Can't sleep? Here's what causes insomnia and how to treat it

From eu.usatoday.com

By Daryl Austin

Few experiences are more frustrating than lying awake at night while desperately wanting to fall asleep. Your body feels exhausted, but your mind refuses to settle. As the minutes tick by, it's easy to become increasingly anxious about how little sleep you're getting − and how much harder tomorrow is going to be as a result. That growing anxiety can then make it even harder to fall asleep, creating a vicious cycle in which poor sleep fuels even more sleeplessness.

As discouraging as insomnia like this can be, it may be helpful to know you're far from alone. In fact, "insomnia is the most common sleep disorder, with roughly 10% to 15% of adults experiencing chronic insomnia and up to 40% to 50% experiencing occasional symptoms," says Wendy Troxel, a senior behavioural sleep scientist at the RAND Corporation.

Here's what insomnia is, what causes it and how it's typically treated.

Few experiences are more frustrating than lying awake at night while desperately wanting to fall asleep.  lakshmiprasad S, Getty Images

What is insomnia?

Insomnia is a sleep disorder "that makes it difficult to fall asleep or stay asleep throughout the night, wake up too early or get good quality sleep despite having the opportunity to do so," explains Dr. Raj Dasgupta, a pulmonary and sleep specialist at Huntington Memorial Hospital in California.

He explains that the defining feature isn't simply getting too little sleep − it's that those night-time difficulties lead to daytime consequences such as fatigue, trouble concentrating and reduced productivity and performance at school or work.

Over time, "chronic insomnia can also affect mood, memory, focus, energy, relationships and overall health," he adds. "People with chronic insomnia also have a twofold increased risk of depression and an increased risk of cardiovascular disease," Troxel notes.

While "a random bad night of rest is normal for most people," Dasgupta explains, chronic insomnia is generally diagnosed when symptoms occur at least three nights a week for three months or longer. He adds that diagnosis is usually "based on your sleep history, symptoms, medical history and how the sleep problem affects you during the day."

What causes insomnia?

Insomnia rarely has a single cause. Instead, it usually develops from a combination of biological, psychological and lifestyle factors.

Stress is among the most common triggers, Troxel says, whether it's related to work, finances, relationships or major life changes. "Anxiety and depression are also closely linked to insomnia," she adds, with each capable of worsening the other.

Physical conditions such as chronic pain, asthma, acid reflux, neurological disorders, sleep apnoea and thyroid disease can also interfere with healthy sleep. "And perimenopause and menopause are significantly underrecognized triggers in women," Troxel says. She adds that medications such as certain antidepressants, stimulants, decongestants and corticosteroids can sometimes contribute as well.

Lifestyle habits also frequently play a role. For instance, Dasgupta says that consuming caffeine or alcohol too late in the day, keeping an irregular sleep schedule, working overnight shifts, taking frequent naps or spending time on phones and other bright screens before bed can all disrupt the body's natural sleep-wake cycle.

How is insomnia treated?

Regardless of the cause, the most effective long-term treatment for chronic insomnia isn't medication − "it's cognitive behavioural therapy for insomnia, or CBT-I," Dasgupta says. CBT-I is a structured program that helps people identify and replace the thoughts and behaviours that interfere with sleep while building healthier sleep habits and routines. It's so effective, in fact, that major sleep organizations usually recommend CBT-I as the first-line treatment because research consistently shows it produces lasting improvements without the risks associated with long-term use of sleep medications.

Why 'good' sleep is about more than just the hours 

Other insomnia treatments and recommendations may include improving sleep habits such as maintaining a consistent bedtime and wake time, limiting caffeine and alcohol intake (especially later in the day), exercising regularly (though not immediately before bed), creating a cool, dark, quiet sleep environment and avoiding prolonged screen use before bedtime, Dasgupta notes.

Health care providers may also recommend sleep medications for short-term relief, but these are generally viewed as temporary tools rather than permanent solutions, explains Troxel.

Anyone whose sleep difficulties significantly affect daytime functioning, occur several nights a week for extended periods or are accompanied by unusual night-time behaviours should seek medical evaluation rather than trying to manage the problem alone, advises Troxel.

