14 Medical Conditions That Contribute to Insomnia

June 1, 2020

Kate Richards, MD , Jeremy Demartini, MD , Glen Xiong, MD

Finding and treating the underlying cause of sleep disturbance is critical to effective management. Here are a few medical conditions that may trigger key disrupting symptoms.

The most common sleep disorder both in the general population and in seniors is insomnia. Many factors can contribute to insomnia, including psychiatric or neurological disorders, medical conditions, polypharmacy, medication adverse effects, substance use, environmental changes (home, hospital, care home), decreased sensory input (blindness, deafness), unrealistic expectations of sleep, lifestyle changes (retirement, change in daily structure), and psychosocial stressors. Finding and treating the underlying cause of the sleep disturbance is critical to effective management. Here are some illnesses can disrupt sleep and compromise the well-being of your patients, along with key sleep disrupting symptoms associated with those illnesses.

Key sleep disrupting symptoms: Paroxysmal nocturnal dyspnea (sudden shortness of breath awakening a person); orthopnea (difficulty breathing while lying down)

Key sleep disrupting symptoms: Coughing; oxygen desaturation; shortness of breath

Key sleep disrupting symptoms: Nocturnal angina pectoris (chest pain at night)

Key sleep disrupting symptoms: Heartburn worse while lying down or eating too close to bedtime; nocturnal cough

Key sleep disrupting symptoms: Fatigue; poor sleep quality; restless legs

Key sleep disrupting symptoms: Sleep disturbances with dementia-related sleep behaviors, cognitive decline, hypoxia, confusion, and shifted sleep-wake cycle; increased association of REM sleep behavior disorder with Parkinson disease

Key sleep disrupting symptoms: Waxing and waning mental status; disrupted sleep-wake cycles

Key sleep disrupting symptoms: Increase risk of obstructive sleep apnea; hypersomnia (increased daytime sleepiness)

Key sleep disrupting symptoms: Awakenings or arousals with apneic episodes; daytime fatigue despite adequate time asleep

Key sleep disrupting symptoms: Delay in falling asleep; frequent awakenings; difficulty finding a comfortable position

Key sleep disrupting symptoms: Nocturia; urinary retention

Key sleep disrupting symptoms: Excessive daytime sleepiness; restless legs

Key sleep disrupting symptoms: Hot flashes; night sweats; nocturnal awakenings; daytime fatigue

Key sleep disrupting symptoms: Polyuria (increased urination), polydyspiapolydipsia (increased thirst), and polyphagia (increased appetite); fluctuating blood sugars (hyperglycemic and hypoglycemic episodes)

For more on this topic, see Understanding Sleep Disorders in Older Adults, on which this slideshow is based.

This article was originally posted on March 16, 2018, and has since been updated. -Ed