Insomnia

The Silent Struggle for Rest

Insomnia is one of the most common sleep disorders, affecting up to one-third of adults at some point in their lives. It can take the form of difficulty falling asleep, staying asleep, or waking too early and not being able to return to sleep. While it may seem like a personal or temporary issue, chronic insomnia can lead to serious physical, emotional, and cognitive health consequences. It also disproportionately affects underserved communities, making it a key issue in the conversation about sleep health equity.

Types of Insomnia

Acute Insomnia – Short-term sleep difficulty, often caused by stress, life events, or changes in schedule or environment.
Chronic Insomnia – Trouble sleeping at least three nights a week for three months or more. Often linked to mental health issues, chronic illness, or environmental stressors.
Sleep-Onset Insomnia – Difficulty falling asleep at the beginning of the night.
Sleep-Maintenance Insomnia – Trouble staying asleep through the night or waking up too early.

Symptoms of Insomnia

Lying awake for long periods
Waking up frequently during the night
Feeling tired despite spending enough time in bed
Trouble concentrating or remembering things
Increased irritability or mood changes
Daytime fatigue, clumsiness, or low motivation

Causes and Risk Factors

Biological and Psychological Factors

Anxiety, depression, PTSD
Chronic pain or illness
Hormonal changes (e.g., menopause)
Neurodivergent conditions (e.g., ADHD)

Environmental and Lifestyle Factors

Poor sleep hygiene (screen time before bed, inconsistent schedule)
Stressful living conditions or unsafe housing
Shift work or irregular job hours
Noise, light, or shared living spaces

Societal and Structural Factors

Discrimination, racism, and chronic stress
Lack of access to healthcare or mental health support
Housing instability and neighborhood violence
Cultural stigma around mental health or rest

Health Consequences of Chronic Insomnia

Increased risk of heart disease, hypertension, and stroke
Higher likelihood of depression, anxiety, and suicidal ideation
Impaired cognitive performance and memory
Weakened immune system and frequent illness
Greater risk of substance use or dependency
Lost productivity, increased work absences, and financial stress

Diagnosis and Assessment

If you’re experiencing symptoms of insomnia, a healthcare provider may ask questions about:

Sleep patterns and routines
Daytime functioning
Medical and mental health history
Lifestyle, stress levels, and environment

You may be asked to complete a sleep diary, insomnia severity index (ISI), or even undergo a sleep study if another disorder like sleep apnea is suspected.

Insomnia and Health Equity

Marginalized communities face higher exposure to the root causes of insomnia—including unsafe neighborhoods, trauma, racism, unstable work schedules, and limited access to healthcare. These compounding stressors aren’t solved by just “going to bed earlier.”

Improving sleep outcomes means expanding access to mental health care, culturally competent providers, safer living environments, and structural changes that reduce systemic stress.

Treatment Options

Managing sleep disorders and hypertension can bith significantly improve blood pressure and your overall health. Strategies include:

Cognitive Behavioral Therapy

CBT is the single most effective treatment for chronic insomnia:

Focuses on replacing unhelpful thoughts and behaviors around sleep
Involves sleep restriction, stimulus control, relaxation techniques
May be offered in-person, online, or through apps

Lifestyle Changes

Sleep Hygeine Changes:

Consistent bedtime/wake time
Limiting screen time before bed
Avoiding caffeine, alcohol, or heavy meals in the evening
Creating a comfortable sleep environment

Holisitic approaches:

Meditation, yoga, breathing exercises
Physical activity (earlier in the day)
Herbal remedies

Medication

Medication for insomnia should be used in the short term only. Options inlcude:

Melatonin
Melatonin receptor agonists
Sedative-hypnotics
Others

Sources

1.American Academy of Sleep Medicine (AASM). (2021). Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults. https://aasm.org/clinical-resources/practice-standards/insomnia/ 2.National Heart, Lung, and Blood Institute (NHLBI). (2020). What Is Insomnia? https://www.nhlbi.nih.gov/health/insomnia 3.Centers for Disease Control and Prevention (CDC). (2022). Insomnia and Sleep Health. https://www.cdc.gov/sleep/data_statistics.html 4.Morin, C. M., & Benca, R. (2012). “Chronic insomnia.” The Lancet, 379(9821), 1129–1141. https://doi.org/10.1016/S0140-6736(11)60750-2 5.Ong, J. C., & Manber, R. (2011). Cognitive Behavioral Therapy for Insomnia in Those with Depression. Behavioral Sleep Medicine. https://doi.org/10.1080/15402002.2011.533987 6.Grandner, M. A., & Patel, N. P. (2020). “Sleep-related disparities: A focus on insufficient sleep and insomnia.” Sleep Health, 6(5), 430–441. https://doi.org/10.1016/j.sleh.2020.04.002 7.Hale, L., & Troxel, W. (2020). “Sleep health as a public health issue: Promoting health equity through better sleep.” Sleep Health, 6(4), 365–367. https://doi.org/10.1016/j.sleh.2020.05.004 8.National Institutes of Health (NIH). (2019). Insomnia: Causes, Diagnosis, and Treatments. https://www.ninds.nih.gov/health-information/disorders/insomnia