Overview
- Clinicians define insomnia by daytime sleepiness and functional impairment rather than the number of hours spent awake at night.
- In adults over 65, about 15% struggle to fall asleep, 20% to stay asleep, and 35% wake too early, underscoring the burden in older age.
- Experts emphasize three pillars of healthy sleep—regularity, adequate total sleep time, and quality with ≥85% efficiency—with consistent schedules linked to lower all-cause mortality and short sleep tied to a possible doubling of dementia risk.
- Up to 20% of people have chronic sleep disorders, yet most have never discussed sleep with a primary care clinician; formal diagnoses typically require symptoms for at least three months, though earlier evaluation is advised, especially for red flags like excessive daytime sleepiness that may signal sleep apnea or, more rarely, narcolepsy.
- Frequent use of alcohol, diphenhydramine, cannabis, or over-the-counter melatonin to fall asleep can degrade sleep quality and obscure underlying conditions, and new research in Spain associates sleep problems at ages 8–9 with later ADHD symptoms, supporting early screening.