Insomnia
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Try one of these related symptoms.
Inability to sleep
Hard to fall asleep or stay asleep
Waking up in the middle of the night
Trouble sleeping
Cannot sleep well
Staying awake throughout the night and sleeping during the day
Feeling tired or sleepy during the day
Sleep inversion
Sleep deprivation
Waking up in the early morning
Unable to sleep
Wake up early morning and can't go back to sleep
About the Symptom
Trouble falling or staying asleep. It can be caused by many different physical or psychiatric conditions.
When to See a Doctor
Seek professional care if you experience any of the following symptoms
- Photophobia
- Change in personality
- Disorder of consciousness
- Abdominal pain
Possible Causes
Generally, Insomnia can be related to:
- Sleep Disorder
Sleep disorders are conditions that affect the quality, timing, or duration of your sleep, impacting your ability to function when you're awake. There are many types of sleep disorders, including disturbances in sleep quality or quantity, excessive daytime sleepiness, abnormal behaviors during sleep, sleep disorders related to mental disorders, and more. Narcolepsy is one such disorder, often grouped under hypersomnias - a category of conditions characterized by excessive daytime sleepiness - and can be mistaken for or coexist with other sleep disorders like sleep apnea. Accurate diagnosis is essential for effective treatment.
- Fibromyalgia
A condition causing widespread pain and muscle aches throughout the body that may come and go with certain identified triggers. The cause is not well understood.
- Alcohol Dependence / Delirium Tremens
A condition in which the patient depends on alcohol and experiences withdrawal symptoms if they don't have a drink. These symptoms can range from mild (e.g., irritation, sleeplessness) to severe (confusion, coma, seizures).
- Depression
- Bipolar Disorder
- Night Terrors
- Obsessive-Compulsive Disorder
- Psychogenic Vomiting
- Adjustment Disorder
Related Serious Diseases
Sometimes, Insomnia may be related to these serious diseases:
- Exploding Head Syndrome (EHS)
Exploding head syndrome (EHS) is a sleep disorder where someone hears a loud noise or explosive crashing sound in their head. The sound isn't real or heard by anyone else.
Doctor's Diagnostic Questions
Your doctor may ask these questions to check for this symptom:
- Are you having trouble sleeping?
- When did you first notice trouble sleeping?
- How often do you experience trouble sleeping?
- How is your trouble sleeping now?
- How severe is your trouble sleeping?
Reviewed By:
Charles Carlson, DO, MS (Psychiatry)
Dr. Carlson graduated from Touro University in Nevada with a degree in osteopathic medicine. He then trained as a resident in Psychiatry at Case Western Reserve University/University Hospitals where he was also a chief resident and completed a fellowship in Public and Community Psychiatry. After training, he started practicing in | Addiction Psychiatry at the U.S. Department of Veterans Affairs where he also teaches Psychiatry residents.
Yu Shirai, MD (Psychiatry)
Dr. Shirai works at the Yotsuya Yui Clinic for mental health treatment for English and Portuguese-speaking patients. He treats a wide range of patients from neurodevelopmental disorders to dementia in children and participates in knowledge sharing through the Diversity Clinic.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Feb 6, 2025
Following the Medical Content Editorial Policy
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With a free 3-min Insomnia quiz, powered by Ubie's AI and doctors, find possible causes of your symptoms.
This questionnaire is customized to your situation and symptoms, including the following personal information:
Biological Sex - helps us provide relevant suggestions for male vs. female conditions.
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History - considers past illnesses, surgeries, family history, and lifestyle choices.
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Wake up early in the morning
- Waking up in the very early morning and can't go back to sleep
- Restlessness when sleeping
- Staying awake all night and sleeping during day
- Sudden waking in the middle of night
- Difficulty falling asleep
- Wake up in the middle of the night
- Reversal of sleeping tendencies
- Early morning awakening
- Difficulty staying asleep
- Sleep-wake inversion
- Waking up too early
- Can't sleep well at night
- Day-night reversal
See full list
Find Similar Symptoms
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FAQs
Q.
Still Awake? Why Doxylamine Succinate Fails & Medical Next Steps
A.
Doxylamine succinate often fails because it only makes you sleepy rather than treating root causes, so stress or anxiety, circadian disruption, sleep apnea, restless legs, depression, wrong dosing, and tolerance can keep you awake, and some people even get paradoxical alertness with anticholinergic risks from long-term use. Next steps include CBT-I and better sleep habits, medical screening for causes such as sleep apnea, thyroid disease, depression, or RLS, and discussing targeted options with a clinician like low-dose doxepin, melatonin for timing issues, or orexin receptor antagonists while avoiding alcohol, dose increases, and stacking sedating meds. There are several factors to consider, and urgent red flags plus step-by-step guidance are outlined below.
References:
* Becker L, Mokhlesi B, St. Louis EK, Teo SY, O'Connell M, Krystal AD. Efficacy and Safety of Over-the-Counter Sleep Aids: A Systematic Review. J Clin Sleep Med. 2023 Dec 1;19(12):2125-2144. doi: 10.5664/jcsm.10985. PMID: 37380965; PMCID: PMC10850024.
* Verster JC. First-generation H1-antihistamines: new evidence for their misuse as hypnotics. J Sleep Res. 2021 Apr;30(2):e13192. doi: 10.1111/jsr.13192. Epub 2020 Jul 20. PMID: 32686259.
* Sateia MJ, Buysse DJ, Krystal AD, Neubauer DH, Heald JL. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017 Feb 15;13(2):307-349. doi: 10.5664/jcsm.6470. PMID: 28162040; PMCID: PMC5263093.
* Ong JC, Smith CE, Buysse DJ. Cognitive Behavioral Therapy for Insomnia (CBT-I): An Overview for Psychiatrists. Focus (Am Psychiatr Publ). 2019 Spring;17(2):162-169. doi: 10.1176/appi.focus.20180027. PMID: 31057416; PMCID: PMC6497723.
* Baglioni C, Nissen L, Spiegelhalder K. Current Perspective of Insomnia: From Definition to Management. Curr Opin Psychiatry. 2023 Nov 1;36(6):448-454. doi: 10.1097/YCO.0000000000000889. PMID: 37722741.
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