Insomnia may have many causes and, as described earlier, it can be classified based upon the underlying cause.
Situational and stress factors leading to insomnia may include:
- physical discomfort (hot, cold, lighting, noise, unfamiliar surroundings),
- working different shifts,
- stressful life situations (divorce or separation, death of a loved one, losing a job, preparing for an examination),
- illicit drug use,
- cigarette smoking,
- caffeine intake prior to going to bed,
- alcohol intoxication or withdrawal, or
- certain medications.
Most of these factors may be short-term and transient, and therefore insomnia may resolve when the underlying factor is removed or corrected.
Sleep hygiene
Sleep hygiene can play an important role in insomnia. Poor sleep hygiene includes physical factors such as:
- using the bedroom for things other than sleeping,
- eating or exercising prior to sleep,
- going to bed hungry,
- sleeping in a room with too much noise or lighting, or
- doing work in bed.
Medical and psychiatric conditions
Medical and psychiatric conditions may also contribute to insomnia.Some of these common medical conditions may include:
- breathing problems from chronic heart or lung disease (asthma, chronic obstructive pulmonary disease (COPD),
- congestive heart failure,
- obstructive sleep apnea),
- obesity,
- acid reflux,
- hyperthyroidism,
- urinary problems (frequent urination, urinary incontinence),
- chronic pain,
- fibromyalgia,
- Parkinson's disease, or
- dementia.
Common psychiatric problems can be responsible for insomnia including:
- depression,
- psychosis,
- mania,
- anxiety, or
- posttraumatic stress disorder (PTSD).
Some common physiologic conditions can lead to insomnia such as:
- menopause,
- menstrual cycle,
- pregnancy,
- fever, or
- pain.
Other causes of insomnia may be related to sleep disorders including:
- sleep walking,
- sleep apnea,
- restless leg syndrome (creeping sensations in the leg during sleep, relieved by leg movement),
- periodic limb movement disorder (involuntary repeated leg movement during sleep), or
- circadian sleep disturbance (unusual sleep time due to disturbed biological clock).
What are other causes of insomnia?
Besides the conditions listed previously, there are other types of insomnia that are not necessarily linked to an underlying condition. Some of the common types of insomnia are listed in this section.
Psychophysiological insomnia
Psychophysiological insomnia or primary insomnia is a type of insomnia in which learned behaviors prevent sleep. Individuals with this condition are unable to relax their minds (racing thoughts) and have an increased mental function when they try to fall sleep.
This may become a long-term issue, and going to bed becomes associated with an increased level of anxiety and mental arousal, leading to chronic insomnia. This condition may be present in about 15% of people who undergo formal sleep studies for evaluation of chronic insomnia.
Idiopathic insomnia
Idiopathic insomnia (without an obvious cause) (childhood onset insomnia or life-long insomnia) is a less common condition (1% of young adults or adolescents) that starts in childhood and may continue into adulthood.
These individuals have difficulty initiating and maintaining sleep and have chronic daytime fatigue. Other more common conditions need to be evaluated and ruled out before this diagnosis is made. This condition may run in families.
Paradoxical insomnia
Paradoxical insomnia is also called subjective insomnia or sleep state misconception. In this condition, individuals may report and complain of insomnia;, however, they would have a normal pattern of sleep if they were to have a formal overnight sleep study done.
source : www.medicinenet.com
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