Insomnia (trouble falling asleep or staying asleep) is a common problem. It can cause
daytime tiredness and sleepiness and difficulty paying attention at school or being alert at work. Insomnia can begin at an early
age and affects people of all ages. Insomnia can be transient (short-term) and related to a specific
condition like stress or travel, or it can be a chronic (long-term) problem that persists
for many months and may be caused by another medical problem.
The May 21, 2003, issue of JAMA includes an article about insomnia, its causes,
and its treatments.
Use of stimulants such as caffeine, cocaine, and some diet drugs
Shift work or keeping erratic hours
Environmental factors like noise and light
Depression or anxiety disorders
Medical problems including sleep apnea (waking up
frequently during the night, severe snoring, and
brief periods of not breathing)
Restless legs syndrome (uncomfortable leg sensations at night that are relieved by
walking, rubbing, or other movements that prevent sleeping)
Keep a regular schedule with a consistent bedtime
Use your bedroom mainly for sleep
Exercise regularly, but try to finish exercise at least 3 to 4 hours before going to bed
Avoid caffeine for at least 6 hours before going to bed
Avoid large meals close to bedtime
If you nap during the day, try to do so at the same time each day, and limit napping to an hour or less
If you experience persistent insomnia, see your doctor. Depending on the cause of the insomnia, your doctor may prescribe various
treatments ranging from psychiatric counseling to drug therapy.
National Sleep Foundation
American Insomnia Association
To find this and previous JAMA Patient Pages, go to the Patient Page link on
JAMA's Web site at www.jama.com. Many are available in English and
Spanish. A Patient Page on breathing problems during sleep was published in the June 13, 2001, issue.
The JAMA Patient Page is a public service of JAMA. The information and
recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis.
For specific information concerning your personal medical condition, JAMA suggests that you consult your
physician. This page may be photocopied noncommercially by physicians and other health care
professionals to share with patients. Any other print or online reproduction is subject to AMA approval.
To purchase bulk reprints, call 718/946-7424.
Sources: National Sleep Foundation, American Insomnia Association, National Center on Sleep
Disorders Research, American Academy of Sleep Medicine
Topic: SLEEP DISORDERS
Parmet S, Lynm C, Glass RM. Insomnia. JAMA. 2003;289(19):2602. doi:10.1001/jama.289.19.2466