Insomnia can originate from a range of both physical and/or psychological factors. The cause of insomnia can be a temporary problem, such as short-term stress or jetlag. This is typically the case with short-term or acute insomnia. In more severe cases, insomnia may stem from an underlying medical condition or a more deeply rooted issue. This is the case with chronic insomnia.
In many instances, particularly with regards to chronic insomnia, there is no single underlying cause, but rather a combination of factors that contribute to the initiation and exacerbation of insomnia. Sleep deprivation can also trigger or worsen other health conditions, creating a complex chain of cause-and-effect for insomnia.
Some of the most common causes of insomnia include heightened stress levels, having an irregular sleep schedule, an irregular working schedule, dealing with any changes to your body’s internal clock, poor sleeping habits, jetlag, unhealthy lifestyle choices, lack of exercise, pain and physical illnesses, certain types of medications, mental health disorders such as depression and anxiety, neurological problems, and specific sleep disorders, to mention a few.
In this article, we’ll dive deeper into the main causes of insomnia, providing you with all the information you need to know.
Holistic cause of insomnia
On a holistic level, insomnia is believed to be caused by a state of hyperarousal that either disrupts your ability to fall asleep (also known as sleep-onset insomnia), or your ability to stay asleep (also known as sleep maintenance insomnia). A state of hyperarousal can be both physical and/or mental and can be triggered by a variety of circumstances, internal and external stressors, and health issues.
Insomnia and Stress
Stress, along with anxiety and depression, is one of the most common causes of both short-term and chronic insomnia. Stress can provoke a profound reaction in the body that poses a challenge to your quality and quantity of sleep. This stress response can be triggered by a variety of sources, some of which include work, school, family dynamics, financial stressors, social and romantic relationships – depending on the stage of your life.
The body’s physical response to stress contributes to a state of hyperarousal. This is the same effect elicited by mental stress. Being in a state of hyperarousal and heightened mental awareness significantly impacts your ability to sleep. In turn, the inability to sleep may itself become a source of stress. It also has the potential to worsen symptoms of anxiety, stress, and depression, ultimately making it increasingly harder to break the cycle of stress and insomnia.
Exposure to traumatic situations and painful life events can create chronic stress within an individual who has had to endure it. This includes post-traumatic stress disorder (PTSD). Chronic stress can have a dramatic and long-lasting impact on your ability to sleep. If left untreated, it will continue to worsen over time, ultimately impacting the individual’s ability to perform basic daily tasks. It is vital to seek help as soon as possible.
According to research, some individuals are more prone to developing stress-induced sleeping problems. These individuals are considered to have high ‘sleep reactivity’, which is tied to other issues affecting their sleep as well as their physical and mental health.
Insomnia and Irregular Sleep Schedules
Disrupted or irregular sleep schedules is one of the main causes of insomnia worldwide. The body’s internal clock, known as its circadian rhythm, is influenced by a variety of environmental cues, especially light, and is directly tied to the cycle of day and night. Your circadian rhythm plays a vital role in your sleep-wake cycle.
In an ideal world, one’s circadian rhythm closely follows the daily pattern of day and night. However, in reality, a large majority of people adopt sleep schedules that cause minor to severe misalignments of their circadian rhythm. Disrupting your body’s circadian rhythm is a major contributor to developing insomnia.
Two of the most common causes of circadian rhythm disruption is shift work and jet lag. Jet lag disturbs your sleep schedule because your body simply can’t adjust to a rapid change in time zones. Shift work has a big impact on your circadian rhythm as it requires you to work through the night and sleep during the day – This results in a complete disruption to what is regarded as the ‘normal’ circadian rhythm necessary to for you to sleep properly and function optimally throughout the day.
In some individuals, circadian rhythms can be shifted forward or backward without any clear cause or explanation. This can cause persistent difficulties in sleep timing and overall sleep quality.
Alongside irregular sleep schedules, poor sleep habits such as irregular bedtime schedules, taking frequent naps throughout the day, engaging in over-stimulating activities before bed, an uncomfortable sleeping environment, and watching TV, playing video games, and using your computer, smartphone, or other screens just before bed can greatly interfere with your sleep cycle and ability to sleep.
Insomnia and Mental Health Disorders
Mental health conditions such as depression, anxiety, bipolar disorder, anxiety disorders (such as post-traumatic stress disorder), and substance abuse disorders are regarded as some of the top causes of insomnia. It is so severe in fact that Richard J. Schwab, MD at the University of Pennsylvania, Division of Sleep Medicine, estimated that 40% of people with insomniasuffer from some sort of mental health disorder.
Mental health conditions can incite mental hyperarousal as well as pervasive negative thoughts that can drastically disrupt and negatively impact your ability to sleep. Additional studies have indicated that insomnia can further exacerbate mood and anxiety disorders, making symptoms worse and even increasing the risk of suicide in individuals suffering from depression.
