Wellness: Prevention

The Many Causes of Insomnia

Anxiety and stress are thought to be the most common causes of insomnia. More than half of people with insomnia have depression or anxiety.

But sleeplessness can also be caused by a variety of medical conditions, medications, and environmental factors. If you suffer from insomnia and have any of the following medical conditions, talk with your health care provider about possible treatments.

Respiratory conditions

Allergies, asthma, bronchitis, and emphysema can interfere with your breathing at night and can cause you to wake up frequently. In addition, many medications used to treat these conditions cause insomnia. Ask your health care provider to give you a dosage schedule least likely to interfere with your bedtime.

Restless legs syndrome

Restless legs syndrome (RLS) is a disorder of the sensory nervous system. It causes an irresistible urge to move your legs because of an unpleasant feeling described as creeping, crawling, tingling, or burning. Moving your legs temporarily eases the feelings. The unpleasant feelings may also occur in your arms. RLS can make it hard to fall asleep and stay asleep. Doctors often can't determine the cause of RLS. It can occur as a result of a disease or condition, such as iron deficiency (with or without anemia), kidney failure, diabetes, Parkinson disease, rheumatoid arthritis, or pregnancy. Some medications, such as antidepressants, antinausea and antipsychotic medicines, and antihistamines can bring on or make symptoms worse.

Simple self-care approaches and lifestyle changes can help relieve symptoms. These include avoiding tobacco, alcohol, and caffeine; walking or stretching; taking a hot or cold bath; massage; and heat or ice packs. Some prescribed medications, such as dopamine agonists, may help.


Heartburn can interfere with your sleep when stomach acid seeps into the esophagus, triggering a reflex that wakes you up. To reduce the incidence of heartburn, avoid coffee, alcohol, chocolate, and high-fat and highly acidic foods. Don't eat late at night. Raise the head of your bed 6 inches by placing blocks of wood under the bedframe, or sleep on 2 or 3 pillows  Stop smoking; tobacco smoke weakens the esophageal sphincter.


The pain and stiffness of arthritis often keep sufferers from sleeping through the night. Pain relievers and regular exercise that increase your joints' range of motion may provide relief.


Many women experience restless sleep, night sweats, and early morning awakenings when they reach menopause. Women on hormone therapy (HT) are less likely to experience sleeping problems. Because HT carries increased health risks, a woman should talk to her health care provider about what is best for her.

Medications and sleep

Many prescription and nonprescription medications can cause insomnia. Ask your health care provider if you can change to a related drug or alter the dosage or the time you take the medication if you have sleep problems and regularly take one or more of these drugs: medications containing caffeine, such as Excedrin Migraine; prescription diet pills and other drugs that contain amphetamine; decongestants; antidepressants; steroids; thyroid hormones; broncho-dilating drugs for asthma; and tranquilizers.

Nicotine and alcohol

Nicotine is a stimulant. Smokers experience nicotine withdrawal during sleep and can have difficulty falling asleep and problems waking up.

Alcohol may allow you to drift off into sleep, but it increases the number of times you awaken throughout the night.

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