Insomnia: Causes, Consequences and How to Overcome It

You turn over in bed for the tenth time, check the clock, calculate how many hours you have left before the alarm — and that very calculation keeps you even more awake. If this scene repeats itself often, you're not alone: insomnia is one of the most common, and most underestimated, disorders in Italy, and understanding its mechanisms is often the first step toward overcoming it.

How common is insomnia in Italy

Official estimates put chronic insomnia at around 6% of the Italian population with a diagnosis of chronic insomnia, but several experts believe the real figure, including those who never receive a diagnosis, is much higher — up to 10-15%, for an estimated total of 4-5 million people living with the problem without any structured treatment. Among those who do get a diagnosis, only 40% actually receive treatment. It affects women in particular (about 70% of patients) and has two peaks of incidence: the 45-55 age group and people over 65, but it is also rising among children and teenagers, often linked to excessive smartphone use in the evening.

Clinically, insomnia is diagnosed when poor sleep quality occurs at least three nights a week, for at least three consecutive months — a useful threshold for telling apart a rough patch from an actual disorder.

The most common causes

Insomnia rarely has a single cause. Among the factors that come up most often:

• Stress and worry: the mind stays in "alert" mode even in bed, making it hard to fall asleep.
• Anxiety: recurring, anticipatory thoughts tend to intensify precisely in the silence and stillness of the evening.
• Evening habits poorly suited to sleep: bright screens, afternoon caffeine, irregular schedules.
• Medical conditions or chronic pain, which call for specific evaluation.
• Insomnia itself, paradoxically: the fear of not sleeping generates the very activation that makes it even harder to fall asleep — a vicious circle well known in sleep psychology.

The consequences, often underestimated

Insomnia isn't just an uncomfortable night: it has a measurable impact on health, safety, and the economy. In Italy, the estimated costs linked to insomnia exceed 14 billion euros a year (about 0.74% of GDP), between lost productivity (estimated at around 5,500 euros per year for each person affected) and accidents. This isn't a minor detail: an estimated 7 to 10% of workplace accidents are linked to excessive sleepiness, and about 25% of road accidents are related to a sleep deficit, with a share of them, unfortunately, fatal.

On a personal level, chronic sleep deprivation lowers the threshold for emotional activation: people become more irritable, more vulnerable to anxiety and stress, and less clear-headed in everyday decisions — a cycle that often feeds into burnout, where sleep is often the first thing to go.

When It's Time to See a Psychotherapist

Not every rough night calls for professional support, but it's worth seeking a consultation when: the problem has persisted for weeks or months (the clinical threshold is three nights a week for three months); daytime fatigue interferes with work, study, or relationships; there's marked anxiety specifically tied to the fear of not sleeping; or you notice you've developed increasingly rigid rituals around sleep (checking the clock, avoiding evening plans, counting the hours left) that, paradoxically, make the problem worse instead of better — the same avoidance mechanism seen in many forms of anxiety.

How It's Addressed in Psychotherapy

Psychological treatment for insomnia typically works on several levels: cognitive restructuring of catastrophic thoughts about sleep ("if I don't sleep, tomorrow will be a disaster"), which often fuel the very activation that prevents falling asleep; work onsleep hygiene (regular schedules, reducing screens and caffeine, using the bed only for sleeping); and, when insomnia is tied to underlying stress or anxiety, broader work on what's keeping the mind on alert. In my work I integrate a Gestalt -oriented approach with cognitive-behavioral tools and, when indicated, Autogenic training, a structured relaxation technique that's particularly effective at lowering the baseline level of activation, not just in acute moments.

Frequently Asked Questions

How many hours of sleep does a person actually need per night?
It varies from person to person, but most adults need 7-9 hours. More than the absolute number, what matters is sleep quality and how you feel during the day.

Do natural sleep remedies work?
Some have a mild relaxing effect, but no natural or pharmacological remedy on its own changes the mechanisms that maintain insomnia (performance anxiety about sleep, checking rituals, irregular schedules). They can support a treatment process, not replace it. Talk to your doctor about any supplement or medication.

Can insomnia be caused by stress alone, with no other cause?
Yes, it's one of the most common causes. But if it persists even after stress decreases, it's worth exploring whether an independent vicious cycle has taken hold, driven by the fear of not sleeping itself.

From what point can we talk about chronic insomnia rather than just a difficult period?
Clinically, when the sleep difficulty occurs at least three nights a week for at least three consecutive months.

I Also Work on This, in Florence

I am Dr. Martina Fino,  a psychologist and psychotherapist in Florence registered with the Board of Psychologists of Tuscany. I often work with people whose insomnia is linked to stress, anxiety, or evening rumination, integrating cognitive-behavioral techniques, sleep hygiene work, and, when useful, Autogenic Training. I see clients at my practice in Florence, in the Campo di Marte-Coverciano area, and I also offer online sessions for those who live outside the city or in other parts of Tuscany.

To schedule a first consultation: 392 693 1473 (WhatsApp available) — fino.martina@gmail.com

In summary

• Chronic insomnia officially affects 6% of Italians, but the realistic estimate reaches 10-15% including undiagnosed cases.
• Clinically, insomnia is defined as lasting at least three months, at least three nights a week.
• The consequences go beyond tiredness: they affect productivity, road and workplace safety, and the economy (over 14 billion euros a year in Italy).
• Insomnia often feeds itself: the fear of not sleeping creates the very activation that prevents falling asleep.
• Psychotherapy works on sleep-related thoughts, sleep hygiene, and underlying causes (stress, anxiety).

This article is for informational purposes only and does not replace a personalized medical or psychological evaluation or consultation.

Sources

• Quotidiano Sanità — data on prevalence, economic impact, and safety linked to chronic insomnia in Italy
• ACI/ISTAT — data on road accidents related to sleep deficit
• Board of Psychologists of Tuscany (Ordine degli Psicologi della Toscana)