"And," she adds, "you should also talk to a doctor if you have loud snoring, gasping in the night, restless legs, morning headaches or unexplained mood changes."

https://eu.usatoday.com/story/life/health-wellness/2026/08/30/what-is-insomnia/90911040007/ 

Taking Melatonin Every Night? Sleep Experts Say There’s Something You Should Know

From savingadvice.com

Melatonin has become the bedtime routine many people barely think about anymore: brush your teeth, plug in your phone, take a gummy, and turn out the lights. Because melatonin is available without a prescription and is naturally produced by the body, it’s easy to assume that taking it nightly is essentially harmless. Yet sleep experts draw an important distinction between occasional short-term use and relying on a supplement indefinitely to treat persistent insomnia. The National Center for Complementary and Integrative Health says melatonin appears relatively safe for short-term use, but its long-term safety has not been established.

That uncertainty doesn’t mean nightly melatonin has been proven dangerous; it means researchers don’t yet have enough high-quality evidence to say with confidence what years of routine use may mean for everyone. If taking melatonin every night has become something you do automatically, there are several things worth understanding before tonight’s dose.

Melatonin Isn’t Really a Traditional Sleeping Pill

Melatonin is a hormone your brain naturally produces in response to darkness, helping regulate the body’s circadian timing and sleep-wake cycle. Supplemental melatonin is often used when the problem involves sleep timing, including situations such as jet lag, while research into its effectiveness for shift workers has produced more limited or inconclusive results. NCCIH reports that research suggests melatonin may also modestly improve how quickly some people with insomnia fall asleep and reduce daytime sleepiness. However, a review cited by NCCIH found that it did not improve other important outcomes such as overall sleep quality or the amount of time people remained awake during the night. That means taking melatonin every night may not address the actual reason you’re struggling to sleep.

Sleep Experts Don’t Recommend It as the Go-To Treatment for Chronic Insomnia

This is probably the biggest misconception surrounding nightly melatonin use. The American Academy of Sleep Medicine’s pharmacologic guideline recommends against using melatonin to treat sleep-onset or sleep-maintenance insomnia in adults because the evidence supporting its effectiveness was considered insufficient. That recommendation doesn’t mean melatonin never helps anyone, nor does it mean a clinician will never suggest it for a particular sleep problem. It means chronic insomnia shouldn’t automatically be treated by indefinitely adding an over-the-counter supplement to your nightly routine. If you’ve been taking melatonin every night for months because you cannot sleep without it, persistent insomnia itself deserves attention.

Melatonin may help certain sleep problems, but its long-term safety isn’t fully established. If nightly use has become a months- or years-long habit, consider discussing the dose, medications, and underlying sleep problem with a healthcare professional. Poh Smith/Shutterstock

We Know More About Short-Term Use Than Years of Nightly Use

One of the challenges with melatonin is that widespread availability can create more certainty about long-term safety than the evidence actually supports. NCCIH specifically says short-term use appears relatively safe for most people, while the long-term safety of melatonin supplements has not been established. That’s different from saying researchers have proven that taking it for years is dangerous; rather, the evidence isn’t strong enough to make confident conclusions about prolonged routine use. People sometimes hear “natural” and translate that into “safe at any dose for any length of time,” which isn’t how hormones or supplements work. A person who has used melatonin nightly for years shouldn’t panic, but discussing continued use with a healthcare professional is reasonable.

The Side Effects Can Show Up the Next Day

Melatonin’s potential drawbacks aren’t limited to questions about years of use because some people notice effects much sooner. NCCIH says mild side effects reported in short-term studies have included headache, dizziness, nausea, and sleepiness. Daytime drowsiness deserves particular attention if you’re driving, operating equipment, or already taking medications that can make you sleepy. Older adults may also process melatonin differently; it may remain active longer in older people and contribute to daytime drowsiness. If taking melatonin every night leaves you groggy the following morning, that is worth discussing with a healthcare professional rather than assuming feeling sluggish is simply the price of getting to sleep.

