Common insomnia causes & cures

If you’ve had trouble sleeping during the COVID-19 pandemic, you’re not alone.  Google searches for “insomnia” hit an all-time high during the lockdown, with more than one in five Americans reporting that the pandemic is interfering with their sleep.

Insomnia can make it difficult to fall asleep, difficult to stay asleep, or difficult to go back to sleep if you wake up too early.

Even before the pandemic began, Americans were already not getting the recommended amount of sleep each night.  The Center for Disease Control (CDC) reports that 30% of adults in the U.S. get less than the recommended 7-9 hours of sleep a night.

Here are some factors that can cause insomnia, and tips to help improve it.

Poor Sleep Hygiene

“Sleep Hygiene” is a phrase that refers to practices and habits that can help people experience consistent, restorative sleep.  Poor sleep hygiene is a common reason why people have difficulty sleeping.

Examples of good sleep hygiene include sticking to a consistent sleep schedule, limiting daytime naps to no more than 30 minutes, following a relaxing bedtime routine, cutting off screen exposure (i.e., smartphones, computers, and TVs) one hour before bedtime, getting aerobic exercise during the day, avoiding stimulants like caffeine and nicotine before bed, and sleeping in a cool, darkroom.

Underlying Medical Conditions

Sometimes insomnia happens for no identifiable cause, which is referred to as primary insomnia.  However, in many cases, insomnia is a symptom of an underlying condition, which is known as

Medical conditions that can cause secondary insomnia include allergies, an overactive thyroid (called hyperthyroidism), chronic pain, acid reflux, and sleep apnea. 

Working with a health care provider to identify and treat these underlying disorders can help improve the quality and quantity of your sleep.

Mental Health Concerns

Mental health concerns are one of the most common causes of insomnia.  People who are experiencing anxiety, depression, or increased stress are likely to also experience a disruption in their sleep.

Consulting with a mental health professional is often helpful.  Treatment options include medication, various forms of therapy, and self-soothing practices such as meditation and mindful breathing.

Medications

While some medications can make you drowsy, other medications have the opposite effect and make it more difficult for you to fall or stay asleep. 

Examples of insomnia-inducing drugs include certain medications used to treat depression, epilepsy, ADD, nasal congestion, heart arrhythmias, asthma, headaches, and thyroid disorders.

It’s important to work with a healthcare professional to see if adjusting the amount of medication or the time of day you take it could be helpful, or if switching to a different class of medication is an option for you.

Substance Use/Abuse

Substance use and/or abuse is another common cause of insomnia.  Caffeine, amphetamines, nicotine, methamphetamine, and cocaine all have stimulant effects.  Withdrawing from sedating substances like benzodiazepines can cause insomnia as well.

Alcohol is another substance that often interferes with sleep.  While many people find that having a “nightcap” at bedtime helps them fall asleep faster, alcohol consumed within one hour of bedtime often impairs sleep quality and causes people to wake up early and not be able to fall back asleep.

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Written by Sarah Thebarge, Physician Assistant