Depression and menopause are just two medical conditions that can rob you of sleep. Discover other culprits that can cause insomnia.
Having problems going to sleep or staying asleep? A health condition could be to blame. Research suggests that sleep disturbances such as insomnia are rooted in certain medical conditions.
“We’re finding that both the quantity and quality of sleep a person gets can be linked to a number of health issues and diseases,” says James Wellman, MD, medical director of the Sleep Disorders Center of Georgia in Augusta. Sleep problems may be caused by physical, emotional, or hormonal conditions — everything from asthma to depression to menopause. Here are the most common culprits.
Sleep problems and depression are common bedfellows. Some research shows that 90 percent of people with depression experience troubled sleep. “In low-grade depression, insomnia is often the most prominent symptom,” says Dr. Wellman. Waking up too early in the morning is a hallmark of serious depression. Other depression-related sleep problems include difficulty falling asleep and sleeping excessively. Anxiety (persistent worrying and uneasiness) can also leave you wide awake due to the inability to relax. Appropriate medications can help ease depression and anxiety, as well as the resulting sleep problems.
As a woman’s periods start to end, insomnia may begin. According to the National Sleep Foundation, 61 percent of menopausal women have sleep problems. One possible reason: Progesterone levels drop off during menopause. “Progesterone is a sleep-promoting hormone,” says Wellman. Changing levels of estrogen during menopause can also cause sleep disruptions by bringing on hot flashes, sudden waves of intense body heat, and sweating.
Diabetics often find restful sleep elusive due to blood sugar fluctuations, night sweats, and the need to urinate frequently during the night. Insomnia can also increase the risk of developing diabetes. In a recent study involving 1,741 adults, people who slept less than six hours were more likely to develop type 2 diabetes than those who got more sleep.
The intense pain of arthritis can make drifting off to dreamland difficult. Plus, arthritis patients who must shift positions during the night often find it hard to fall asleep again. A pain reliever before bed can help ease sleep-stealing arthritis pain. Fibromyalgia, a condition characterized by painful ligaments and tendons, has also been linked with sleep disturbances, as well as next-day fatigue.
Two common cardiovascular conditions, coronary artery disease and congestive heart failure, have been linked to sleep problems. In coronary artery disease, fluctuations in circadian rhythms can cause chest pain, an irregular heartbeat, or even a heart attack while sleeping. Congestive heart failure prevents the heart from pumping enough blood to reach all parts of the body. As a result, extra fluid accumulates around the lungs while you are lying down, causing you to wake up during the night. Using pillows to elevate the upper body can help.
People with asthma often have sleep disturbances because of breathing difficulties, wheezing, and coughing, says Wellman. Asthma symptoms are usually worse at night due to night time changes in functioning that constrict the airway, increasing the risk of asthma attacks during the night. Some of the medications used to treat asthma can also cause insomnia and fragmented sleep.
Heartburn or GERD
In heartburn or gastroesophageal reflux disease (GERD), acidic juices in the stomach flow back into the esophagus, causing irritation and painful burning sensations. This can make it difficult to fall asleep and stay asleep. Lying down often worsens the condition. Avoiding big meals, coffee, and alcohol in the evening may help relieve heartburn and bring on a restful night’s sleep.
“Anorexia has been found to interrupt normal sleep patterns, possibly due to malnutrition and excessive weight loss,” says Wellman. Research suggests that anorexics get more non-REM sleep and less REM sleep than people of normal weight, resulting in next-day tiredness. Bulimia is often characterized by eating binges and purges during the night, interfering with a good night’s sleep.
Kidney disease prevents the kidneys from filtering wastes from the blood, which can lead to insomnia or restless legs syndrome. Dialysis or even a kidney transplant doesn’t always result in normal sleep, says Wellman. Researchers aren’t sure why.
An overactive thyroid gland (hyperthyroidism) can cause sleep-busting night sweats, while an underactive thyroid gland (hypothyroidism) brings on excessive daytime sleepiness. Both of these thyroid conditions can be diagnosed with a simple blood test and easily treated with medications.
When sleep problems are due to a medical problem or physical condition, treating the condition will often resolve the insomnia and ease sleep disturbances, says Wellman. See your doctor for an evaluation, and you may find that your insomnia does a disappearing act. If not, the next step is to make an appointment with a sleep specialist.
By Jan Sheehan – Medically reviewed by Lindsey Marcellin, MD, MPH