Underlying Health Conditions May Be Causing Your Insomnia

For many people, there are few more frustrating experiences than trying to rest an exhausted body but being unable to sleep. Insomnia is the most commonly experienced sleep disorder globally, and Cleveland Clinic reports approximately one-third to one-half of all adults experience insomnia symptoms at some point in their lifetime. At any one time, it's estimated that about 10 percent to 15 percent of the population faces chronic insomnia, a disorder that often results from mental or physical distress or impairment.

Along with mental and physical well-being, a lack of quality sleep can lead to sexual dysfunction for men and women. Research studies have found that sleep deprivation has been associated with reduced sexual desire and arousal in women, and linked to a higher risk of erectile dysfunction (ED) in men, according to the Sleep Foundation.

To conquer insomnia, it's helpful to trace its roots. What exactly is insomnia, where does it come from and who is at an increased risk of developing it?

What is insomnia?

Chelsie Rohrscheib, Ph.D., is a researcher in clinical sleep medicine and a sleep specialist at Wesper, a company based in New York City that produces wearable sleep diagnosis tools. She explained that certain criteria must be met in order to receive a medical diagnosis of insomnia, adding that some people may experience only one of the following symptoms, while others may face all of them.

"A person has insomnia when they have difficulty falling asleep for more than 30 minutes a night at least three times a week," Rohrscheib noted. "A person also has insomnia if they wake up frequently in the middle of the night or if they take longer than 30 minutes to fall back asleep at least three times a week. Finally, a person has insomnia if they wake up at least one hour too early at least three times a week. Additionally, insomnia is considered acute if it's been occurring from less than three months or chronic if it has been occurring for longer."

Health risk factors contributing to insomnia

If you receive an insomnia diagnosis, the first action your medical professional may take is to identify any underlying health conditions that commonly cause or contribute to insomnia.

Here are the most common health risk factors associated with insomnia:

• Advancing age: "As the body ages, sleep patterns can change, so individuals over 60 can experience insomnia more frequently," said Po-Chang Hsu, M.D., a medical content expert for SleepingOcean, a Canadian online resource for information and products that support healthy sleep.
• Being a woman: "Hormonal shifts and the circadian rhythm differences they cause can explain why women are more likely to experience insomnia than men," Hsu said. Rohrscheib also noted that insomnia can especially impact women during menopause.
• Chronic pain or other chronic health conditions
• Heart conditions
• Mental health conditions, such as depression and anxiety
• Other sleep disorders: "People who have restless legs syndrome (RLS), sleep apnea or a circadian rhythm disorder are more likely to experience insomnia," Rohrscheib said.
• Respiratory conditions
• Stress: The stressors you experience in the daytime—and your responses to that stress—are significant sources of insomnia at bedtime.

Common causes of insomnia

In addition to health conditions, a plethora of behavioral and environmental factors can leave a detrimental impact on your sleep.

Hsu and Rohrscheib identified some major factors that can contribute to chronic insomnia disorder:

• A busy or irregular travel or work schedule. "When traveling in different time zones or working different shifts, the body's clock, or circadian rhythm, can get disrupted, causing unwanted changes in the sleep schedule," Hsu said. This type of disruption can apply to shift workers who have to sleep and work at abnormal times, Rohrscheib added.
• Consuming a lot of food in the evening or night. "Eating more than 200 kilocalories before your bedtime or in the evening is associated with nocturnal awakening and disrupted sleep," Hsu explained. "That's why it's recommended not to eat a lot in the three hours before sleep time to avoid an increased risk of insomnia."
• Consuming stimulants and other drugs. "People with irregular sleep schedules due to consuming excessive amounts of coffee, alcohol or drugs can experience insomnia more often," Hsu said.
• Poor sleep hygiene. "An irregular sleep schedule, napping, being too active before sleep, looking at your TV, smartphone or computer screens before bed, and working in bed are all bad habits that can interfere with the sleep cycle and lead to insomnia," Hsu advised.
• Geographical areas where there is prolonged or limited sunlight. "People who live in areas of the world that get limited sunlight during the winter or too much sunlight in the summer, like Alaska for example, are at an increased risk for insomnia," Rohrscheib said.
• People whose romantic partners are dealing with insomnia. "If your sleep habits are disruptive to your partner, it can affect their ability to practice good sleep hygiene and regulate their sleep cycle," Rohrscheib said. "This, in turn, can increase their risk for insomnia. That's why it's recommended for partners with different sleep tendencies or schedules to sleep in separate beds or in separate rooms."
• Personality. "People with insomnia tend to have certain personality traits, such as perfectionism, the tendency to fix things, the tendency to think of solutions, obsessive-compulsive traits, anxiety and distress," said Hsu, who referred to a study published in 2010 in Sleep Medicine Reviews. Researchers noted future longitudinal studies may be needed to pull apart causation from correlation, but stated, "Personality factors may play a causal role in the development of insomnia but may also be a consequence of the sleep problem and the associated daytime dysfunction."

Adopting good sleep hygiene practices

Your doctor may prescribe one or more treatment methods, such as cognitive behavioral therapy (CBT) or medication, to help ease your insomnia over time.

Michael Pelekanos, M.D., medical director of Valley Sleep Center in Chandler, Arizona, said there are many small changes you can adopt today that may lead to big sleep health benefits. Of course, these strategies are intended to accompany and support, and not replace, the treatment methods prescribed by your doctor.

"Simple lifestyle changes can help in creating a healthy sleep pattern," he said. "Instead of focusing on the quantity of sleep, the emphasis should be on the quality of sleep."

Here are six guidelines that Pelekanos offered for a good night's sleep:

• Avoid alcohol and prescription drugs. These substances can lead to fragmented sleep, so it's best to avoid them.
• Avoid stimulants. No caffeine, carbonated drinks or high-calorie energy drinks several hours before bedtime.
• Don't monitor the time. Try to avoid looking at the clock, because it will only make you more anxious.
• Maintain a nightly bedtime. Try to go to bed at the same time each night and stick to that time as strictly as possible.
• Practice mindfulness from the moment you get in bed. Once in bed, avoid focusing on work or any other distracting thoughts.
• Transform your room into a sleep sanctuary. Make your bedroom or sleeping area as comfortable as possible with a comfortable mattress and pillow, no distracting lights and no noise. Turn off distractions such as the TV, phone, laptop, tablet or any other connected devices that you use.