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Conditions You May Have With Insomnia

Medically Reviewed by Brunilda Nazario, MD on July 19, 2021

If you’re living with insomnia, you might have some other health conditions that need attention, too. These other conditions may interfere with sleep. It’s also possible for lack of sleep to raise your risk for or trigger another health problem. Or you could simply have insomnia and another unrelated problem at the same time.

It’s important to make sure you don’t have any other untreated health problems when you seek treatment for insomnia. Sometimes if a doctor treats only your sleep troubles, it could make other undiagnosed conditions, such as COPD or acid reflux, worse. On the other hand, when you get other illnesses under control, it could help you sleep better, too.

These are some of the health conditions that most often go hand in hand with insomnia.

Depression and Other Mental Health Conditions

As many as 4 in 10 people with insomnia have a mental health condition, too.

Depression and anxiety. Many people who have insomnia and a mood disorder have depression. Depression and insomnia are related conditions. On the one hand, ongoing insomnia can lead to symptoms of both depression and anxiety. But having mood disorders such as depression and anxiety can also cause insomnia. People who have these conditions often have trouble getting to sleep or staying asleep.

Substance use disorder. Just as with depression, there’s a two-way street between substance use disorder and insomnia, too. Most substance use, whether it’s alcohol or any one of many other drugs, interrupts the body’s natural sleep cycle. That makes it harder to fall asleep and stay asleep and makes sleep less restful. When you try to quit alcohol or other drugs, withdrawal can sabotage your sleep, too. This can push you to start drinking or using again. On the other side of the coin, ongoing insomnia may raise the odds that you use substances and become addicted to them.

Chronic stress. Stress can both cause and be the result of sleep trouble. That matters because both long-term stress and long-term sleep deprivation could lead to a buildup of inflammation in your body over time. Ongoing, unchecked inflammation may be a culprit in the development of many chronic diseases.

Bipolar disorder. Trouble sleeping is a key symptom of bipolar disorder. During manic episodes, you may stay awake for days on end. During times of depression, you may have insomnia, or the opposite of insomnia: You may sleep far more than normal. Some strategies to keep bipolar episodes at bay include treating sleep problems.

Physical Health Conditions

Doctors see a number of medical conditions more frequently in people who have insomnia than in others.

Diabetes. When you have diabetes, swings in your blood sugar levels can make it hard to sleep at night and make you feel sleepy during the day. Stress, anxiety, and depression about your health problems can also keep you up. Thus begins a vicious cycle: Poor sleep has connections with high blood sugar in people with diabetes and prediabetes, though it’s not clear that poor sleep directly causes these sugar highs.

Overweight and obesity. Getting too little sleep throws off the balance of hormones in your body that help regulate your eating and your weight. When you don’t sleep enough, you may be more likely to overeat and gain weight more easily. Excess weight is a risk factor for many diseases, including diabetes, so this may explain insomnia’s role in other conditions.

Chronic obstructive pulmonary disease (COPD). About 1 in 4 people with COPD also have insomnia. Among smokers and people with depression, the rate is even higher. People who use oxygen for their COPD seem to sleep better. Traditional sleeping pills can slow breathing to a dangerously low rate in people who have COPD. That’s why it’s important that doctors first diagnose and treat COPD before addressing sleep directly.

Heart problems. Studies show that insomnia has connections with increased rates of high blood pressure, heart disease, heart rate issues such as atrial fibrillation, and heart failure. Doctors don’t fully understand the connection, but they say it could be due to the increased inflammation and hormone imbalances that poor sleep can cause.

Acid reflux. Also known as gastroesophageal reflux disease (GERD), acid reflux pushes digestive acids in your stomach up into your esophagus. This leads to heartburn, which can keep you up at night. GERD may be worse at night for a few reasons. When you’re lying down, you don’t have the force of gravity to pull that acid back down to your stomach, where it belongs. You also don’t swallow as much when you sleep, which is another way your body pushes the acid down. Saliva also helps neutralize this burning acid, but your body doesn’t make as much while you sleep. Traditional sleeping pills can make acid worse, too.

Chronic pain. This is one of the most common causes of insomnia. It’s another case of the vicious cycle: Pain makes it hard to sleep, and poor sleep can make pain worse. Opioid painkillers, which many people take for chronic pain, can also take a toll on sleep. They can keep you up and make the sleep you do get less restful.

Sleep Apnea and Other Sleep Disorders

For some people, insomnia isn’t the only sleep disorder they have. Insomnia can happen along with or as a result of other sleep problems.

Sleep apnea. If you have this sleep disorder, you stop breathing for a while as you’re sleeping. When this happens -- possibly numerous times throughout the night -- you wake up, take a breath, then fall back to sleep. Waking up throughout the night is a common symptom of insomnia, too. This fragmented sleep is less restful than a night of nonstop sleep and makes you feel tired throughout the day, the same way insomnia does.

Restless legs syndrome. While this isn’t exactly a sleep disorder, the constant, uncontrollable urge to move your legs is worse in the evenings and when you lie down. As a result, this condition makes it hard to sleep and can lead to insomnia.

WebMD Medical Reference

Sources

SOURCES:

Drugs: “Management of insomnia in patients with chronic obstructive pulmonary disease.”

Annual Digestive Diseases Week Meeting: “Hypnotic medications impair nocturnal esophageal acid clearance: a double blind, placebo controlled study using simultaneous pH testing and polysomnography.”

Journal of Clinical Sleep Medicine: “Insomnia: Definition, Prevalence, Etiology, and Consequences,” “Comorbid Insomnia With Obstructive Sleep Apnea: Clinical Characteristics and Risk Factors.”

National Institute on Drug Abuse: “Connections between Sleep and Substance Use Disorders.”

National Sleep Foundation: “Stress and insomnia,” “Lack of sleep and diabetes,” “The Link Between Obesity and Sleep,” “GERD and sleep.”

World Psychiatry: “Insomnia and inflammation: a two hit model of depression risk and prevention.”

Frontiers in Human Neuroscience: “Inflammation: The Common Pathway of Stress-Related Diseases.”

Clinical Psychology: “Sleep Disturbance in Bipolar Disorder Across the Lifespan.”

SLEEP: “Insomnia in patients with COPD.”

Contemporary Reviews in Sleep Medicine: “Insomnia and Risk of Cardiovascular Disease.”

Cleveland Clinic: “How to Beat Insomnia When You Have Chronic Pain.”

Mayo Clinic: “Restless legs syndrome.”

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