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What kinds of medical problems cause insomnia?

Sep 06, 2016
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Tamara Kaye Sellman, RPSGT, CCSH
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insomnia

pain_and_illness_is_a_common_reason_we_can_suffer_from_insomniaYou may struggle with sleeping problems even though you practice good sleep hygiene. 

Did you know that many chronic illnesses or medical conditions can also cause insomnia?

What is insomnia? It's defined as difficulty falling asleep, difficulty maintaining sleep, and awakening too early. (You can read more about insomnia here.)

It's usually not considered a primary sleep disorder, but a symptom: the result of an external factor, such as medical diseases, disorders, and conditions.

many_medical_conditions_can_cause_insomniaDiseases and disorders that can be causes of insomnia

Examples of medical conditions that can cause insomnia are:

  • Alzheimer's disease:  "Sundowning” is a state in which those with this disease grow increasingly restless and confused as dusk arrives, and they may be more prone to nighttime wandering. These situations contribute to insomnia symptoms for as many as half of all people with mild to moderate cases of Alzheimer's 
  • Arthritis: Whether it's rheumatoid arthritis or osteoarthritis, the pain and discomfort of inflammation in the joints can lead to long periods of poor sleep at night
  • Asthma: This restrictive disease of the lungs can attack even during sleep, causing significant struggles with breathing
  • Cancer: Its physical symptoms and pain can be disruptive to sleep
  • Chronic obstructive pulmonary disease (COPD): As with asthma, COPD can make it very difficult for people to breathe and to maintain adequate levels of blood oxygen; respiratory struggles lead to sleepless nights
  • Diabetes: Between blood sugar and insulin imbalances, frequent urination, and peripheral neuropathy, people with diabetes are destined to sleep poorly when their condition is uncontrolled
  • Epilepsy: Seizure activity can happen during periods of sleep, interrupting sleep architecture, flooding the bloodstream with stress hormones, and leading to wakeful periods at night
  • Fibromyalgia: Three quarters of people with this disorder suffer from sleep disturbances and complaints of nonrestorative, nonrefreshing sleep; these are related to neurological interruptions of sleep architecture that can lead to insomnia
  • Gastroesophageal reflux disease (GERD): The discomfort of recurring reflux or heartburn can lead to many sleepless nights and can even increase the risk for snoring and sleep apnea
  • Heart failure: While reclined, people with heart failure struggle to breathe freely due to the collection of fluid in their lungs
  • Kidney disease: When the kidneys cannot properly filter waste products, this can result in chemical imbalances in the bloodstream that lead to arousals, as well as a secondary symptom of renal failure: restless legs
  • Multiple sclerosis: This autoimmune condition occurs when the immune system attacks the central nervous system. Its resulting damage interferes with electrical activity in the brain, which can include the signaling which moderates the sleep-wake cycle
  • Parkinson's disease: The symptoms of this neurological disease—tremor (shaking), rigidity (stiffness), slow motor activity, problems with balance and coordination—can lead to serious sleep disruptions
  • Stroke: In the wake of a stroke, damage to the centers in the brain which control the sleep drive and its biochemical components can lead to periods of sleeplessness
  • Thyroid disease: Whether this gland is overactive or sluggish, in either case, the result can be symptoms of insomnia
  • Undiagnosed or untreated sleep disorders: These include obstructive sleep apnea (OSA), narcolepsy, circadian rhythm sleep disorders, periodic leg movement disorder (PLMD), and restless leg syndrome (RLS)

Other medical conditions that can make you sleepless in Seattle:

  • Nasal/sinus allergies: Struggles with congestion, runny nose, and scratchy throat can interrupt a good night's sleep
  • Angina: Regular bouts of chest pain at night can lead to sleep fragmentation
  • Concussion, head trauma, or TBI: Any kind of injury to the brain can wreak havoc on the brain structures responsible for modulating the sleep process
  • Menstruation, pregnancy, and menopause: Shifts in hormone activity in the female body can lead to periods of sleeplessness
  • Chronic pain—especially headaches, peripheral neuropathy, and low back pain: Pain is the enemy of sleep. A person with unmanaged pain is destined to sleep poorly, which leads to sleep deprivation, a situation which then amplifies pain
  • Enlarged prostate and nocturia: Frequently rising to use the bathroom can lead to long periods of wakefulness throughout the night
    insomnia_can_be_thought_of_as_the_down_side_to_being_a_night_owl

Don't forget that there are other reasons why you might not be getting the sleep you need; aside from poor sleep hygiene, you might be experiencing the side effects of medications used to treat your medical conditions, for instance. 

If you don't treat your medical problems, you can't expect to sleep better. In the event you are experiencing long-lasting bouts of insomnia, consult your primary care physician and a sleep specialist to determine whether you need to take a closer look.

Discovering and treating an undiagnosed condition, or being more proactive about treating a condition you already know you have, can do wonders for your nightly slumber. 


Sources:

Alzinfo.org
American Academy of Sleep Medicine
The American Association of Endocrine Surgeons
American Sleep Association
Cancer.gov
Harvard Health
Mayo Clinic
Medscape Multispecialty
National Heart, Blood, and Lung Institute
National Sleep Foundation

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