What Causes Insomnia?
Insomnia can pop up at any point in time for almost any one. It doesn’t discriminate, though you are statistically more likely to have it if you’re female, senior, or are financially stressed. As I mentioned in the previous section, the primary causes for secondary insomnia (either transient, acute, or chronic) include:
- A medical condition
- Lifestyle factors
- Life change or significant stressor
- A mood disorder (e.g., anxiety, depression)
Here’s another ‘not a doctor’ disclaimer because, ya know, I’m not a doctor. Nor a psychologist. Please speak with an appropriate medical professional if you have any of the following concerns.
There are a plethora of medical conditions that causes insomnia. Here are just a few listed by the Mayo Clinic1:
- Breathing issues (asthma, sleep apnea, snoring, allergies, COPD)
- Pain (arthritis, back pain, fibromyalgia, sciatica, injury)
- Neurological conditions (parkinsons, MS, dementia)
- Hormones (hypothyroidism, hyperthyroidism, menopause, diabetes)
- Sleep-specific disorders (restless leg syndrome, sleep walking, sleep paralysis, sleep apnea, delayed phase disorder)
- I encourage you to look into these disorders if you believe you have one. E.g., if you can sleep 7-8 hours but only if you fall asleep at 3am, you may have delayed phase disorder and not insomnia
- Other health conditions (acid reflux, anemia, high blood pressure)
If you have a medical condition that affects your sleep, suspect you have one, or even if you feel perfectly healthy, I encourage you to see your doctor and get a physical. It’s good to get a full stock of your physical health to rule out anything that can work against you.
If you don’t have a medical condition or your medical condition is appropriately managed but you still can’t sleep, then this course will address the anxiety around sleep that may have been triggered by medical conditions.
There are also a multitude of medications that causes insomnia. Just a few of them include alpha blockers (usually prescribed for high blood pressure), beta blockers (also for high blood pressure and heart arrhythmias), corticosteroids (for inflammation), and SSRIs (for depression and anxiety)2. If you think that if only you were off a certain medication then you’d be able to sleep, your first course of action is to address this with your doctor. See if there is an alternative prescription they can provide.
Again, if you have changed medications and you still don’t sleep well, it has likely become an anxiety issue around sleep, and this program will help you deal with that.
Pregnancy hormones are no joke. They do all sorts of things to you during pregnancy and in the months after giving birth. Progesterone, estrogen, human chorionic gonadotropin (hCG), prolactin, and oxytocin are at all-time highs and while they’re vital to a healthy pregnancy, they can cause a host of physical changes that make it difficult to sleep3. Some of these include increased need to urinate, congestion, heartburn, nausea, and edema. There is also the physical aspect of discomfort from the pregnancy itself. Pelvic pain, back pain, prodromal labour, braxton hicks, your baby moving or just not being able to get comfortable can all lead to a poor night’s sleep.
There is also the mental aspect of being pregnant that can keep you up at night. Worries about changes in finances, relationship, lifestyle, and simply the uncertainty of it all is a lot to contend with.
New Parenting Absolutely Causes Insomnia
Once the baby arrives, your baby will of course be waking up to feed. This is to be expected – they need to gain twice their body weight in the first five months of life4. If you had to gain twice your bodyweight in such a short amount of time only drinking milk, you’d be up every few hours to eat too! But as a new parent, give yourself some grace. I truly mean that. Having a baby is a life changing event. The flood of emotions coupled with a baby that wakes up several times a night, can and will affect anyone’s sleep.
There is an expectation that your sleep will be disturbed for a few months (I discuss how to manage sleep when a baby comes into the picture in week 5). However, if you are getting anxious about sleep and have a hard time falling asleep, getting to sleep, or falling back asleep after a nighttime feed, the same rules apply to you throughout this program.
There are plenty of ways in which we conduct our lives that can throw off a good night’s sleep including but not limited to:
- Erratic sleep schedule
- Recreational drugs, alcohol, and nicotine
- Poor diet (bloating, constipation, and diarrhea can all keep you up)
- Too much daily stress
- Too much stimulation before bed (e.g, playing video games, going on your phone, working in bed)
You, of course, can’t control every lifestyle factor that can mess up your sleep (like if you work night shift or travel a lot) but you can control much of your lifestyle that promotes and even greatly facilitates sleep. We will be discussing lifestyle factors in greater detail in week 5.
Known Life Change or Major Stressors Causes Insomnia
A multitude of life events can jump-start a bout of insomnia. Here are just a few of the many events that can cause us stress even if it’s ‘good’ stress (Bourne, 2015):
- Change in finances
- Change in relationships (marriage, divorce, separation)
- Death of someone close to you
- Changes in your job situation (change in responsibilities, layoffs, career switch)
- Starting or finishing school
- Interpersonal conflict (with spouse, parents, friends, coworkers, boss, etc.)
- Personal injury or illness
- Pregnancy and new parenting
Sometimes it is really easy to pinpoint which life change or event was the instigating factor that causes your insomnia. If so, it’s still worthwhile to look into why the change was so jarring. Some are obvious (death of a loved one) but others, like changing jobs or getting a divorce, usually have more layers that likely require a gentle curiosity about yourself. Try to see why the change affected you the way it did. Was it inconsistent with your values? Was it a shock to how you thought your life should be? Did it change how you thought life would unfold for you?
Unknown (or Unacknowledged) Stressors
Sometimes, it’s not so easy to identify changes that made chronic insomnia a thing in your life. For me, it took me years to realize the series of life changes and stressors that weighed heavily on me and what they all had in common – my inability to deal with uncertainty and a lack of control.
If you’re not sure why you have insomnia, I encourage you to think back from the time you stopped sleeping until now to see if there’s a common theme to what has happened or how you have reacted to what has happened. There may be a nugget of wisdom in there.
This course obviously doesn’t deal with initial stressors, but it can help you with the sleep part. This will also help you deal with whatever your primary concern is with a lot more clarity and level headedness.
Mood Disorders – The Cornerstone of What Causes Insomnia
Ah, the chicken or the egg conundrum. Did a mood disorder like anxiety, depression, OCD, etc. cause insomnia? Or did insomnia cause a mood disorder?
As you can see by my amazing graphic design skills, they can play into each other. A mood disorder can overflow and create a special “cup” (or space in your mind) for insomnia. Likewise, insomnia can overflow and create a new cup for mood disorders. Then there’s a straw between them where they feed into and off of each other. Because they are both kind of assholes like that.
My guess is that if you’re here and this is your situation, they are separate beasts and have lives of their own, but still thrive off of each other. You have the mood disorder, and you also have insomnia. I’m not going to lie, it is a bit more difficult to overcome insomnia if you are particularly anxious or depressed.
If this is the case, I highly recommend seeing a registered psychologist, social worker, therapist, psychiatrist, or medical doctor that understands mood disorders. They can either help give you additional strategies, or prescribe medications that can be truly transformative in helping you get better. If you are in a financial position where therapy is not possible, there are self-directed therapies for free or for a low cost listed in the Additions Resources section in the final wrap-up.
Empty the Insomnia Cup
In the meantime, I hope to empty – or at least greatly reduce – the contents of your insomnia cup. My hope is in turn, you will have a lot more space and energy to deal with your mood disorder, and anything else going on in your life.
In short, many events, thoughts, behaviours, and medical issues causes insomnia. The one thing that all of these seemingly unrelated things have in common is they can disrupt sleep that then self perpetuates into its own problem of chronic insomnia.
Bourne, E. J. (2015). The Anxiety and Phobia Workbook 6th ed. New Harbinger Publications, Inc. Oakland, CA. Page 46.