What’s in the Bottle May Not Match What’s on the Label

Another issue has nothing to do with melatonin itself and everything to do with the supplement marketplace. The Food and Drug Administration does not approve dietary supplements for safety and effectiveness before they reach consumers, placing responsibility on manufacturers to comply with applicable safety and labelling requirements. NCCIH highlights a 2023 analysis of 25 melatonin gummies in which 22 were inaccurately labelled, with measured melatonin ranging from 74% to 347% of the labelled amount among products containing detectable melatonin. FDA researchers have separately analysed supplement products and found wide variation in melatonin content relative to label claims, reinforcing concerns about quality control. Consequently, taking melatonin every night doesn’t necessarily mean you’re consistently consuming exactly the dose printed on the bottle.

Quality-control concerns aren’t limited to one small study. FDA researchers analysing 110 melatonin supplement products marketed for children found measured amounts ranging from zero to 667% of the label claim, further illustrating why consumers should not assume every supplement precisely matches its packaging.

More Melatonin Isn’t Necessarily Better

Melatonin has become a nightly habit for many adults, but sleep experts say long-term safety has not been established and persistent insomnia may warrant a closer look at what is disrupting sleep. Microgen/Shutterstock

Walk through the supplement aisle and you’ll find melatonin products marketed in dramatically different strengths, which can make larger numbers look more powerful. But melatonin isn’t a medication where doubling the dose automatically produces twice the sleep benefit, and taking more can increase the opportunity for unwanted effects without addressing the cause of poor sleep. The uncertainty surrounding supplement content makes casually escalating the dose even less appealing when the amount inside some products may already differ from what’s printed on the package.

Timing matters too because melatonin is involved in signalling the body’s biological night, so taking an arbitrary dose at an arbitrary bedtime isn’t necessarily equivalent to using it strategically for a specific circadian problem. There also isn’t one universally appropriate over-the-counter dose for every adult, making self-escalating from one gummy to several a poor substitute for determining why sleep remains difficult.

Rather than repeatedly increasing the dose because the previous amount “stopped working,” that’s a good point to talk with a physician, pharmacist, or sleep specialist about what’s actually disrupting sleep. Persistent trouble falling asleep, frequent awakenings, or poor daytime functioning can have causes that another gummy won’t solve.

Melatonin Can Matter When You Take Other Medications

Over-the-counter doesn’t mean interaction-free, particularly for older adults taking several prescription medications. NCCIH advises people taking medications to consult their healthcare providers before using melatonin and specifically notes that people taking blood thinners or those with epilepsy should use it under medical supervision. This is especially relevant because supplement use can easily be forgotten when a doctor asks someone to list their “medications.” Bring the bottle or write down the product, dose, and frequency at your next appointment so your clinician or pharmacist knows exactly what you’re taking. If taking melatonin every night is part of your routine, it belongs on your medication-and-supplement list just like everything else.

Your Sleep Problem May Need a Different Treatment

Taking something every night can gradually shift attention from the question that matters most: Why aren’t you sleeping? Chronic insomnia can coexist with medical conditions, medication effects, mood disorders, restless legs, sleep apnoea, irregular schedules, and behavioural patterns that need different approaches. For chronic insomnia, current American Academy of Sleep Medicine guidance strongly recommends cognitive behavioural therapy for insomnia, or CBT-I, which combines techniques designed to change sleep-related behaviours and thought patterns. NCCIH’s review of that guidance identifies CBT-I as a strongly recommended treatment for adults with chronic insomnia. Someone who has spent months taking melatonin every night without consistently sleeping well may benefit more from evaluating the underlying sleep problem than simply continuing the same routine.

Don’t Panic About Tonight’s Dose

None of this means everyone using melatonin should suddenly throw the bottle away. Melatonin has legitimate uses, short-term use appears relatively safe for most people, and individual circumstances matter when deciding whether it belongs in someone’s sleep routine. The concern is turning an occasional sleep aid into an indefinite nightly treatment without ever asking whether it’s working, whether the dose is appropriate, whether it interacts with other medications, or why insomnia continues. If you’re taking melatonin every night, particularly for months or years, consider reviewing the habit with your doctor or pharmacist rather than automatically increasing the dose or assuming long-term use has been thoroughly studied.

