What are the most common causes of insomnia?

This question was asked in Irvine, California on 01/18/2012.
I have had problems ever since I can remember. I have not seen anyone about this and have not tried any medication. I work a normal 9AM to 5PM job and engage in no habits that I can think would lead to insomnia. What are the most common causes of insomnia?

Doctors Answers (2)

Richard J. Schumann Jr., MD
Answered on: 1/18/2012

Transient insomnia is usually due to periods of adjustment or poor sleep hygiene (excess caffeine or periods of stress) and are self limiting.  Chronic insomnia is usually due to a primary idiopathic disturbance that involves with neuronal control of sleep.  Insomnia due to psychiatric disease or medical conditions are the next most frequent causes.  

There are many causes for insomnia. Noise, light and temperature can affect a person’s ability to get to sleep or stay asleep. Alcohol, caffeine, nicotine and many medications can contribute to insomnia as well. Lifestyle factors such as stress, exercise, jet lag and shift work often play a major role contributing to insomnia. Finally, physical and psychiatric illnesses are often associated with insomnia.

Why Can't I Sleep?

People experience difficulty sleeping for a variety of reasons. Temporary stress brought on by family, work or school can keep people's thoughts running through their heads all night, preventing them from getting the quality of sleep they need to function during the day. Though trouble sleeping for a brief period of time may not be a serious concern, there is such a condition as temporary insomnia that affects most adults at one point in their lives. Common causes of insomnia, temporary or chronic, include:

  • Mild-to-severe anxiety disorders
  • Clinical depression caused by chemical imbalances in the brain's hormone levels
  • Over-consumption of caffeine, alcohol or nicotine
  • Side effects of some prescription and over-the-counter medications
  • Alzheimer's disease
  • Parkinson's disease
  • Arthritis
  • Gastroesophageal reflux disease (GERD)
  • Lung disease
  • Heart failure
  • Stroke
  • Overactive thyroid

Some of these causes make it difficult for people to fall asleep when they first lay down to rest, such as the aforementioned anxiety disorders. Other causes, such as having too much caffeine, alcohol or nicotine, make it so that although the patient may be sleeping all night, deep REM sleep cycles are not reached, which results in poor sleep quality and symptoms of excessive daytime sleepiness upon waking. Finally, some causes of insomnia simply wake the person up frequently during the night, which prevents him or her from sleeping for an extended period of the nighttime, such as in the case of over-the-counter allergy medications that trigger the need to urinate at night.

How Insomnia Affects Health

When insomnia is chronic, meaning that trouble falling asleep and staying asleep persists for a long period of time (sometimes as long as that patient can remember), treatment for insomnia or tests to diagnose an underlying cause of insomnia may be necessary. Depending on the underlying condition, an insomniac's health may be at risk. Examples include depressed patients whose symptoms are worsened when they are sleep-deprived and any patient with an existing medical condition whose immune system suffers more so when they fail to establish a healthy sleep regimen.

Insomnia Cure

The first thing to realize is that insomnia is a symptom, not necessarily a sleep disorder or a medical condition. Oftentimes insomnia is a side effect of another, undiagnosed medical or mental disorder that is affecting the patient. There are many sleep tests available at sleep centers that will be able to shed some light on whether excessive daytime sleepiness, trouble with insomnia or other sleep deprivation symptoms are a product of a sleep disorder or some underlying medical condition.

Contact a sleep center for advice from a professional sleep doctor if you are having trouble sleeping and think you need therapy for insomnia. Sleep doctors have years of experience with many disorders that many patients have not even heard of - so it's important to consult a professional instead of giving yourself a diagnosis and seeking out treatment on your own. If your insomnia is a product of a sleep breathing disorder called obstructive sleep apnea, for example, then there is a big chance that you do not realize the problem. Call a sleep center to get on the path to proper treatment for insomnia.