When Sleep Breaks Down: Recognizing Insomnia and Rebuilding Rest

Typical Human Sleep Hypnogram: Progression of Sleep Stages Across Five Cycles (Light Sleep, Deep Sleep, and Increasing REM)

What Insomnia Is

Insomnia is a common sleep disorder marked by ongoing difficulty sleeping despite having enough time and opportunity. Symptoms fall into two groups: nighttime sleep problems and daytime consequences.

Nighttime Symptoms

• Trouble falling asleep (taking >20–30 minutes).
• Trouble staying asleep with frequent awakenings.
• Waking too early and unable to return to sleep.
• Sleep that feels unrefreshing or poor‑quality.

For a formal diagnosis, symptoms occur ≥3 nights/week for ≥3 months and cause distress or impairment.

Daytime Symptoms

• Fatigue, low energy, or sleepiness.
• Difficulty concentrating, memory lapses, slower thinking, or more mistakes.
• Irritability, anxiety, low mood, or frustration about sleep.
• Reduced motivation, productivity, or performance; higher accident risk.
• Physical discomforts like headaches, tension, stomach issues, or feeling unwell.

Common Patterns

• Acute insomnia: Lasts days to weeks (e.g., stress, travel).
• Chronic insomnia: Lasts ≥3 months, often mixing onset, maintenance, and early awakening.

Insomnia isn’t only about trouble sleeping at night—it’s about how those disrupted nights spill into your days. Patterns also shift with age: older adults wake more often, while younger adults tend to struggle with falling asleep. And even brief, repeated awakenings accumulate over time, including the ones you don’t fully remember.

Infographic Credit: Microsoft Copilot

Infographic Credit: Microsoft Copilot

Why Good Night Sleep Is Essential?

Insomnia touches a huge portion of the population—about 12% of adults meet criteria for chronic insomnia, and nearly half experience symptoms weekly. If you’re noticing similar patterns, simple tools like a sleep diary and Cognitive behavioral therapy for insomnia (CBT‑I) can make a meaningful difference, often without medication. Understanding why sleep matters so much is the next step.

• Protects the Heart: Supports repair of blood vessels; poor sleep raises risks of heart disease, hypertension, stroke, kidney disease, inflammation, and shorter lifespan.
• Helps Manage Weight: Regulates hunger/satiety hormones; short sleep (<7 hrs) increases obesity risk and undermines weight‑loss efforts. Obesity and sleep disorders worsen each other.
• Strengthens Immunity: Sleep boosts protective cytokines and immune cells. Even one sleepless night increases inflammation and weakens defenses against infection.
• Supports Growth & Repair: Deep sleep triggers growth hormone for muscle repair, tissue recovery, healthy development, puberty, and fertility.
• Improves Blood Sugar Control: Too little or too much sleep increases insulin resistance and type 2 diabetes risk; poor sleep quality and irregular patterns worsen it further.
• Boosts Learning & Memory: Sleep consolidates memories, sharpens focus, and improves reasoning. Lack of sleep causes brain fog, slower reactions, and accelerates cognitive aging.
• Enhances Safety & Performance: Sleep loss impairs judgment, attention, and emotional control—contributing to major accidents and everyday errors.
• Supports Mood & Mental Health: Good sleep improves resilience and well‑being; poor sleep increases stress, irritability, depression, anxiety, and ADHD symptoms.
• Improves Appearance & Vitality: Better circulation during sleep supports skin and hair health; chronic deprivation accelerates aging and reduces physical performance.

Sleep Hygiene — Start With CBT‑I

Once you understand how insomnia works and why sleep matters, the next step is rebuilding healthy sleep patterns. Focus on solid sleep habits, use CBT‑I as the first‑line approach, and keep medications for situations where they’re truly necessary to support overall well‑being.

A simple CBT‑I practice: keep a sleep diary.

1. Before bed (~15 min): Write down the day’s stresses or discomforts to offload them.
2. If still unsettled: Black out or tear up the page as a symbolic “reset.”
3. Morning: Record sleep timing and duration.

These routine lowers anxiety and reinforces healthier patterns.

Notes

• Sleep diaries remain essential for monitoring progress and guiding adjustments.
• CBT‑I is effective even alongside conditions like depression, anxiety, or chronic pain.
• Digital CBT‑I programs that include these components improve access and show strong outcomes.
• It outperforms sleep medications over the long term, without side effects or dependence.

If insomnia continues to disrupt your nights, consider reaching out to a sleep specialist or CBT‑I–trained therapist. Many people improve with self‑guided strategies, but professional support often leads to steadier, longer‑lasting, and medication‑free progress.

References

1. Baglioni, C., Johann, A. F., Benz, F., Steinmetz, L., Meneo, D., Frase, L., Riemann, D., & Spiegelhalder, K. (2025). Cognitive behavioral therapy for insomnia in people with chronic disease: A systematic review and meta-analysis. JAMA Internal Medicine, 185(11), 1350–1361. 
• This meta-analysis confirms strong efficacy and acceptability of CBT-I for insomnia comorbid with chronic diseases, showing significant improvements in sleep outcomes.
2. Machado, E., et al. (2025). Is insomnia linked to sleep bruxism in adults? A systematic review and meta-analysis. Journal of Oral Rehabilitation, 53(1), 257–264. 
• Findings indicate no consistent significant association between insomnia and sleep bruxism, based on self-report and PSG data up to March 2025.
3. Wang. M., et al. (2025). Effects of a cannabidiol/terpene formulation on sleep in individuals with insomnia: A double-blind, placebo-controlled, randomized, crossover study. Journal of Clinical Sleep Medicine. 
• One of the top-cited 2025 studies in JCSM; explores a novel CBD/terpene approach for insomnia symptoms.
4. Winkelman, J., et al. Treatment of restless legs syndrome and periodic limb movement disorder: An American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. Journal of Clinical Sleep Medicine. 
• Highly read/impactful; while focused on RLS/PLMD, it overlaps with insomnia comorbidities and treatment evidence.
5. Gao, J., et al. (2025). Association between insomnia symptoms and risk of heart failure: A meta-analysis of prospective cohort studies. Journal of Cardiology. Advance online publication.
• Confirms increased heart failure risk linked to specific insomnia symptoms like difficulty initiating sleep.
6. Benjafield, A. V., et al. (2025). Estimation of the global prevalence and burden of insomnia: A systematic literature review-based analysis. Sleep Medicine Reviews, 82, Article 102121.
• Updated global burden estimates, highlighting insomnia's medical, mental health, and economic impacts.
7. [Preliminary/observational from AHA 2025]. (2025). Long-term melatonin use and cardiovascular outcomes in chronic insomnia (presented at American Heart Association Scientific Sessions).
• "…while the association we found raises safety concerns about the widely used supplement, our study cannot prove a direct cause-and-effect relationship. This means more research is needed to test melatonin's safety for the heart."
8. [From Nature outlook]. (2025). New treatments to put insomnia to bed. Nature. 
• Review of emerging options: orexin antagonists, cannabis-derived molecules, brain-modulating wearables, and CBT-I delivery advances.
9. Capturing Awakenings for Better Sleep - Medical Frontiers (Watch the video on YouTube)