On occasion, every one of us will have a night where we can't fall asleep or we keep waking. The cause may be a stressful day, too much caffeine, or worry or excitement about tomorrow. But when a person continues to experience insomnia, seek the advice of a health care provider. Without treatment, insomnia that persists can develop into a chronic (long-lasting) and relapsing condition.

Types of insomnia

Acute insomnia is most commonly the result of:

• A stressful event
• Environmental disturbances such as noise or extreme temperatures (you feel too hot or too cold)
• Disruption of your normal sleep/wake cycle, from jet lag or caring for a newborn, for example
• Side effects of certain medications (like some cough and cold medications)

Chronic insomnia tends to have more complex causes, including an underlying health condition and certain lifestyle habits. Physical or mental health conditions that cause insomnia follow:

• Asthma, rheumatoid arthritis or other chronic pain conditions and congestive heart failure
• Mental health disorders, such as depression, anxiety or chronic stress
• Certain medications used to treat such conditions, including some drugs for high blood pressure, decongestants and stimulating antidepressants. Note that caffeine, nicotine, alcohol and "recreational" drugs also can disrupt sleep. (Editor's Note: Antidepressants may increase the risk of suicide or the worsening of depression, especially at the start of treatment or when changing the dose.)
• A specific sleep disorder such as sleep apnea (a sleep-associated breathing problem) or restless leg syndrome

Behavioral or lifestyle factors that can affect sleep include:

• Excessive worrying, including worry about not being able to sleep
• Too much caffeine, alcohol or other substances
• Disruption of sleep/wake cycle from shift work
• Poor sleep hygiene

When to see your doctor
Acute insomnia often requires no medical treatment, as long as it occurs only occasionally and stops once you identify and address the cause. But acute insomnia should not be dismissed as "not serious." The need for treatment actually depends on the severity of the acute episodes of insomnia, how long they last and how they are harming your overall sense of well-being.

If insomnia lasts for more than a few nights or becomes predictable, call your doctor, since sleeplessness will inevitably affect your daytime function and may be a symptom of an underlying problem. In addition, frequent acute insomnia may develop into "learned" insomnia and become chronic.

Sadly, more than half of people who believe they have chronic insomnia have never talked about it with their doctor. As a result, many people may needlessly suffer sleepless nights when effective treatments are available.