What do insomnia do at night

Sleep Disorder - Causes? What helps?

Insomnia - what is it?

Everyone sleeps badly. But about 6 out of 100 people have problems sleeping: they cannot fall asleep or stay asleep. They don't wake up refreshed in the morning. If this happens at least three times a week for over a month, experts call it one Insomnia.

Affected people think a lot about their sleep disorders in bed at night. You torment yourself with thoughts like "I absolutely have to sleep now, otherwise I won't be fit tomorrow". Then during the day they worry about lack of sleep. A vicious circle can arise.

Many sufferers suffer significantly from insomnia or feel impaired in everyday life as a result.

What are the possible causes?

Many circumstances can promote or trigger problems falling asleep and staying asleep. Examples are:

  • Stress, for example at work or in private life

  • Caffeine, alcohol, or drugs

  • physical or mental illnesses such as pain, stroke, depression or dementia

  • Medications, such as certain antibiotics, blood pressure or asthma medicines

  • shift work

  • Personality traits, such as perfectionism

  • hereditary predisposition

Nocturnal brooding or sleeping habits, such as an afternoon nap, can help make the sleep disorder permanent.

Does insomnia make you sick?

Those who sleep badly can get mentally ill. Above all, insomnia can make you depressed.

In addition, those affected have a higher risk of high blood pressure, heart attack or heart failure in the long term. It is still unclear whether too little sleep makes you fat.

How do you diagnose insomnia?

During the conversation, your doctor will ask questions about pain, illness, medication, stress, working hours or sleeping patterns. This includes whether you drink alcohol or use intoxicants. Your answers will help to find the reason for your complaint. Physical examinations, sleep diaries, or questionnaires provide additional information.

There are small portable devices to record bed and bed times. Measurements with apparatus in the sleep laboratory can provide further information in certain cases.

Treatment options

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a form of psychotherapy. As studies show, it helps with permanent insomnia. The effectiveness persists long after the end of therapy. Therefore, professionals recommend CBT as the first step for adults.

CBT is available as individual, group or online therapy. It consists of many building blocks. Among other things, you will learn to relax or receive tips on how to sleep better. Techniques also help break negative thought loops.


Your doctor can offer you medication if CBT does not work well or is not possible. However, these can cause side effects. For example Benzodiazepines or substances similar to benzodiazepines addict quickly. Also calming antidepressants can come into question with insomnias. According to professionals, you can Benzodiazepine-like agents or antidepressants improve sleep, but only if taken for a short time. Because of the available data and possible side effects, they are currently unable to make a general recommendation for long-term treatment.

The benefits of herbal remedies with valerian, passion flower, lemon balm or hops have not yet been well proven. Therefore, experts do not give any recommendation for it.

Further procedures

These include, for example, mindfulness, acupuncture, aromatherapy, exercise, homeopathy, light therapy, massage, meditation, music therapy or yoga. However, their benefits have not yet been adequately proven in studies.

What can I do myself?

Before you start treatment, these rules may help improve your sleep:

  • After lunch, you should stop drinking beverages with caffeine, such as coffee, black tea, or cola.

  • Drink little or no alcohol before bed. A "nightcap" or "after-work beer" are not good sleeping pills.

  • Choose light meals as possible in the evening.

  • Try to be physically active on a regular basis.

  • Let the day end relaxed. Refrain from mentally or physically strenuous activities before going to bed.

  • Find your personal sleep ritual and create a comfortable sleeping environment.

  • Do not look at the clock if you cannot fall asleep or if you woke up at night.

The following procedure can help against the nocturnal carousel of thoughts and sleep-disrupting behaviors. The technical term is Stimulus control:

  • Only go to bed at night when you are really tired. Important: The bed is only there for sleeping or for sex.
  • If you cannot fall asleep, get up after 15 minutes and leave the bedroom. Don't go back to bed until you are sleepy. You can repeat this procedure if necessary.
  • Always get up at the same time in the morning. Avoid taking a nap in between.

You can get more tips and support in self-help groups.

August 2018, published by the German Medical Association and the National Association of Statutory Health Insurance Physicians