Risk Factors for Insomnia

A risk factor is something that increases your likelihood of getting a disease or condition.

It is possible to develop insomnia with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing insomnia. If you have a number of risk factors, ask your healthcare provider what you can do to reduce your risk.

Insomnia is often the result of a behavior or a symptom of an underlying mental or physical problem. These behaviors and conditions increase your risk of having insomnia. They include:

Advanced Age

People over the age of 60-65 are more likely to complain of insomnia than are younger people. Older people may be less likely to sleep soundly because of bodily changes related to aging and because they may have medical conditions that disturb sleep.

Chronic Disease

Chronic disease and pain can cause insomnia for a variety of reasons.

  • Diabetes and kidney disease can cause frequent urination that can disturb sleep.
  • Chronic lung disease can cause frequent waking due to decreased oxygen and a feeling of air hunger.
  • Arthritis causes joint pain and stiffness.
  • Alzheimer’s disease and Parkinson’s disease cause restlessness and frequent waking in the night.
  • Heart disease can cause chest pain and difficulty breathing when lying down.
  • Gastrointestinal reflux disease (GERD) or an ulcer can cause heartburn-like pain or discomfort, especially when lying down.
  • Sleep apnea (stopping breathing for short periods while sleeping) causes brief awakenings (often unnoticed) and excessive daytime sleepiness.
  • Restless legs syndrome and other disorders that cause involuntary limb movements during sleep break up the normal sleep pattern and may make sleep less refreshing.
  • Other causes of pain, such as fibromyalgia and back pain, can create sleep disturbances.

Medications

Certain medications can cause sleeping problems as a side effect. Having to take one or more of these drugs can lead to insomnia. Some of these medications include:

  • Decongestants and cough and cold remedies
  • Diet pills
  • Steroids
  • Some high blood pressure medications (beta blockers)
  • Theophylline ( asthma )
  • Phenytoin ( seizures )
  • Levodopa (Parkinson’s disease)

Gender

Insomnia occurs more often in women than in men. Pregnancy and hormonal shifts can disturb sleep. Hormonal changes that cause premenstrual syndrome (PMS) and menopause (with its accompanying hot flashes) can also cause sleep disorders.

Psychological Factors

Stress is considered by most sleep experts to be the number one cause of short-term sleeping difficulties. Common triggers include school- or job-related pressures, a family or marriage problem, or a serious illness or death in the family. Insomnia is also a very common symptom of anxiety disorders, bipolar disorder , and depression .

Lifestyle Behaviors

Habits and activities that you do during the day or night can interfere with getting a good night's sleep. These include:

  • Smoking or using other tobacco products
  • Drinking alcohol or beverages containing caffeine in the afternoon or evening
  • Exercising close to bedtime
  • Following an irregular morning and nighttime schedule
  • Working or doing other mentally intense activities right before or after getting into bed

Night Shift Work

Night shift work forces you to try to sleep when activities around you and your own "biological rhythms" signal you to be awake. Shift workers are more likely than are employees with regular, daytime hours to fall asleep on the job because of poor sleep quality.

Long-range Jet Travel

Jet lag is the inability to sleep as a result of crossing many time zones in a short period of time, as when you travel by jet. This can disturb your biological rhythms and deprive you of good sleep until your body can adjust to the new time zone.

Poor Sleep Environment

A distracting sleep environment such as a room that's too hot or cold, too noisy, or too brightly lit can be a barrier to sound sleep. Interruptions from children or other family members can also disrupt sleep. Other influences may be the comfort and size of your bed and the habits of your sleep partner.

References:

ABCs of ZZZs—when you can’t sleep. National Sleep Foundation.n website. Available at: http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2453615/apps/nl/content3.asp?content_id={1636C27B-B123-4CEE-BE7D-FABE706709E7}&notoc=1 . Accessed May 15, 2007.

Czeisler CA, Winkelman JW, Richardson GS. Sleep disorders. In: Harrison’s Internal Medicine. 16th ed. McGraw-Hill Companies, Inc; 2005. Available at: http://www.accessmedicine.com/content.aspx?aID=53393 . Accessed May 15, 2007.

National Center on Sleep Disorders Research website. Available at: http://www.nhlbi.nih.gov/about/ncsdr/index.htm . Accessed May 14, 2007.

National Sleep Foundation website. Available at: http://www.sleepfoundation.org/ .



Last reviewed May 2007 by Janet H. Greenhut, MD, MPH

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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