The Most Common Causes of Insomnia

Research suggests that caffeine, nicotine, and alcohol can all disrupt sleep.  Study results indicate that high degrees of nicotine dependence cause short sleep duration and that caffeine reduces total sleep time and sleep quality, increasing nighttime wakefulness and arousal.

One extensive study on African American adults showed that using nicotine and alcohol within four hours of bedtime led to increased sleep fragmentation.

Stress and insomnia seem to be directly linked, with many adults reporting that their stress increases when their sleep quality decreases. Survey findings also show that adults who report lower stress sleep more hours a night and have better quality sleep than those with high stress.

Adults who sleep fewer than eight hours a night report they feel overwhelmed, lack motivation, and skip exercise. Forty-nine percent of adults who report high stress say they do not getting enough sleep because their minds race.

More middle-aged and older adults report insomnia than younger adults, but insomnia is not a normal part of aging. There are many reasons for this inequality. For example, retirement-age adults may change their usual sleep/wake cycles, and middle-aged and older adults are more likely to have other health conditions and take more medications that affect their sleep.

Many adults report poor sleep quantity and quality, but when this leads to daytime impairment over a long period, it may become a true sleep disorder.

Sleep disturbances during pregnancy are common, and studies show many things contribute to them, including maternal age, anxiety, maternal obesity, and depression. The overall prevalence of insomnia during pregnancy is 38.2%, with insomnia symptoms much more common in the third trimester.

Other studies show that insomnia during pregnancy correlates with higher rates of complications for the mother, including preeclampsia and gestational hypertension, and increased likelihood of mental health issues. Overall, insomnia leads to a 24 percent increase in severe complications for the mother.

All medications have side effects, and insomnia is common to a few drugs. Some cold and allergy medicines contain pseudoephedrine which has a stimulating effect that can cause insomnia. Antidepressants can make it difficult to fall asleep, too.

Doctors commonly prescribe beta-blockers for high blood pressure and other heart problems, but they also lower the amount of melatonin secreted by the body, leading to sleep changes. Another class of drugs that causes insomnia is corticosteroids. Studies show that sleep disorders with insomnia and restlessness occurred in 73 percent of participants taking a corticosteroid.

Many people experience orthopnea or difficulty breathing when lying down, which can lead to interrupted sleep or insomnia.

Orthopnea is common in people who have heart or lung problems, like COPD or heart failure, but it can result from other conditions, too. These include obesity, sleep apnea, snoring, and panic disorders.

Other sleep disorders can cause insomnia. Two of the most common are sleep apnea and restless leg syndrome. There are three kinds of sleep apnea.

• Obstructive sleep apnea occurs when the muscles in the throat relax, interrupting breathing.
• Central sleep apnea results from the brain not sending the proper signals for breathing control.
• Complex sleep apnea is a combination of the two.

Any of these can lead to difficulty staying asleep. Another sleep disorder, restless leg syndrome, is characterized by an uncontrollable urge to move when at rest, which constantly interrupts sleep. Interrupted sleep over a period of time can cause insomnia.

Insomnia can be a symptom of a mental health condition. [citation href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6879516/" title=Neuropsychopharmacology" desc="Sleep, insomnia, and depression"]Some studies show that insomnia is an independent predictor for suicidal ideation, suicide attempts, and depressive disorders.

Research also indicates that sleep disturbances in people with bipolar disorder vary from stage to stage of the illness. During the mania phase, they need less sleep and report difficulties falling and staying asleep, and during the depression phase, they often experience severe insomnia.

Many people with neurological conditions experience insomnia. It affects about half of people with chronic migraines and as many as 55 percent of people with multiple sclerosis.

More than a third of people with epilepsy also experience insomnia, and it is a common side effect of stroke. About half of people who have had a stroke experience insomnia, a third of which did not have insomnia before their stroke.

Just about any illness that causes pain can cause insomnia. Chronic pain can occur alongside a variety of conditions, from rheumatoid arthritis to back pain to fibromyalgia.

Other conditions that cause pain and insomnia include osteoarthritis, peripheral neuropathy, disc degeneration, and endometriosis. People with cancer also deal with insomnia more often than the general population.