Hypoxia and Medicine

What underlying medical conditions cause insomnia?

I have struggled with insomnia for nearly 20 years. I do triathlons so I definitely get enough exercise and I eat healthily. I am constantly exhausted and my eyes are closing at around 10pm, so I head on up to bed. After that, it can be up to 4 hours before I finally fall asleep and no matter what time I do doze over, I'm usually awake no later than 5 a.m. I'm constantly exhausted but can't seem to get any sleep - I've tried every OTC sleeping pill around and within a week of beginning use I'm immune to them. I've started using melatonin but I'm already beginning to get used to that. Can anybody advise me please - my doctor isn't very sympathetic. Thank you

Public Comments

1. * Stress. Concerns about work, school, health or family can keep your mind active at night, making it difficult to sleep. Stressful life events, such as the death or illness of a loved one, divorce, or a job loss, may lead to insomnia. * Anxiety. Everyday anxieties as well as more-serious anxiety disorders may disrupt your asleep. * Depression. You might either sleep too much or have trouble sleeping if you're depressed. This may be due to chemical imbalances in your brain or because worries that accompany depression may keep you from relaxing enough to fall asleep. Insomnia often accompanies other mental health disorders as well. * Medications. Prescription drugs that can interfere with sleep include some antidepressants, heart and blood pressure medications, allergy medications, stimulants (such as Ritalin) and corticosteroids. Many over-the-counter (OTC) medications, including some pain medication combinations, decongestants and weight-loss products, contain caffeine and other stimulants. Antihistamines may initially make you groggy, but they can worsen urinary problems, causing you to get up more during the night. * Caffeine, nicotine and alcohol. Coffee, tea, cola and other caffeine-containing drinks are well-known stimulants. Drinking coffee in the late afternoon can keep you from falling asleep at night. Nicotine in tobacco products is another stimulant that can cause insomnia. Alcohol is a sedative that may help you fall asleep, but it prevents deeper stages of sleep and often causes you to awaken in the middle of the night. * Medical conditions. If you have chronic pain, breathing difficulties or need to urinate frequently, you might develop insomnia. Conditions linked with insomnia include arthritis, cancer, congestive heart failure, diabetes, lung disease, gastroesophageal reflux disease (GERD), overactive thyroid, stroke, Parkinson disease and Alzheimer's disease. Making sure that your medical conditions are well treated may help with your insomnia. If you have arthritis, for example, taking a pain reliever before bed may help you sleep better. * Change in your environment or work schedule. Travel or working a late or early shift can disrupt your body's circadian rhythms, making it difficult to sleep. Your circadian rhythms act as internal clocks, guiding such things as your wake-sleep cycle, metabolism and body temperature. * Poor sleep habits. Habits that help promote good sleep are called "sleep hygiene." Poor sleep hygiene includes an irregular sleep schedule, stimulating activities before bed, an uncomfortable sleep environment and use of your bed for activities other than sleep or sex. * 'Learned' insomnia. This may occur when you worry excessively about not being able to sleep well and try too hard to fall asleep. Most people with this condition sleep better when they're away from their usual sleep environment or when they don't try to sleep, such as when they're watching TV or reading. * Eating too much late in the evening. Having a light snack before bedtime is OK, but eating too much may cause you to feel physically uncomfortable while lying down, making it difficult to get to sleep. Many people also experience heartburn, a backflow of acid and food from the stomach to the esophagus after eating. This uncomfortable feeling may keep you awake.