Insomnia: It's Causes, Symptoms and Effects

Causes of Insomnia

• Insomnia can be caused by unhealthy sleep habits, specific substances, psychiatric and medical conditions, and/or certain biological factors. Recently, researchers have begun to think about insomnia as a problem of your brain being unable to stop being awake because our brain has a sleep cycle and a wake cycle (when one is turned on the other is turned off). Insomnia can be a problem with either part of this cycle; it can be too much wake drive or too little sleep drive. It’s important to first understand what could be causing your sleep difficulties.

Common causes of insomnia include:

• Mental health disorders: Anxiety disorders, such as post-traumatic stress disorder, may disrupt your sleep. Awakening too early can be a sign of depression. Insomnia often occurs with other mental health disorders as well.
• Medications: Many prescription drugs can interfere with sleep, such as certain antidepressants and medications for asthma or blood pressure. Many over-the-counter medications such as some pain medications, allergy and cold medications, and weight-loss products contain caffeine and other stimulants that can disrupt sleep.
• Medical conditions: Conditions linked with insomnia include chronic pain, cancer, diabetes, heart disease, asthma, gastro esophageal reflux disease (GERD), overactive thyroid, Parkinson’s disease and Alzheimer’s disease.
• Sleep-related disorders: Sleep apnea causes you to stop breathing periodically throughout the night, interrupting your sleep. Restless legs syndrome causes unpleasant sensations in your legs and an almost irresistible desire to move them, which may prevent you from falling asleep.
• Caffeine, nicotine and alcohol: Coffee, tea, cola and other caffeinated drinks are stimulants. Drinking them in the late afternoon or evening can keep you from falling asleep at night. Nicotine in tobacco products is another stimulant that can interfere with sleep. Alcohol may help you fall asleep, but it prevents deeper stages of sleep and often causes awakening in the middle of the night.
• Changes in sleep patterns: Sleep often becomes less restful as you age, so noise or other changes in your environment are more likely to wake you. With age, your internal clock often advances, so you get tired earlier in the evening and wake up earlier in the morning. But older people generally still need the same amount of sleep as younger people do.
• Changes in activity: You may be less physically or socially active. A lack of activity can interfere with a good night’s sleep. Also, the less active you are, the more likely you may be to take a daily nap, which can interfere with sleep at night.
• Changes in health: Chronic pain from conditions such as arthritis or back problems as well as depression or anxiety can interfere with sleep. Issues that increase the need to urinate during the night such as prostate or bladder problems can disrupt sleep. Sleep apnea and restless legs syndrome become more common with age.

Chronic Insomnia

Chronic insomnia is usually a result of stress, life events or habits that disrupt sleep. Treating the underlying cause can resolve the insomnia, but sometimes it can last for years.

Common causes of chronic insomnia include:

• Stress: Concerns about work, school, health, finances or family can keep your mind active at night, making it difficult to sleep. Stressful life events or trauma — such as the death or illness of a loved one, divorce, or a job loss — also may lead to insomnia.
• Travel or work schedule. Your circadian rhythms act as an internal clock, guiding such things as your sleep-wake cycle, metabolism and body temperature. Disrupting your body’s circadian rhythms can lead to insomnia. Causes include jet lag from traveling across multiple time zones, working a late or early shift, or frequently changing shifts.
• Poor sleep habits. Poor sleep habits include an irregular bedtime schedule, naps, stimulating activities before bed, an uncomfortable sleep environment, and using your bed for work, eating or watching TV. Computers, TVs, video games, smartphones or other screens just before bed can interfere with your sleep cycle.
• Eating too much late in the evening. Having a light snack before bedtime is OK, but eating too much may cause you to feel physically uncomfortable while lying down. Many people also experience heartburn, a backflow of acid and food from the stomach into the esophagus after eating, which may keep you awake.

Symptoms of Insomnia

Insomnia itself may be a symptom of an underlying medical condition. However, there are many signs and symptoms that are associated with insomnia:

• Difficulty falling asleep at night.
• Waking during the night.
• Waking earlier than desired.
• Still feeling tired after a night’s sleep.
• Daytime fatigue or sleepiness.
• Irritability, depression, or anxiety.
• Poor concentration and focus.
• Being uncoordinated, an increase in errors or accidents.
• Tension headaches (feels like a tight band around head).
• Difficulty socializing.
• Gastrointestinal symptoms.
• Worrying about sleeping.

Sleep deprivation can be another symptom. The sleep deprived person may wake up not feeling fully awake and refreshed, and may have a sensation of tiredness and sleepiness throughout the day. Insomnia could be a result of behavioral pattern (for example, your nighttime routines do not cue your body for sleep, or your sleep schedule is out of sync with your biological clock), or it could be link to another medical or psychiatric issue that needs to be addressed. The duration of insomnia is important. Doctors consider insomnia chronic if it occurs at least three nights per week for three months or longer. Regardless of its cause, if insomnia has become a regular occurrence, talking to your doctor about treatment may be a good idea.

You may also want to consider whether and to what degree insomnia is affecting your life. If you feel fatigued or have low energy during the day and it gets in the way of your productivity and enjoyment of friends, family, or hobbies that probably means you could benefit from talking to your doctor. If you’ve tried on your own to make adjustments to your sleep routines and it hasn’t worked, you may want to enlist the help of a sleep specialist.