Pain from arthritis, other rheumatologic diseases, cancer, and various neurological disorders, like neuropathy from diabetes are common causes of insomnia. Gastrointestinal disorders like acid reflux and stomach ulcers, as well as angina from heart disease may cause chest pain, and consequent awakenings during the night. In addition, cluster headaches may be precipitated during certain stages of sleep or occur from lack of sleep.
Treatment for these types of insomnia rests primarily with treating the underlying medical condition. These conditions, as with many others, interact with sleep in a complex manner, with each impacting the other. Exactly how all these factors interact is not completely known, but being aware of the sleep component allows us to target each aspect individually and achieve vastly improved interventions and treatments. So it is critical to understand and communicate to your doctor how your condition affects your sleep and that your sleep disturbances may exacerbate your medical condition. This will ensure that he/she may integrate your sleep problem into the overall treatment plan, and utilize a sleep specialist, if needed.
The "pins and needles," "internal itch," or "creeping, crawling sensation" of restless leg syndrome (RLS) also make it quite difficult to fall asleep, especially since those symptoms occur more often when one is sleepy or lying down and are relieved only by vigorously moving the legs. The symptoms of RLS may awaken one out of sleep, forcing the sufferer to walk around to relieve the discomfort.
Most people with RLS also have periodic limb movement disorder (PLMD), repetitive movements of the toe, foot, and sometimes knee and hip during sleep. These movements may cause arousals that lead to non-restorative sleep. Your doctor can prescribe various medications to reduce or eliminate the movements and the associated sleep disturbances (arousals) caused by these disorders. This results in a more sound sleep, one from which you awaken restored and refreshed.
Other illnesses that often have nighttime symptoms that cause awakenings include:
- An enlarged prostate that frequently awakens men to urinate
- Congestive heart failure and emphysema, which cause difficulty breathing
- The immobility from paralysis or Parkinson's disease
- Hyperthyroidism stroke, and alcoholism
Another reason why communicating symptoms of insomnia to your doctor is so important is the possibility that the treatments for medical conditions themselves may cause or worsen insomnia. Following is a brief list of some classes of drugs that may fall into this category: