1. Insomnia Pictures Slideshow: 10 Tips to Avoid Insomnia
2. Sleep Slideshow: Foods That Help or Harm Your Sleep
3. Sleep Quiz: Test Your Medical IQ

Medical Author:

Siamak T. Nabili, MD, MPH

Siamak T. Nabili, MD, MPH

Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• What is insomnia?
• What causes insomnia?
• What are other causes of insomnia?
• What are the risk factors for insomnia?
• What are the symptoms of insomnia?
• When should I call the doctor about insomnia?
• How is insomnia diagnosed?
• How is insomnia treated?
• What are non-medical treatments for insomnia?
• What is sleep hygiene?
• How can stimulus control help with insomnia?
• What is sleep restriction?
• What medications are used to treat insomnia?
• What is the outlook for insomnia?
• Insomnia At A Glance
• Patient Comments: Insomnia - Treatment
• Patient Comments: Insomnia - Causes
• Find a local Sleep Specialist in your town
• Insomnia Index

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:

• jet lag,
  
  
• 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).