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JAMA Patient Page
June 27, 2012


JAMA. 2012;307(24):2653. doi:10.1001/jama.2012.6219

Insomnia is a sleep disorder that includes trouble falling asleep, staying asleep, or waking too early, resulting in daytime impairment. It is a common problem, usually occurring along with other diseases or emotional stress (comorbid insomnia). It can also exist without other medical or mental health causes (primary insomnia). Long-standing (chronic) insomnia can lead to daytime consequences such as fatigue or sleepiness, difficulty with thinking, and mood impairments, which can interfere with performance at school and work.

Risk factors for insomnia

  • Age older than 60 years

  • History of mental health disorders including depression, generalized anxiety disorder, and posttraumatic stress disorder

  • Emotional stress

  • Working at night or in shifts

  • Traveling through different time zones


  • Go to sleep and get up at the same time every day.

  • If you are having a hard time falling asleep, leave the bedroom and engage in a quiet activity until you feel sleepy. Return to bed to try to sleep again.

  • Avoid drinking caffeinated beverages during the 8 hours before your bedtime. Also avoid eating heavy meals immediately before sleep and drinking alcohol close to bedtime.

  • Create a calming environment when you go to sleep.

  • Although exercise can help you sleep better, avoid exercising immediately prior to your bedtime.

  • Do not use your bed for work or other activities; use it only for sleep or sex.


  • If the problem is comorbid insomnia, treat the associated disorder in addition to focusing on insomnia.

  • If sleep hygiene changes are not successful, your physician may suggest cognitive behavioral therapy, which modifies sleep behaviors and explores your attitudes toward and thoughts about sleep.

  • Several prescription medications are available for insomnia, but these should be used only under the guidance of physicians and only for a short period.

For more information

Inform yourself

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's website at Many are available in English and Spanish.

Sources: National Heart, Lung, and Blood Institute; Cleveland Clinic


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. To purchase bulk reprints, call 312/464-0776.