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The Many Causes of Insomnia

Anxiety and stress are thought to be the most common causes of insomnia. About 35 percent of people with chronic insomnia suffer from depression or anxiety.

But sleeplessness can also be caused by a variety of medical conditions, medications, and environmental factors. If you suffer from insomnia and have any of the following medical conditions, ask your health care provider to discuss possible treatments.

Respiratory conditions

Allergies, asthma, bronchitis, and emphysema can interfere with your breathing at night and can cause you to awaken frequently. In addition, many medications used to treat these conditions cause insomnia. Ask your health care provider to give you a dosage schedule least likely to interfere with your bedtime.

Restless legs syndrome

Restless legs syndrome (RLS) is a disorder of the sensory nervous system. It causes an irresistible urge to move the legs because of an unpleasant feeling described as creeping, crawling, tingling, or burning. Moving the legs temporarily eases the feelings. The unpleasant feelings may also occur in the arms. RLS can make it hard to fall asleep and stay asleep. Often the cause of RLS cannot be determined. It can occur as a result of a disease or condition, such as iron deficiency (with or without anemia), kidney failure, diabetes, Parkinson’s disease, rheumatoid arthritis, and pregnancy. Some medications, such as antidepressants, antinausea and antipsychotic medicines, and antihistamines can make symptoms worse.

Simple self-care approaches and lifestyle changes can help relieve symptoms. These include avoiding tobacco, alcohol, caffeine; walking or stretching; taking a hot or cold bath; massage; and heat or ice packs. Some prescribed medications may help. Levodopa can be used to treat mild cases. Dopamine agonists, such as pramipexole and ropinirole, can be used for severe cases.


Heartburn can interfere with your sleep when stomach acid seeps into the esophagus, triggering a reflex that wakes you up. To reduce the incidence of heartburn, avoid coffee, alcohol, chocolate, and high-fat and highly acidic foods. Don't eat late at night. Raise the head of your bed six inches by placing blocks of wood under the bedframe. Stop smoking; tobacco smoke weakens the esophageal sphincter.


The pain and stiffness of arthritis often keep sufferers from sleeping well. Pain relievers and regular exercise that increase your joints' range of motion may provide relief.


Many women experience restless sleep, night sweats, and early morning awakenings when they reach menopause. Women on hormone therapy (HT) are less likely to experience sleeping problems. Because HT carries increased health risks, a woman should talk to her health care provider about what is best for her.

Medications and sleep

Many prescription and nonprescription medications can cause insomnia. Ask your health care provider if you can change to a related drug or alter the dosage or the time you take the medication if you have sleep problems and regularly take one or more of these drugs: medications containing caffeine, such as Excedrin Migraine; prescription diet pills and other drugs that contain amphetamine; decongestants; antidepressants; steroids; thyroid hormones; broncho-dilating drugs for asthma; and tranquilizers.

Nicotine and alcohol

Nicotine is a stimulant. Smokers experience nicotine withdrawal during sleep and can have difficulty falling asleep and problems waking up.

Alcohol may speed the beginning of sleep, but it increases the number of times you awaken in the later half of the night.