Insomnia and Lifestyle
Unhealthy lifestyle habits as well as unhealthy and unsustainable diets (diets that are high in sugars, processed foods, saturated and trans-fats, and low in fibre, essential vitamins and nutrients, fruits, vegetables, legumes, whole grains, and nuts) can greatly increase your risk of insomnia.
Here are a few of the top lifestyle choices and unhealthy habits that can bring about sleeping problems:
- Keeping your brain stimulated until late in the evening by either working late or using various electronic devices.
- Frequent napping or napping late in the afternoon can significantly throw off your sleep timing as well as disrupt your body’s internal clock. This will make it much harder to fall asleep at night.
- Using your bed for activities other than sleeping can create a mental association between your bed and wakefulness. This is problematic as it will not only affect your quality of sleep, but your ability to sleep. Ultimately leading to insomnia.
- Sleeping in later to try make up for lost sleep can confuse your body’s internal clock (circadian rhythm). This will not only make it increasingly difficult to establish a healthy sleep schedule, but is a major contributor to developing insomnia.
Although it’s a factor that is often overlooked, your diet can play a crucial role in the development of sleeping problems and sleep disorders like insomnia.
- Caffeine: Caffeine is a stimulant that can stay in your system for hours. When consumed in the afternoon and/or evening it can make it difficult to go to sleep, potentially contributing to insomnia. Much like caffeine, nicotine is another stimulant that can negatively affect your ability to sleep.
- Alcohol: While alcohol is in fact a sedative that can make you feel sleepy, on the flip side, it can actually worsen your sleep by disturbing your sleep cycle and causing fragmented, non-restorative sleep.
In addition to caffeine, nicotine, and alcohol, eating spicy foods or heavy meals can be hard on your digestive system and its processes. Consuming these types of meals late in the evening has the potential to generate sleeping problems.
Insomnia and Neurological Problems
Research studies have found that problems affecting the brain, including neurodevelopmental and neurodegenerative disorders are associated with an elevated risk of insomnia.
Neurodegenerative disorders, such as dementia and Alzheimers dementia, has the ability to throw off and interfere with an individual’s circadian rhythm as well as alter their perception of daily cues which are responsible for driving the sleep-wake cycle. The associated night-time confusion can worsen both sleep quality and quantity.
Neurodevelopmental disorders like attention-deficit hyperactivity disorder (ADHD) can cause a state of hyperarousal, making it harder for an individual to get the sleep they need. Sleeping problems and disorders are very common among children with Autism Spectrum Disorder (ASD) and may persist into adulthood, ultimately resulting in insomnia.
Insomnia, Pain, and Physical Illness
Pain is a major disrupter of sleep. Almost any condition that causes pain can impair your ability to sleep comfortably. By fixating on the pain you are experiencing while lying sleepless in bed, you amplify the situation, only increasing your stress, anxiety, and inability to sleep.
With regards to illness, health complications related to Type II diabetes has been found to be a potential underlying cause of insomnia. This includes increased pain from peripheral neuropathy, rapid blood sugar surges and changes, and more frequent need for hydration and urination, all of which can greatly disrupt one’s sleep. There is also a correlation between diabetes and other health conditions, including obstructive sleep apnea (OSA) and depression. Both of which are known to interfere with sleep.
Other types of physical illnesses, including those affecting the nervous system and respiratory system, may pose various sleeping challenges which can culminate into developing either short-term or chronic insomnia. Examples of physical illnesses and conditions linked with insomnia include cancer, heart disease, chronic pain, asthma, overactive thyroid, gastroesophageal reflux disease (GERD), chronic obstructive pulmonary disease (COPD), Parkinson’s disease and Alzheimer’s disease.
Often, symptoms of another health issue or natural transition can cause difficulty sleeping – contributing to insomnia. For example, during menopause, hormonal changes can lead to severe night sweats, which can interrupt your sleep and sleeping schedule.
In extremely rare and severe cases, some people may have a rare genetic disorder called fatal familial insomnia. This form of insomnia not only prevents sleep but can be life threatening.
Insomnia and Medications
Insomnia and difficulty sleeping can be a side effect of various medications and prescription drugs. Examples of medications that can interfere with sleep include, blood pressure drugs, anti-asthma medications, and antidepressants. Several over-the-counter medications such as certain allergy and cold medications, pain medications, and weight-loss products contain caffeine and other stimulants that can disrupt your sleep. Other drugs/medications may cause daytime drowsiness which can throw off your sleep schedule.
According to the American Association of Retired Persons, the following medications can cause insomnia:
- selective serotonin reuptake inhibitor, or SSRI, antidepressants
- angiotensin converting enzyme, or ACE, inhibitors
- angiotensin II receptor-blockers, or ARBs
- cholinesterase inhibitors
- nonsedating H1 agonists
- a combination of glucosamine and chondroitin
It is not only taking certain medications that can disrupt your sleep, but the opposite applies too. If you stop taking a particular drug / medication, symptoms of withdrawal as well as other aspects of the body’s reaction system can impair your ability to sleep.
