What causes chronic insomnia?
Chronic insomnia is more complex and often results from a combination of factors, including underlying physical or mental disorders. One of the most common causes of chronic insomnia is depression. Other underlying causes include arthritis, kidney disease, heart failure, asthma, sleep apnea, narcolepsy, restless legs syndrome, Parkinson's disease,
and hyperthyroidism. However, chronic insomnia may also be due to behavioral factors, including the misuse of caffeine, alcohol, or other substances; disrupted sleep/wake cycles as may occur with shift work or other nighttime activity schedules; and chronic stress.
Health conditions, pain, or discomfort impair sleep. Among the many medical problems (and some of the drugs that treat them) that can cause insomnia are allergies, arthritis, heart disease, hypertension, asthma, rheumatologic conditions, Alzheimer's disease, Parkinson's disease, hyperthyroidism, and attention deficit hyperactivity disorder.
A large percentage of chronic insomnia cases prove to have a serious psychologic or psychological basis. The disorders that most often cause insomnia are chronic anxiety, depression, and bipolar (manic) depression. At least 70% of people with depression complain of insomnia. Depression has been associated with abnormal levels of certain stress hormones that can impair sleep are similar to those associated with aging. It should be noted, however, that insomnia may also cause emotional problems and it is often unclear which condition has triggered the other.
Fluctuations in female and stress hormones play a major role in insomnia in women. Progesterone promotes sleep, and levels of this hormone plunge during menstruation, causing insomnia, and rise during ovulation, when women may be sleepy. During pregnancy, progesterone levels in the first and last trimester can disrupt normal sleep patterns. Insomnia can be a major problem in the first phases of menopause, when hormones are fluctuating intensely. Hot flashes, sweating, and a sense of anxiety can awaken women suddenly and frequently at night during the first months of menopause. Insomnia may also be perpetuated by psychologic distress provoked by this life passage.
Normal aging is associated with a blunting in the surges of growth hormone, a substance associated with sleep. In addition, increased levels of cortisol, a major stress hormone, have been observed in some, but not all studies. (Contrary to previous information, levels of melatonin, the hormone secreted by the pineal gland that is associated with sleep, does not appear to decrease as one ages.)
Parents who do not regulate bedtime schedules may encourage a tendency for sleeplessness in their child. In such cases, however, the insomnia is usually mild and occasional. Severe sleep disturbances were associated with the temperament of the child. Children with such sleep problems were more high-strung, intense, and easily upset than other children. The study did not examine, however, whether these traits might have derived from problems in the home, such as marital discord or parental depression.
Delayed sleep-phase syndrome is the term for a circadian clock that runs late but reliably. People who have this condition fall asleep very late at night or in early morning hours, but then they sleep normally. Leg disorders that occur at night, such as restless legs syndrome or leg cramps, are a common cause of insomnia, particularly in older people. Sleep problems among identical twins are more likely to be connected than among fraternal twins, indicating that sleep disturbances probably have a genetic component. Chronic insomnia can also be due to behavioral factors. For example, the misuse of caffeine, alcohol or other substances, disrupted sleep/wake cycles and chronic stress.
More information on insomnia
What is insomnia? - Insomnia is difficulty falling asleep or staying asleep or a disturbance in sleep that makes sleep seem inadequate or unrefreshing.
What types of insomnia are there? - Insomnia can be classified as transient, intermittent, and chronic insomnia. Insomnia is also characterized as primary or secondary insomnia.
What causes insomnia? - About half of all insomnia cases are caused by psychological or emotional problems. Sleep apnea or hyperthyroidism can also cause insomnia.
What causes transient insomnia? - Transient insomnia is often caused by a temporary situation. A reaction to change or stress is one of the most common causes of short-term and transient insomnia.
What causes chronic insomnia? - One of the most common causes of chronic insomnia is depression. Other underlying causes include arthritis, kidney disease, heart failure, asthma.
What're the risk factors for insomnia? - The strongest risk factors for insomnia are psychiatric problems. Insomnia is more common in women than men.
What're the complications of insomnia? - Complications of insomnia include impaired mental functioning, accidents, mortality rates, stress and depression, heart disease, headaches.
What are the symptoms of insomnia? - Symptoms of insomnia can be different for each individual, and people with insomnia might experience a variety of symptoms.
How is insomnia diagnosed? - The diagnosis of insomnia is made by a physician based on the patient's reported signs and symptoms.
What's the treatment for insomnia? - Treatment of insomnia may involve treatment of the underlying medical disorder. Medications given for insomnia include sedatives, tranquilizers, and antianxiety drugs.
Behavioral and non-drug treatment therapies for insomnia - Behavioral therapies are effective for insomnia. Stimulus control is the standard treatment for primary chronic insomnia.
What prescription drugs are available for insomnia? - Rescription sleep medication may be required to cure insomnia. Various types of prescription medication include benzodiazepines, antidepressants.
What over-the-counter medications are available for insomnia? - Over-the-counter medications for insomnia include Nytol, Sleep-Eez, and Sominex. Antihistamines may be used as mild sleep inducers.
Does melatonin help to cure insomnia? - Melatonin, or 5-methoxy-N-acetyltryptamine, is a hormone produced by pinealocytes in the pineal gland. Melatonin may help certain older people with insomnia.
What natural insomnia remedies are available? - Many alternative treatments are effective in treating both the symptom of insomnia. Many people with insomnia choose herbal remedies for treating insomnia.
How to prevent insomnia? - Prevention of insomnia involves balance of rest, recreation and exercise in combination with stress management, regular physical examinations, and a healthy diet.