If you’ve ever had trouble falling asleep—or, once you have fallen asleep, have awakened only to be kept up by racing thoughts—you are not alone. Insomnia is one of the most common sleep disorders, with the Centers for Disease Control and Prevention reporting that as many as one in two adults experience short-term bouts, while one in 10 may be dealing with chronic insomnia.
That’s troubling news, considering that many Americans already have a sleep deficit. According to the CDC, roughly 38% of adults were not getting enough sleep—meaning less than seven hours per night—as of 2022. And it is well-known that sleep deprivation negatively impacts one’s health, causing everything from decreased cognitive functioning to a suppressed immune system.
So what can we do about those nights where sleep eludes us? Fortune spoke with experts to figure out the best strategies for getting our zzzs.
What is insomnia?
According to Dr. Eric Sklar, board-certified neurologist and sleep medicine doctor, insomnia is the inability to get to sleep or stay asleep. It can also be waking up at night or, in the morning, earlier than desired.
And it’s something that will often interfere with your day, leading to sleepiness or impairment in functioning, Sklar says.
“It’s not just a nighttime problem,” adds sleep expert Alaina Tiani of the Cleveland Clinic Sleep Disorders Center. "It tends to infiltrate your daytime life, as far as the effects.”
The symptoms of insomnia, Tiani says, are when you can’t fall asleep for more than 30 minutes, when you stay up for more than 30 minutes after waking at night, or when you wake up in the morning more than 30 minutes earlier than you intended.
And there are two different types of insomnia, according to Sklar: episodic, or acute, insomnia, and chronic insomnia. To qualify for the latter, you’d have to experience symptoms for three months or more, he says.
But at one point or another, everyone will experience acute moments of insomnia.
“It’s one of the most common sleep disorders in the world,” Sklar tells Fortune.
How does insomnia impact your health?
Lack of sleep impacts the mind and body in many ways, with most immediate effects being impaired concentration, increased irritability, chronic headaches, reduced productivity, and, for drivers, increased risk of car accidents, Sklar says.
Over time, insomnia can take a serious toll.
That is especially the case for brain health, both Tiani and Sklar stress. While depression and anxiety can lead to insomnia, losing sleep can exacerbate those symptoms even more. Studies have also linked insomnia to dementia, as a lack of sleep adversely impacts brain health—but Tiani doesn’t want anyone with insomnia to panic just yet.
“Just because you have insomnia does not mean you are guaranteed to have dementia,” she says. “Insomnia is one piece of the puzzle that poses some degree of risk, but there are so many other factors.”
Physically, insomnia can weaken heart health—leading to more heart palpitations, for example—and make weight-loss more difficult, Tiani says. In addition to that, your immune system becomes weakened from a lack of sleep, leaving you more susceptible to the common cold and other viruses.
“It’s not a good baseline quality of life,” Sklar says of being sleep-deprived.
What causes insomnia?
Sklar says there can be many reasons why someone experiences insomnia, spanning medical and psychiatric issues to outside stressors and daytime habits.
Often, people who experience insomnia will have anxiety or another type of mood disorder, he says, with Tiani adding that women are also more susceptible.
Physical conditions, chronic pain, or needing to urinate multiple times per night can contribute to insomnia as well—as can health conditions including fibromyalgia, chronic pain, tinnitus, thyroid problems, and deficiencies in certain vitamins or nutrients, such as iron.
Chronic insomnia, however, is often due to stress, Tiani says. That can be triggered by traumatic experiences or substantial life changes like losing a job, divorce, or the loss of a loved one.
How to beat insomnia
Since insomnia is often influenced by stress or adverse mental health, experts advise tackling your mind first—perhaps by scheduling an appointment with a therapist
Both Sklar and Tiani recommend cognitive behavioral therapy for insomnia (CBT-I) as the first line of defense. Tiani says that CBT-I helps people “really get to the root of the problem.”
Therapy can also help with the management of stress—the main reason for insomnia, Sklar and Tiani agree.
“Once the stressor goes away, your sleep tends to get better on its own,” Tiani says, noting that implementing mindfulness practices can help you cultivate present-moment awareness and understand the thoughts or feelings impacting your sleep.
Tiani is also a proponent of addressing how you think about sleep and insomnia, through what’s called “cognitive restructuring.” That’s where experts like Tiani will help someone look at their sleep-related thoughts and beliefs.
For example, if you are thinking, “I won’t be able to function tomorrow if I don’t sleep well,” Tiani will challenge that thought, and ask, “Have there been times when you didn’t sleep well but you actually had an okay day? Can we amend your thought to say, ‘Maybe it’s not so black and white, maybe it’s not the worst day ever…maybe I’ll still be able to do the majority of the things I want to do?’”
Sleep hygiene also plays a crucial role in how well you rest at night. And one of the main mistakes people make, experts say, is staying in bed while you are awake, restless, and anxious.
“It’s important to prevent the association of not sleeping and being in bed, because that also perpetuates things,” Sklar says. Tiani adds to help make sure your bed is solely a place for sleep, that you go to bed only when you are truly ready.
If you do find yourself unable to fall asleep or stay asleep, Sklar recommends getting out of bed and doing something calming—like reading a physical book or magazine or listening to a podcast—until you feel sleepy and can return to bed. That prevents your mind from associating your bed with the inability to sleep, he says.
Tiani adds that the more you do to try and fight the impacts of insomnia during the day without addressing the root of the problem, the more you could be sabotaging your sleep at night.
For instance, if you have poor sleep hygiene—drinking caffeine too late in the day, drinking alcohol, using screens too close to bedtime, taking daytime naps, or not going to bed at the same time each night—those should also be some of the first things you address to ward off insomnia, he says.
“In the long-term, these perpetuating factors—napping, drinking coffee, spending excess time in bed—can actually be the things that keep the insomnia going,” Tiani says. “It starts this vicious cycle.”
Still, she emphasizes, the things we do to perfect our sleep routine won’t matter if our mental health and stress aren’t in check.
“It’s not always the stuff that we do, it’s the stuff that we think,” she says. “Blackout curtains are not going to solve insomnia for most people.”
For more on sleep:
- Is melatonin or ashwagandha better for sleep? Experts weigh in
- Sleep 101: Tips and habits for getting a good night’s rest and boosting your health
- Getting enough sleep but still exhausted? These 7 types of rest can help
