What is sleep-onset insomnia?

Dr. Colleen Ehrnstrom's profile picture
Dr. Colleen Ehrnstrom, PhD
Aug 23, 20214 min read
Pug wrapped in blanket

Do you have difficulty falling asleep? Do you wake up in the middle of the night, unable to fall back asleep?

If that sounds like you, you may be struggling with sleep-onset insomnia. Not being able to fall asleep when you want to can be a huge source of frustration.

However, there is good news. Understanding what’s keeping you awake and the options for improving your sleep quality is the first step to putting insomnia to rest.

Sleep Latency Definition

Some people lay down in bed and fall asleep minutes after turning off the light, while for others, falling asleep can be a longer struggle.

The time it takes to transition from being awake to entering a state of sleep is called sleep latency. Your sleep latency is an indicator of how healthy your sleep patterns are. Sleep latency depends on many different factors, and it is important to note that the occasional night where it takes longer to fall asleep is not necessarily significant. However, If you frequently experience that it takes you longer than 10 to 20 minutes to fall asleep, it can indicate an unhealthy sleep pattern, as adults with healthy sleep patterns typically fall asleep within 10 to 20 minutes of going to bed.

Understanding Sleep-Onset Insomnia

Prolonged sleep latency is a symptom of sleep-onset insomnia. Sleep-onset insomnia is the inability to sleep when one is ready to, at the beginning of the night.

The struggle to fall asleep can be temporary (acute) or long-term (chronic). If not treated properly, acute insomnia can become chronic. Chronic insomnia refers to difficulty sleeping 3 or more nights per week for at at least 3 months.

Sleep-Onset Insomnia Symptoms

Everyone struggles to sleep from time to time, but if it becomes a pattern, you may be experiencing insomnia. In addition to difficulty falling asleep, symptoms of sleep-onset insomnia include any or all of the following:

  • Mood swings
  • Irritability
  • Poor concentration
  • Persistent fatigue
  • Loss of libido
  • Anxiety and depression
  • Loss of coordination

If you are consistently experiencing one or more of these symptoms, it may be time to consider speaking to your health care provider.

Sleep-Onset Insomnia Causes

Several factors may contribute to sleep-onset insomnia. The Sleep Foundation lists common causes of insomnia as:

  • Stress
  • Irregular Sleep Schedules
  • Lifestyle Choices
  • Mental Health
  • Physical Illness or Pain
  • Medication
  • Neurological Conditions
  • Other Sleep Disorders
  • Age

Sleep-Onset Insomnia Impacts

According to the Centers for Disease Control and Prevention, adults need an average of at least seven hours of sleep per night to function optimally. Sleep-onset insomnia reduces total sleep time, which can have an impact on overall health.

Lack of sleep increases the risk of developing chronic health conditions, including diabetes, heart disease, obesity, and depression. Sleep deficits also increase the risk for accidents and decrease quality of life.

Treating Sleep-Onset Insomnia

Your health care provider can help you determine the cause of your insomnia and guide you to find the right course of treatment to return to getting a healthy, restful, consistent night’s sleep.


Medication that has a sedating effect may be used to treat sleep-onset insomnia by promoting drowsiness. The goal when using sleep medication should always be to return to a natural cycle of sleep and not create dependency on medication to achieve sleep.

Cognitive-Behavioral Therapy for Insomnia (CBT-I)

As described by The Sleep Foundation, “CBT-I focuses on exploring the connection between the way we think, the things we do, and how we sleep. During treatment, a trained CBT-I provider helps to identify thoughts, feelings, and behaviors that are contributing to the symptoms of insomnia.”

In CBT-I, you will:

  • Learn strategies to challenge unhelpful thinking patterns.
  • Get help identifying and changing habits that stand in the way of a great night of sleep.
  • Understand how the connection between thoughts, feelings, behaviors, and sleep is central to CBT-I.

CBT techniques for insomnia have been proven to work in numerous clinical trials and are more effective than medication. Between 70% and 80% of patients experience sustained improvement in sleep after CBT-I.

Start your journey to a restful night’s sleep!

Head over to our sleep questionnaire form to learn more about how CBT-I can effectively treat your sleep onset insomnia and why working with the sleep coaches at Dawn is the right choice for you.

Dr. Colleen Ehrnstrom's profile picture
Dr. Colleen Ehrnstrom, PhD

Dr. Colleen Ehrnstrom is a licensed clinical psychologist with a specialty practice in Acceptance and Commitment Therapy (ACT). Areas of expertise include insomnia and other sleep disorders, anxiety, and depression.

Dr Ehrnstrom is the co-author of the book End the Insomnia Struggle: A Step by Step Guide to Help you Get to Sleep and Stay Asleep which offers a comprehensive, personalized sleep program that integrates the physiology of sleep, cognitive behavioral therapy for insomnia (CBT-I) and acceptance and commitment therapy (ACT).

It’s time to stop blaming the night monsters.

Let’s work together to transform your sleep for the better.