Medical Health Encyclopedia

Sleeping difficulty

A life-threatening disease is rarely the cause of problems with sleep. For many people, poor sleep habits are the cause. However, because insomnia is a key symptom of depression, you should be evaluated for depression if you are having sleeping difficulties.

Insomnia may cause a reduced energy level, irritability, disorientation, dark circles under the eyes, posture changes, and fatigue.

It may help to consult a psychiatrist, another physician, or another mental health practitioner for evaluating psychiatric disorders that can lead to insomnia. If you are depressed, antidepressants can help both the sleeping problem and the depression. These medications do not carry the same concerns about tolerance and dependence as sedatives.

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Nightmares and dreams that interfere with sleep may also respond to counseling.

Common Causes:

• jet lag
• shift work
• wake-sleep pattern disturbances
• grief
• depression or major depression
• worry
• anxiety or stress
• exhilaration or excitement
• bed or bedroom not conducive to sleep
• nicotine, alcohol, caffeine, food, or stimulants at bedtime
• aging
• excessive sleep during the day
• excessive physical or intellectual stimulation at bedtime
• overactive thyroid
• side effect of a new medication
• alcoholism or abruptly stopping alcohol after long-term use
• not getting enough bright-light exposure during waking hours
• abruptly stopping a medication (such as sleeping pills)
• medications or illicit "street drugs" (for example, excessive thyroid replacement hormone, amphetamines, caffeine-containing beverages, cocaine, ephedrine, phenylpropanolamine, theophylline derivatives)
• withdrawal of medications (such as sedatives or hypnotics)
• interference with sleep by various diseases, including an enlarged prostate (men), cystitis (women), COPD, pain of arthritis, heartburn, and heart or lung problems
• restless leg syndrome