Insomnia and Specific Sleep Disorders / Sleep-related Disorders
Specific sleep disorders or sleep-related disorders can be a big cause of insomnia. Here are a few examples of sleep disorders that can contribute to insomnia:
- Obstructive sleep apnea: Obstructive sleep apnea can cause numerous breathing lapses / cause you to stop breathing periodically throughout the night, resulting in temporary sleep interruptions. It is said to affect up to 20% of people and can be a major underlying factor causing insomnia as well as daytime sleepiness.
- Restless Leg Syndrome (RLS): Restless Leg Syndrome causes unpleasant sensations in your legs and an almost irresistible and powerful urge to move your legs. This detracts you from your sleep and may even prevent you from falling and/or staying asleep.
- Abnormal behaviors during sleep, known as parasomnias, can interfere with your ability to sleep. Some well-known examples include nightmares, night terrors, sleep walking, and sleep paralysis.
What Are The Main Causes of Insomnia in the Elderly?
Insomnia becomes more common with age. According to the National Library of Medicine and the American Academy of Sleep Medicine, insomnia occurs in 30-48% of older adults, who often have struggles with sleep maintenance.
Similarly to the younger population, factors such as stress, mental health problems, pain and physical ailments, unhealthy lifestyle choices, poor sleep habits, and irregular sleeping schedules can all cause insomnia in the elderly. However, unlike their younger counterparts, elderly individuals are often more sensitive to these causes. This is because of the increased prevalence of chronic health conditions, an increased use of multiple prescription drugs, and a greater degree of social isolation.
Further research indicates that people over the age of 60 have a lower sleep efficiency. These individuals spend less time in deep sleep and REM sleep, which makes it easier for their sleep to be disturbed. Elderly individuals, especially those in managed care settings, often experience a significant decrease in daylight exposure as well as reduced environmental cues for sleep and wakefulness. This can affect their circadian rhythm, ultimately contributing to poor sleep quantity and quality, as well as insomnia.
As you get older, you may also experience:
- Changes in sleep patterns: Sleep becomes less restful as you age. Your internal clock often advances as you get older – this means you tend to get tired earlier in the evening and wake up earlier in the morning.
- Changes in health: Elderly individuals typically experience/suffer from higher levels of chronic pain due to various illnesses as well as physical and mental health conditions. All of which can interfere with their ability to sleep. Other issues like prostate or bladder problems, which increases the need to urinate during the night, can greatly disrupt their sleep schedule. Sleep apnea and restless leg syndrome also become more common with age.
- Changes in activity: As you get older, you may become less physically or socially active. Regular physical activity is vital to optimal sleep. The less active you are, the more daily naps you are likely to take, which ultimately interferes with your ability to sleep at night.
- More medications: Older people typically use more prescription drugs and medication, which increases the chance of insomnia associated with medications.
What Are The Main Causes of Insomnia In Teens?
According to the National Library of Medicine and the Advocate Children’s Hospital, insomnia has been estimated to affect up to 23.8% of teens, with that number only escalating. Research indicates that various biological changes have pushed teens towards adapting a later, “night owl” sleep schedule. This means that they go to bed/fall asleep at a much later hour, however, they are unable to get the necessary/optimal amount of sleep they need due to early school start times.
To further add to their lack of sleep, teens may be especially susceptible to overscheduling and stress from schoolwork, parental pressures, school sport, extra-mural commitments, and social obligations. Teens are also more likely to use various electronic devices at all hours of the day and night, with heightened night-time screen time being of particular concern. Each of these factors contributes to a high rate of insomnia during adolescence.
What Are the Causes of Insomnia During Pregnancy?
Studies have found that more than 50% of pregnant women report experiencing sleeping problems that are consistent with insomnia. During the first trimester of pregnancy, women tend to sleep more total hours, however, the quality of their sleep significantly decreases. Following the first trimester, the quantity of sleep / the amount of total sleep they are getting drastically decreases, with the most significant sleeping problems occurring during the third trimester of pregnancy.
There are multiple factors that can contribute to and cause insomnia during pregnancy. The main causes of insomnia during pregnancy include:
- Discomfort: The changed body composition and increased weight associated with pregnancy can affect your positioning and comfort in bed, making it harder to either fall asleep and/or stay asleep.
- Reflux: Slower digestion often associated with pregnancy can prompt disruptive gastroesophageal reflux in the evening – affecting your ability to sleep.
- Disrupted Breathing: During the various stages of pregnancy, the growth of your uterus may place increased pressure on your lungs, which can create a potential for breathing problems during sleep. Hormonal changes experienced during pregnancy can also increase your snoring, and, more importantly, increase your risk of central sleep apnea, which involves brief lapses in your breathing.
- Restless Leg Syndrome: Pregnant women have a greater risk of developing Restless Leg Syndrome (RLS), even if they have never experienced symptoms before.
- Nocturia: Nocturia refers to the need to go to the bathroom more frequently. Greater urinary frequency results in a greater disruption to one’s sleep and sleep schedule.