Keeping a simple sleep diary for a week or two (recording when you take melatonin, when you go to bed, approximately how long it takes to fall asleep, night-time awakenings, wake time, and next-day grogginess) can also give a clinician more useful information than simply saying the supplement “works” or “doesn’t work.”

https://www.savingadvice.com/articles/2026/08/25/10745328_taking-melatonin-every-night-sleep-experts-say-theres-something-you-should-know.html 

Teens Losing Sleep to Study Face Blood Sugar Warning Signs

From en.sedaily.com

By Ahn Kyung-jin

Almost everyone has had the experience of staring at a smartphone screen past midnight and falling asleep late. Even when the body feels heavy and the mind foggy the next day, it is easy to shrug it off, thinking, "Would missing a day or two of sleep really cause a problem?" But recent research has found that such sleep deprivation goes beyond simple fatigue and can adversely affect blood sugar from a young age.

According to a study by a research team at the University of Copenhagen in Denmark that tracked 206 healthy 18-year-old adolescents for two weeks, blood sugar remained more stable on days following longer sleep, and the range of daily blood sugar fluctuation also decreased. Conversely, when sleep was insufficient, blood sugar was higher and fluctuated more widely. Despite their young age, they showed blood sugar fluctuation patterns similar to those of middle-aged adults. Diabetes and obesity are commonly regarded as problems for those past middle age. However, the researchers warned that if sleep deprivation continues even in one's teens, a period of active growth, blood sugar fluctuation can widen and diabetes can develop. In fact, when adolescents who habitually slept less increased their sleep by about one hour a day, their insulin sensitivity improved. Insulin sensitivity is, put simply, the efficiency with which the body processes blood sugar. When this value improves, blood sugar fluctuates less even when the same amount of sugar is consumed.

An even bigger problem is when one cannot fall asleep despite wanting to get enough rest. Exposed to various stresses ranging from college entrance exams, grades, and career concerns to friendships and social media (SNS), many teens dwell on their worries late into the night and cannot fall asleep. This is not a problem for adolescents alone. Adults, too, each carrying their own concerns over work, relationships, and child-rearing, often toss and turn as one thought leads to another once they lie down to sleep.

                                                                                               Clipart Korea

If this condition persists more than three times a week for over three months, it can be regarded as chronic insomnia. Insomnia does not end with merely feeling tired the next day. When bodily functions that should recover through sleep fail to perform their role, it can burden not only metabolic functions including blood sugar, but also brain and cardiovascular health.

So how should insomnia that has already begun be managed? Korean medicine classifies the causes of insomnia into five types. These include "sagyeol-bulsu," caused by excessive thinking or worrying; "yeonghyeol-bujok," arising from a deficiency of blood; "eumheo-naeyeol," in which deficiency heat prevents sleep; "simdam-heogeop," caused by psychological shock; and "damyeon-ulgyeol," in which phlegm collects in the chest and causes palpitations.

When diagnosed with insomnia, acupuncture is mainly used. According to a paper published by Jaseng Hospital of Korean Medicine in the international journal Healthcare, the number of acupuncture treatments administered to insomnia patients in Korean medicine departments over the seven years from 2010 to 2016 reached about 100,000. Placing needles at key acupoints that calm the mind and nerves, such as Sinmun, Baekhoe, and Sameumgyo, helps with blood circulation and easing tension, and can be expected to balance sleep hormones.

Herbal prescriptions such as Gwibi-ondam-tang, Bohyeol-ansin-tang, and Anmae-tang are sometimes administered in parallel. Bohyeol-ansin-tang, a representative example, is known to replenish depleted blood to supply the nutrition needed by the heart and nervous system, and to help keep an unstable mind and body in a comfortable state. It is also effective in calming nerves made sensitive by stress and inducing stable sleep.

Treating insomnia does not necessarily require enormous cost or effort. Going to bed and waking up at similar times each day, and reducing smartphone use and caffeine intake before sleep, can improve sleep quality on their own. However, if insomnia continues despite these efforts, rather than simply dismissing it as being "the type who cannot sleep," it is advisable to seek professional diagnosis and treatment. Sufficient sleep tonight can be the first step toward protecting not only tomorrow's condition, but also your future metabolic health and cardiovascular and cerebrovascular health. 

https://en.sedaily.com/culture/2026/07/19/teens-losing-sleep-to-study-face-blood-sugar-warning-signs

"I'm a sleep doctor. These are the signs you have a real sleep problem"

From yahoo.com/lifestyle

I'm always tired. I try to prioritize sleep but always end up exhausted despite my best efforts. Why don't I ever feel well rested?

