As we mentioned, transient and short-term insomnia can be caused by significant life events that usually pass when the stress of the incident passes. Other common causes are poor environmental conditions (too light, too cold/hot, too noisy) and jet lag (see blog of July 13, 2006 for more on jet lag).
The more difficult one, obviously for the patient, but even for the doctor to treat is chronic insomnia (CI). CI may be caused by the use of drugs, alcohol, nicotine, caffeine, and even medications used to treat other important diseases. Often CI is caused by a primary sleep problem, but it may be due to other medical, neurological, or psychiatric problems, as well. Just to give you an example of how extensive the list is I will list some of the more common causes:
Medical Diseases associated with CI:
- Heart conditions (congestive heart failure, angina)
- Lung problems (chronic obstructive pulmonary disorder- aka COPD, asthma)
- Digestive disorders (reflux, ulcers)
- Prostate enlargement (due to frequent bathroom trips during the night)
- Endocrine diseases (thyroid problems, menopause)
- AIDS
Neurologic disorders:
- Parkinson’s disease
- Alzheimer’s dementia
- Stroke
Sleep disorders:
- Sleep apnea
- Restless legs syndrome
- Circadian rhythm disorders
- Idiopathic insomnia
- Psychophysiologic insomnia
- Poor sleep hygiene (see blog posted April 18th)
Psychiatric disorders:
- Depression
- Anxiety disorders
- Post-traumatic stress disorder
- Schizophrenia
- Alcohol and drug dependence
Medications:
- Antidepressants
- Corticosteroids- even inhaled (e.g. prednisone, Advair)
- Decongestants (Sudafed)
- β-Blockers
As you can see, the list is wide-ranging and these are just the more common causes! In the next blog I hope to discuss idiopathic and psychophysiologic insomnia more extensively and I will try to explain some aspects of psychiatric illness on insomnia. Stay tuned.
