What Causes Insomnia?

Insomnia is a common sleep disorder that can make it difficult for you to get quality sleep. It can be caused by many different factors, both physical and mental.

The symptoms can vary but the main symptoms are difficulty falling asleep and staying asleep.

If you are experiencing any of the symptoms of insomnia, it is important to see your doctor so that you can get a diagnosis and the best treatment possible.

In this article, we will discuss the causes of insomnia, how to treat it, and some of the best ways to prevent it from happening.

What is insomnia?

Insomnia is a sleep disorder that is characterized by difficulty falling asleep (sleep onset), staying asleep (sleep maintenance), or waking up too early in the morning and all are caused by hyperarousal.

Insomnia can lead to excessive daytime sleepiness, trouble concentrating, and also give you fatigue all due to sleep deprivation.

There are different types of insomnia and two of them involve labeling the condition by how long it affects you as it can be short-term insomnia (acute insomnia) or long-term insomnia (chronic insomnia).

Acute insomnia is when you only have insomnia for anywhere from a day to several weeks while chronic insomnia means you have had difficulty sleeping for three days or more a week for three months or longer.

You are more likely to get insomnia if you are a woman due to hormonal shifts throughout your life or are over the age of 60 because of a higher risk for medical conditions, taking medications that can cause sleep disturbances, and shifts in your sleeping schedule due to old age.

What are the symptoms of insomnia?

Besides sleep loss due to not being able to fall asleep, waking up in the middle of the night, and waking up too early there are quite a few other symptoms if you have insomnia.

Other common symptoms include:

• Unrefreshing sleep
• Daytime fatigue or sleepiness
• Trouble concentrating during the day which can lead to difficulties at work or school
• Difficulty remembering things
• Mood changes
• Depression
• Anxiety
• Irritability
• Increased risk of accidents and falling down

If you have these symptoms and believe you have insomnia you need to talk to your doctor or health care provider for a diagnosis.

What are the causes of insomnia?

There are different causes of insomnia and they can be classified as primary or secondary.

Primary insomnia is when there is no underlying medical reason for the sleep disorder while secondary insomnia is when there is an underlying medical condition that is causing the sleep disturbance.

The most common causes of insomnia include:

• Stressful life events
• Shift work, especially when you work night shifts and disrupt your circadian rhythm (sleep cycle) and sleep patterns causing an irregular sleep schedule
• Jet lag can also throw off your internal clock
• Changes in your sleep schedule not due to work such as taking care of a newborn baby
• Poor sleep habits such as drinking caffeine before bed, working in your bed, being on your phone in bed, or watching television in your bed
• Certain medications such as some asthma medications, blood pressure medications, and some over-the-counter medications that are non-drowsy and contain caffeine or other stimulants
• Substance abuse of alcohol, nicotine, or illicit drugs
• Mental health conditions such as anxiety, depression, post-traumatic stress disorder (PTSD), and bipolar disorder
• Poor sleep environment, for example, the room where you sleep may be too loud, have too much light, or have temperature problems leading to your room being too hot or too cold
• Medical conditions such as chronic pain (for example arthritis or fibromyalgia), diabetes, heart disease, gastroesophageal reflux disease (GERD), attention deficit disorder (ADHD), Parkinson’s disease, and Alzheimer’s disease to name a few
• Other sleep disorders such as restless legs syndrome or obstructive sleep apnea
• Pregnancy can cause hormonal shifts that make it difficult to go to sleep, make it hard to find a comfortable position to sleep, and cause disruptive gastroesophageal refluxamong other factors

How is insomnia diagnosed?

To diagnose insomnia your doctor or health care provider will ask you about your sleep habits and how long you have been experiencing symptoms and then perform a physical exam to make sure there is no obvious medical reason for your insomnia.

They will also ask about your medical history and want to know what medications you are taking, what medical conditions you have, what your mental health is like, and what stressful life events have been going on. A sleep diary, which is a record of your sleep history including any sleep patterns or events that you record yourself, can help provide information about your sleep habits too.

A blood test may also be conducted to rule out any other underlying health conditions as the cause of your insomnia.

If your doctor is still uncertain about the cause of your insomnia they may also refer you to a sleep specialist at a sleep center for additional testing such as an overnight sleep study called a polysomnogram (PSG) or have you take an at-home sleep test to better understand the causes of your sleep difficulties.

What are the treatment options for insomnia?

There are different treatment options for insomnia and the best treatment depends on what is causing your sleep disorder.

The most common treatments for insomnia include:

Cognitive behavioral therapy for insomnia (CBT-I)

Cognitive behavioral therapy for insomnia is a type of therapy that helps you change your thinking and behaviors around sleep. It can help you get rid of any myths about sleep, learn new sleep habits, and help you relax. Examples of cognitive behavioral therapy for the treatment of insomnia include:

• Stimulus control therapy where you remove any objects or activities from your bedroom that are associated with being awake such as working on your laptop in bed or watching television in bed
• Relaxation techniques such as yoga, meditation, or deep breathing exercises
• Sleep restriction where you limit the amount of time you spend in bed and cause sleep deprivation that eventually makes you tired enough to have a normal sleep schedule
• Remaining passively awake, also called paradoxical intention, where you go to bed trying not to sleep to remove any anxiety about trying to fall asleep
• Light therapy where you are exposed to artificial light or natural light to help regulate your sleep-wake cycle

Medications

Both prescription medications and over-the-counter medications and supplements are used to help treat insomnia.

Prescription sleep medicines are only used as a last resort and for a short time to help you sleep as they can be habit forming.

Some over-the-counter medications that make you drowsy such as antihistamines can also help you sleep.

Over-the-counter supplements like melatonin, which is a hormone produced in your body to promote sleep, are also widely available although it is uncertain whether they help as supplements are not regulated by the U.S. Food and Drug Administration (FDA).

Always talk to your doctor or health care provider first before starting any new medication or supplement.

What are the best ways to prevent insomnia?

There are different things you can do to help prevent insomnia. Some general tips include:

• Stick to a consistent sleep schedule by having a regular sleep time and waking up at the same time every day, even on weekends
• Avoid caffeine, nicotine, alcohol, big meals, or consuming lots of liquids before bedtime
• Exercise regularly or perform physical activity but not right before bedtime
• Create a relaxing bedtime routine that can include a warm bath, soothing music, or reading a book for 30 minutes before sleep
• Keep a cool, comfortable, and dark sleeping environment and use any tools that may help your sleep such as an eye mask or white noise machine
• Limit your exposure to bright screens such as televisions, computers, and phones in the evening If you have difficulty sleeping
• Do not lie in bed awake, get up and do something relaxing until you feel sleepy again
• Use the bedroom only for sleeping and sex
• Discuss with your doctor about finding alternatives for any medications you are taking that may be causing you to stay awake at night

Summary

Many different things can cause insomnia.

You may have trouble sleeping for various reasons such as stress, anxiety, or a medical condition among many others that we discuss in detail above including prescription drugs, over-the-counter medications, and cognitive behavioral therapy.

If you have difficulty sleeping, there are different treatment options available depending on what is causing your insomnia.

You can also help prevent insomnia by following some general tips and implementing some lifestyle changes in your daily life.

If you have any questions or concerns, be sure to talk to your doctor or health care provider about what may be causing your insomnia and what the best treatment options are for you for better sleep quality.

References and sources:

Mayo Clinic

• Insomnia – Diagnosis
• Insomnia – Overview

Cleveland Clinic

• Insomnia

Sleep Foundation

• What Causes Insomnia?

WebMD

• Medical Reasons You Could Have Insomnia