For millions of people, poor sleep has become so normalized that they no longer recognize it as a potential medical issue. Feeling tired all the time gets blamed on stress. Freight train snoring becomes a family joke at the dinner table. Trying not to doze off during that weekly meeting means your job is boring.

These signs all point to a possible sleep disorder. Yet, most people push through and ignore them.

The Centers for Disease Control and Prevention and sleep researchers estimate that between 50 million and 70 million Americans have an active sleep disorder, and most people don't know they do.

As a sleep specialist who primarily treats people with chronic insomnia, I can say with confidence that even common sleep disorders remain underrecognized, underdiagnosed and undertreated.

Sleep disorders deserve medical attention - and often are highly treatable. Here are the most common (there are more than 80 clinical sleep disorders, by the way), and the signs you might have one.

Insomnia

Insomnia disorder is defined as difficulty falling asleep, staying asleep or waking up too early at least three nights per week for at least three months. It causes real impairment in daily life.

Sleep onset insomnia is the inability to fall asleep within a reasonable time frame (30 minutes) after getting into bed, while sleep maintenance insomnia involves waking up during the night and having trouble returning to sleep (for 30 minutes or more) or waking up much earlier than desired.

Insomnia can be acute, lasting days to weeks, usually triggered by an identifiable stressor and often resolving on its own, or chronic, persisting three months or longer and typically requiring intervention.

Decades of epidemiological research suggests that 10 to 15 percent of the general population meets the criteria for chronic insomnia disorder, with higher rates among women, older adults and people with co-occurring mental health conditions.

Additional signs of insomnia disorder:

• Feeling exhausted, even after a full night of sleep

• Regularly experiencing irritability, low mood, mood changes, difficulty concentrating or paying attention, or memory problems

• Dread or anxiety as bedtime approaches

• Feeling exhausted getting into bed, but the moment your head hits the pillow, you're wide awake ("tired but wired")

The gold standard treatment is cognitive behaviour therapy for insomnia, also known as CBT-I, though other forms of sleep therapy as well as certain medications may also be appropriate.

Obstructive sleep apnoea

Obstructive sleep apnoea is a medical condition in which the muscles in the throat relax during sleep, causing the airway to narrow or close entirely - which often manifests as snoring, though you don't have to snore to have OSA. As the airway collapses, breathing stops - sometimes for a few seconds, sometimes longer - until the brain partially wakes the body to restore airflow. This cycle can repeat hundreds of times a night, fragmenting sleep so often that most people wake up exhausted.

OSA is estimated to affect more than 30 million Americans. Yet, according to multiple analyses, 80 to 90 percent of OSA cases in the United States go undiagnosed every year. Women are overwhelmingly underdiagnosed because their symptoms often present differently - fatigue, mood changes, insomnia, morning headaches - compared with men, who are more likely to snore loudly or gasp/choke.

I hear this all the time from women in my practice. They didn't fit the typical OSA stereotype, and instead their symptoms were attributed to depression, thyroid problems, stress or another sleep disorder.

Additional signs of OSA:

• Waking up with a dry mouth, sore throat or headaches

• Excessive daytime sleepiness

• Waking frequently to use the bathroom during the night (known as nocturia; this happens when apnoeas strain the heart and the body releases more of a hormone that increases urination)

• Difficulty concentrating, memory problems or cognitive slowing

• Increased irritability, mood changes, anxiety or depression that don't fully resolve with treatment

• A history of chronic insomnia, particularly difficulty staying asleep

• High blood pressure or cardiac issues that are difficult to control

Sleep apnoea is often treated with continuous positive airway pressure therapy, which involves wearing a breathing machine that keeps airways open while sleeping, though other therapies and even surgery may be helpful for some. Lifestyle changes, such as weight loss and avoiding alcohol use, could also help.

Restless legs syndrome

Restless legs syndrome, also known as Willis-Ekbom disease, is characterized by an irresistible urge to move the legs (and/or arms), usually accompanied by uncomfortable sensations: crawling, tingling, pulling, aching, burning, itching or an indescribable inner restlessness.

