Sleep and insomnia

Good sleep helps your mood, your memory and your heart. Poor sleep can make almost every health problem harder to handle, including depression, anxiety and pain. Trouble sleeping is very common, and it often becomes more common later in life.

The good news is that most sleep problems can be treated. This page gives you the big picture, with links to more detail on each topic.

Why sleep matters

While you sleep, your brain stores what you learned during the day, and your heart and blood vessels get time to repair.⁹

Too little sleep can leave you more stressed and more likely to get sick. Over time, it is linked to type 2 diabetes, heart disease, high blood pressure and stroke. It also hurts attention and memory.¹ Small losses add up: losing just 1 to 2 hours of sleep a night for several nights can affect you about as much as staying up a full day or two.⁹

Sleepiness is also a safety problem. In 2024, crashes involving drowsy drivers killed 644 people in the United States, and experts believe the true number is higher.¹⁰ If you nod off, drift across lane lines or hit a rumble strip, pull over somewhere safe.

Sleep, mood and anxiety

Sleep and mental health work in both directions. Poor sleep is linked to depression, suicide and risky behavior. It also makes it harder to manage your emotions and cope with change.⁹ In turn, depression, anxiety and bipolar disorder are common causes of insomnia.²

One large review pulled together 21 studies that followed people over time. People who had insomnia at the start were about twice as likely to develop depression later as people who slept well.³

Read more in Sleep, mood and anxiety. See also Depression, Anxiety and Living well with bipolar disorder.

Insomnia

Insomnia means having trouble falling asleep, staying asleep or getting restful sleep, even when you have enough time and a good place to sleep. It also affects your days. You may feel tired, cranky, low on energy, or have trouble focusing or remembering.²

Doctors talk about two kinds:²

• Short-term insomnia lasts up to 3 months. It often follows stress, a loss, an illness or a change in routine. About 15 to 20 out of every 100 people have it at any one time.
• Chronic insomnia happens at least 3 nights a week for at least 3 months. About 1 in 10 people has it.

Common triggers include stress, grief, pain, menopause, other sleep disorders, some medicines, caffeine, late alcohol, noise, shift work and an irregular schedule. Older adults and women are affected more often.²

Insomnia can last long after its first cause is gone. Worry about sleep and long hours awake in bed can keep it going. Learn more in Insomnia.

Other common sleep disorders

Some sleep problems need their own tests and treatment.¹

Sleep apnea is common, and many people who have it do not know it.^6,11 Without treatment, it can raise the risk of stroke and heart attack. It can also cause problems with focus, memory and decisions.⁶ A doctor can check for it with a sleep study, either in a sleep lab or with a small monitor you use at home.¹¹

Restless legs syndrome may be linked to low iron in the brain, so doctors often check iron levels with a blood test.⁷

REM sleep behavior disorder is often tied to an underlying brain condition, such as Parkinson's disease or dementia with Lewy bodies.⁸ If someone in your home acts out dreams, tell a doctor.

Sleep in later life

Sleep often changes with age. It may feel lighter, and you may wake more during the night. But feeling tired most days is not something you just have to accept. Older adults still need about 7 to 8 hours of sleep.¹

Insomnia is more common in older adults. Pain, health conditions and medicines can all play a part.² Getting up often to urinate can even be a sign of sleep apnea.¹¹

Many sleep medicines carry extra risks for older adults (see below).¹² Read more in Sleep in later life. For people living with dementia, see Sleep problems in dementia, Sundowning and Sleep medicines in dementia.

What helps

The badges show how strong the research is (see how we rate evidence).

To calm your body before bed, try a body scan, muscle relaxation or the cyclic sigh.

A word of caution about sleeping pills

Some sleep aids are riskier than people think, especially for older adults.

Pages in this section

• Insomnia: what it is, why it lasts, and why CBT-I comes first.
• Sleep medicines: what to know: the main types, their risks, and safer choices for older adults.
• Sleep apnea: signs, home sleep tests, CPAP and other treatments.
• Sleep in later life: normal changes, naps, nighttime bathroom trips, pain and dementia.
• Sleep, mood and anxiety: how sleep and mental health affect each other.
• Restless legs syndrome: symptoms, iron and treatment choices.
• Healthy sleep habits: tips checked against the research, and what they can and cannot do.

CBT-I lessons: 1. Sleep diary, 2. Sleep window, 3. Bed and sleep, 4. Sleep thoughts, 5. Wind-down.

In this section

When to get help

Talk with your doctor if:^1,2

• You have trouble sleeping most nights for several weeks, and it affects your days.
• You snore loudly, gasp or choke at night, or someone sees you stop breathing.
• You feel very sleepy during the day, or you nod off while driving or in other unsafe places.
• You act out dreams, or you or your bed partner have been hurt during sleep.
• An urge to move your legs keeps you from falling asleep.

It helps to bring a sleep diary for about two weeks. Note bedtimes, wake times, naps, caffeine, alcohol, exercise and medicines.^1,2 Our sleep diary lesson shows you how.

If poor sleep comes with low mood, hopelessness or thoughts of suicide, call or text 988 any time to reach the 988 Suicide & Crisis Lifeline. If someone is in danger right now, or if a person stops breathing or cannot be woken, call 911. For more ways to reach help, see Get help.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.