distress about the fact that you aren’t sleeping. This anxiety is usually more severe at bedtime or in the middle of the night, but you might notice that you worry about your insomnia during the day too.
Over time, persistent insomnia and chronic lack of sleep can lead to depression and may predispose you to health complications. Not getting enough sleep is associated with lowered immune system function, obesity, and heart disease.
The key feature of primary insomnia is that it doesn’t have an identifiable cause. But there may be some risk factors that predispose you to have primary insomnia.
The condition tends to persist throughout a person’s life, often worsening or improving for months or years at a time. So, you might recall having trouble sleeping for many years. And primary insomnia can be more common among people who have family members with insomnia.
Circadian Rhythm Pattern
Research shows that primary insomnia is associated with circadian rhythm irregularities. Primary insomnia may result in a pattern of falling into deeper phases of sleep earlier in the night than what is normally observed in people who don’t have the condition.
But it is hard to know whether that early deep sleep pattern is actually a cause or an effect of primary insomnia—because sleep deprivation also leads to the abrupt or rapid onset of deep sleep.
Getting enough sleep is a common concern that many people have throughout life. A diagnosis of primary insomnia includes several steps.
One of the main components of identifying insomnia is determining whether you actually need more sleep than you are getting. If you aren’t able to sleep as much as you need to, then the second aspect of primary insomnia diagnosis is focused on finding the reason for your lack of sleep.
The difference between primary insomnia and secondary insomnia is primary insomnia doesn’t have a medical or emotional cause, while secondary insomnia does.
Diagnostic tests can include tests that measure insomnia and its effects. These tests include:
All of these sleep studies are used to help assess whether you are not getting enough sleep and whattype of sleep interruptionyou are experiencing.
Other tests you might need include screening questionnaires or other assessments of emotional issues like depression and anxiety. Sometimes, people are aware of these problems, but many people brush off symptoms of depression and anxiety—and they can manifest as insomnia instead.
Ruling Out Underlying Causes of Insomnia
Sometimes mild cases of primary insomnia improve after a few days. Being really exhausted can make you sleepy, and you might end up falling asleep and getting enough rest.
But often, the sleepiness doesn’t happen when you want it to, and you can end up falling asleep during the day—and then again having trouble sleeping at night when you want to sleep. If the pattern of napping during the day doesn’t work well for you, then you need to make some changes to help alleviate your insomnia.
Sleep Habits
You can make some lifestyle adjustments to help regulate your sleep. The key is to avoid things that prevent you from falling asleep when you want to.
Habits to consider include:
How You Can Sleep Better Tonight
Medical Treatment
If lifestyle habits don’t help alleviate your insomnia, you can talk to your healthcare provider about medical therapy.
Some people notice a benefit from treatment with non-prescription-based strategies like counseling,cognitive behavioral therapy for insomnia (CBT-I), or acupuncture. These approaches might have a longer-lasting effect, without the risk of side effects.
Your healthcare provider might recommend that you trymelatonin, or may prescribe medication such as antidepressants, antihistamines, or benzodiazepines.
Usually, it is not considered ideal to take prescription medication for insomnia for longer than a few weeks. These medications can have side effects, and the benefits might not be long-lasting.
A Word From Verywell
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Flynn-Evans EE, Shekleton JA, Miller B, et al.Circadian phase and phase angle disorders in primary insomnia.Sleep. 2017;40(12):10.1093/sleep/zsx163. doi:10.1093/sleep/zsx163Salisbury-Afshar E.Management of insomnia disorder in adults.Am Fam Physician. 2018;98(5):319-322.Sun Q, Tan L.Comparing primary insomnia to the insomnia occurring in major depression and general anxiety disorder.Psychiatry Res. 2019;282:112514. doi:10.1016/j.psychres.2019.112514Hung CM, Li YC, Chen HJ, et al.Risk of dementia in patients with primary insomnia: a nationwide population-based case-control study.BMC Psychiatry. 2018;18(1):38. doi:10.1186/s12888-018-1623-0Guo HM, Liu M, Xiang YT, et al.Insomnia in adults with chronic hepatitis B, liver failure, and cirrhosis: A case-control study.Perspect Psychiatr Care. 2017;53(1):67-72. doi:10.1111/ppc.12138
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Flynn-Evans EE, Shekleton JA, Miller B, et al.Circadian phase and phase angle disorders in primary insomnia.Sleep. 2017;40(12):10.1093/sleep/zsx163. doi:10.1093/sleep/zsx163Salisbury-Afshar E.Management of insomnia disorder in adults.Am Fam Physician. 2018;98(5):319-322.Sun Q, Tan L.Comparing primary insomnia to the insomnia occurring in major depression and general anxiety disorder.Psychiatry Res. 2019;282:112514. doi:10.1016/j.psychres.2019.112514Hung CM, Li YC, Chen HJ, et al.Risk of dementia in patients with primary insomnia: a nationwide population-based case-control study.BMC Psychiatry. 2018;18(1):38. doi:10.1186/s12888-018-1623-0Guo HM, Liu M, Xiang YT, et al.Insomnia in adults with chronic hepatitis B, liver failure, and cirrhosis: A case-control study.Perspect Psychiatr Care. 2017;53(1):67-72. doi:10.1111/ppc.12138
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Flynn-Evans EE, Shekleton JA, Miller B, et al.Circadian phase and phase angle disorders in primary insomnia.Sleep. 2017;40(12):10.1093/sleep/zsx163. doi:10.1093/sleep/zsx163Salisbury-Afshar E.Management of insomnia disorder in adults.Am Fam Physician. 2018;98(5):319-322.Sun Q, Tan L.Comparing primary insomnia to the insomnia occurring in major depression and general anxiety disorder.Psychiatry Res. 2019;282:112514. doi:10.1016/j.psychres.2019.112514Hung CM, Li YC, Chen HJ, et al.Risk of dementia in patients with primary insomnia: a nationwide population-based case-control study.BMC Psychiatry. 2018;18(1):38. doi:10.1186/s12888-018-1623-0Guo HM, Liu M, Xiang YT, et al.Insomnia in adults with chronic hepatitis B, liver failure, and cirrhosis: A case-control study.Perspect Psychiatr Care. 2017;53(1):67-72. doi:10.1111/ppc.12138
Flynn-Evans EE, Shekleton JA, Miller B, et al.Circadian phase and phase angle disorders in primary insomnia.Sleep. 2017;40(12):10.1093/sleep/zsx163. doi:10.1093/sleep/zsx163
Salisbury-Afshar E.Management of insomnia disorder in adults.Am Fam Physician. 2018;98(5):319-322.
Sun Q, Tan L.Comparing primary insomnia to the insomnia occurring in major depression and general anxiety disorder.Psychiatry Res. 2019;282:112514. doi:10.1016/j.psychres.2019.112514
Hung CM, Li YC, Chen HJ, et al.Risk of dementia in patients with primary insomnia: a nationwide population-based case-control study.BMC Psychiatry. 2018;18(1):38. doi:10.1186/s12888-018-1623-0
Guo HM, Liu M, Xiang YT, et al.Insomnia in adults with chronic hepatitis B, liver failure, and cirrhosis: A case-control study.Perspect Psychiatr Care. 2017;53(1):67-72. doi:10.1111/ppc.12138
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