Symptoms emerge or worsen at rest, and moving around, stretching or walking usually brings temporary relief. It is deeply uncomfortable in a way that makes staying still feel impossible and falling asleep extraordinarily challenging.

Research published in the Journal of Global Health estimates that RLS affects between 7.2 percent and 11.5 percent of the general population, though data suggests it's largely undiagnosed or not diagnosed until years after symptom onset.

Because RLS cannot be visually detected on standard tests, and the sensation is difficult to explain, it was long dismissed as psychological or simply as "growing pains."

Additional signs of RLS:

• Your bed partner complains that you kick or jerk your legs (and/or arms) repeatedly during sleep

• Excessive daytime sleepiness, mood changes, cognitive slowing and increased anxiety or depression

Anti-seizure medications and prescription-strength iron supplements may help, as can treating other health conditions and lifestyle interventions such as regular exercise, eating well, avoiding stimulants, massage, compression wear, hot/cold packs and magnesium supplementation.

Circadian rhythm sleep-wake disorders

Circadian rhythm sleep-wake disorders, or CRSWDs, occur when a person's internal biological clock - which governs the timing of sleep, hormone release, body temperature and dozens of other physiological functions - is misaligned with the external environment or the person's desired sleep schedule. These are not disorders of sleep quality per se but of sleep timing.

This can result in a sleep-wake schedule that's much different from typical social norms, whether that means you can't fall asleep until extremely late at night no matter how early you try, or you get sleepy in the early evening and wake up very early in the morning.

A research review published in the Journal of Clinical Neurophysiology found that up to 3 percent of the adult population has a CRSWD, with rates reaching 7 to 16 percent among adolescents and young adults. The review also noted that CRSWDs are commonly misdiagnosed as other sleep disorders.

Additional signs of circadian rhythm disorders:

• You identify as an "extreme night owl" or "extreme early bird."

• When allowed to sleep freely on vacation or nonwork days, you shift to a dramatically different schedule.

• You work rotating shifts and struggle to sleep when you have the opportunity, despite feeling exhausted.

• You have been told you have insomnia, but sleep medications or standard sleep hygiene advice have not helped.

• Your "insomnia" or "fatigue" has never fully responded to treatment.

The best "treatment" is to adapt your lifestyle so you can sleep in your natural, biological sleep-wake window. When that's not possible, circadian rhythm management (e.g., microdosing melatonin, bright light therapy) or behavioural strategies, such as CBT-I, may be appropriate.

What to do if you suspect a sleep disorder

If any of the signs described above sound familiar, and especially if they've been going on for more than a few weeks, the first step is to talk to your doctor and specifically ask about sleep disorders.

Don't just say you're tired or can't sleep. Be specific: Describe when the problems occur, how long they've lasted, how they affect your daytime functioning and whether your bed partner has noticed anything unusual.

From there, your doctor may refer you to a sleep specialist (or you may need to ask directly for a referral), who can conduct a thorough sleep evaluation and, when appropriate, a sleep study. The list above is not exhaustive; other sleep disorders, such as narcolepsy and idiopathic hypersomnia, are less common but can also cause excessive daytime sleepiness despite your having logged plenty of hours in bed, and require proper diagnosis and treatment.

If you've been exhausted for months or years, and standard sleep hygiene advice hasn't helped improve your sleep, you are not failing at sleep. Your sleep problems are probably not "just stress" or "just how you are," and your exhaustion is not a badge of honour. Your sleep struggles deserve more attention.

Sarah Silverman, PsyD, is a sleep psychologist and behavioural sleep medicine specialist in private practice specializing in women's sleep health and insomnia

https://www.yahoo.com/lifestyle/articles/im-a-sleep-doctor-these-are-the-signs-you-have-a-real-sleep-problem-100000383.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAHA3vF4YQOVMyj1xbpZf7u6z3kWpDSaO133nTybQTDgxSbQSgOUOqFVDBaLy71TRJBFb5A8cLnhPhNFtMFbjBhXQwU5DY16lWfv9U_zrLNCvQOuGgbz1DmzuA4l-2l7Fh0u_N61ZCMiAHwXla1T3Z0ubtztHJqEbDQBPFbliusQk