Insomnia

Insomnia is a sleep disorder marked by persistent difficulty falling asleep, staying asleep or waking too early, together with daytime impairment such as fatigue or poor concentration.

It is classified as short-term when it lasts under three months, often following stress, illness or travel, and chronic when it occurs at least three nights a week for three months or more. Contributors include anxiety, depression, pain, irregular schedules, caffeine, alcohol, certain medications and sleep disorders such as sleep apnea or restless legs. Chronic insomnia is associated with higher risks of depression, accidents and cardiovascular problems.

Assessment relies on sleep history, a two-week sleep diary and questionnaires such as the Insomnia Severity Index, with overnight sleep studies reserved for suspected apnea or other disorders. Cognitive behavioral therapy for insomnia is the recommended first-line treatment, with medication as a secondary option. Randomized evidence on cannabidiol and sleep is mixed, and a consistent benefit for insomnia has not been established.