What causes insomnia?

Diana Meeks
Diana Meeks on behalf of Sigma Nursing
Family Practitioner

Causes of chronic insomnia
Chronic insomnia can have a variety of emotional or physical causes. These include worry, stress, depression, headaches, weak bladder, and menopause. Using caffeine, nicotine, or alcohol can also contribute to chronic insomnia. Sometimes starting or stopping a medication can interfere with sleep. 

Causes of short-term insomnia
Short-term insomnia can have a variety of causes. Some people have trouble sleeping because they are worried or stressed. Sometimes sleep can be difficult due to a physical condition such as depression, a headache, or a weak bladder. Sometimes insomnia is caused by having too much caffeine, nicotine, alcohol, or food before bedtime. In some cases, starting or stopping a medication can interfere with sleep.

Factors that increase your risk for insomnia
Different factors can increase your risk for chronic insomnia. Chronic insomnia can be genetic, so if it runs in your family, your risk might be greater. Insomnia is also more common in women than in men. Taking some medications make sleep difficult. Sometimes an underlying health issue can make chronic sleeplessness more likely. Stress, depression, or an upsetting incident may also increase risk. Working nights or keeping irregular hours may also play a part. Age can also play a part. As people grow older, they more often experience symptoms of insomnia.

Dr. Ruth White, MPH
Social Work Specialist

Some of the conditions that can cause sleeplessness include stress, a change in your normal routine, bright lights, too much caffeine or alcohol use, an uncomfortable bed, a snoring roommate or bed partner, moving to a high altitude, and caring for a child or aging parent. Sleep usually returns when the situation returns to normal.

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Dr. Aruna V. Josyula, MD
Geriatric Medicine Specialist

All of the following can cause insomnia: depression, anxiety, mood disorders, as well as any disorder where you have chronic pain, trouble breathing and sleep apnea. Further, many people are in the habit of watching television or spending time on the computer before going to bed. These activities are known to activate the brain and make sleep more difficult.

Drinking coffee all day keeps you awake and, because it's a diuretic, can increase trips to the bathroom throughout the night. Some people drink alcohol to help them sleep but it causes sleep to be disturbed. Consumption of caffeine, nicotine and alcohol can all cause insomnia.

Dr. Michael T. Murray, MD
Ear, Nose & Throat (ENT Specialist)

The most common causes of insomnia are psychological: depression, anxiety, and tension. If psychological factors do not seem to be the cause, various foods, drinks, and/or medications may be responsible. There are numerous compounds in foods and drinks that can interfere with normal sleep, most notably caffeine. There are more than three hundred drugs that interfere with normal sleep. Over-the-counter and prescription drugs can also cause abnormal sleep patterns.

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Chronic insomnia persists for at least a month and usually requires treatment. The condition may be due to any of the following:

  • Underlying mood disorders, such as depression or anxiety
  • Chronic stress
  • Chronic illness
  • Long-term use of sleeping pills or alcohol
  • Aging
  • Shift work
  • Medical problems, such as chronic pain or overactive bladder
  • Primary sleep disorders, such as sleep apnea or restless legs syndrome
Stacy Wiegman, PharmD
Pharmacy Specialist

Insomnia is usually caused by an underlying condition which may include: psychological conditions such as stress, environmental changes, hormonal changes, and certain medications. Insomnia may also be a result of abnormal daytime naps, caffeine consumption, or withdrawal from cocaine, amphetamines, benzodiazepines, antihistamines, alcohol or marijuana.

Insomnia is most often associated with another problem. Insomnia that is not caused or worsened by other factors is rare. These factors may include:

  • Stress
  • Other sleep disorders
  • Medical conditions
  • Mental disorders
  • Medication or substance use or abuse
  • Environmental factors
  • Habits or lifestyles
  • Pregnancy
  • Menopause

This content originally appeared on the American Academy of Sleep Medicine website.

Dr. Masoud Sadighpour

Chronic insomnia could be due to different reasons.

If somebody is suffering from anxiety disorder and we do not treat the cause of insomnia in such a case, then insomnia might last for years.

In some cases in which patient is conditioned to his or her bed, the patient behavior can make the insomnia stay forever. In this case de-sensitization or Cognitive Behavioral Therapy by an expert such a sleep Medicine doctor can cure the insomnia.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

The main causes for insomnia can be broken up into 3 categories:

  1. Environmental/situational
  2. Medical or psychiatric
  3. Primary sleep disorders

Primary sleep disorders are much less common but include conditions such as narcolepsy, sleep apnea, and restless leg syndrome. These are physical-neurological dysfunctions that need to be treated under a doctor's care and may require medication. Yet for the vast majority of insomnia sufferers, environmental and common medical problems are the source of the problem.

That means there are simple lifestyle changes you can make in your daily routine that may dramatically improve the amount and quality of sleep you get each night. Common insomnia triggers include stress, depression, certain medications (e.g., beta blockers, antihistamines, or antidepressants), caffeine, alcohol, shift work, and underlying health problems. These factors can all impact our ability to fall or stay asleep. Insomnia is also more likely to strike women and older individuals due to hormonal changes and shifting sleep patterns.

Dr. Michael Breus, PhD
Psychology Specialist

We don’t always know what causes insomnia—though identifying the root cause is important in helping to determine the most effective treatment—but there are many factors than can precipitate this lack of sleep. An illness or a medical condition can bring about difficulty sleeping that, without treatment, can evolve into insomnia. Major life events—marriage, divorce, childbirth, death of a loved one, job changes—can bring about insomnia, as can certain lifestyles that include shift work or extensive travel. Stress is an enemy to sleep and is an all-too-common cause of insomnia.

Dr. Lisa Medalie, CBSM, PsyD
Psychology Specialist

Insomnia is caused by a few factors in tandem: genetic predisposition, precipitating events, perpetuating factors and conditioned arousal. Watch sleep behavior expert Lisa Medalie, PsyD, explain how these factors can cause episodes of insomnia.

If you are having trouble sleeping, first, you need to figure out your sleep needs, which is specific to each individual. Some individuals need 8-10 hours of sleep per night, where others function well with only 5 hours of sleep per night.

To determine your needs, start by allowing yourself to sleep and see how many hours it takes to wake up and feel refreshed. Then use those hours to set a schedule and be consistent with that schedule.

Below are few items to keep in mind when trying to determine what keeps you up late or interrupts your sleep throughout the night:

  • Full bladder: It helps if your last beverage is at least 3 hours before bedtime.
  • Dinner routine: The digestive system will keep your brain and body fueled. Do not exceed 500-700 calories at least 2 hours before bedtime. If you eat late, go to bed an hour or two after eating. Choose carbs over protein since carbs have a calming effect and protein tends to make you alert.
  • Desserts: For those who indulge in dessert, a caffeinated beverage or a cup of tea at night, you might want to reconsider your indulgence. Caffeine can remain in your system for up to 7 hours, and can keep you alert for 20 hours. Caffeine also stimulates restless legs syndrome. You don’t have to give up caffeine completely, just refrain from having any after lunch.
  • Relax: Taking a hot bath can assist in relaxing your body, making you fall asleep quicker. Also, a warm glass of milk can soothe you.
  • Exercise: Morning exercise will help you stay active and alert throughout the day, and will work your body to where it will be ready for rest at night.

If you have any questions or concerns about these symptoms or condition, please contact your doctor for an appointment.

This content originally appeared on StoneCrest Family Physicians Blog.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.