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What is it?

Other names for this disorder include the following:

• Organic insomnia
• Insomnia due to an organic condition

This type of insomnia is caused by another medical condition. It results in one or more of these problems:

• Difficulty falling asleep
• Waking often during the night
• An inability to return to sleep
• Worry about poor quality of sleep

This insomnia is a disorder only when it causes you distress or requires separate treatment.

Who gets it?

Many physical illnesses can cause insomnia. It may also result from a problem with the spine or brain. It may be caused by pain, breathing discomfort or limited mobility.

Disorders such as restrictive lung disease and asthma are likely to cause insomnia. Pregnancy is likely to disturb a woman’s sleep during the last trimester. Sleep problems related to menopause are a common problem for middle-aged women.

About 0.5% of people have insomnia due to a medical condition. About 4% of those seeking treatment for insomnia have it. This disorder often begins in middle age. It is most common in older adults. This is because people tend to have more chronic health problems as they age.

The severity and duration of insomnia often varies with the related health condition. At times the medications used to treat a medical condition may result in insomnia.

Depression or another mental health problem may emerge as a result of a chronic health condition. This mental problem can cause or contribute to insomnia as well.

How do I know if I have it?

1. Do you have trouble falling asleep or staying asleep, or do you wake up too early or feel unrefreshed after sleeping?
   
   
2. Does this problem occur even though you have the chance and the time to get a good night’s sleep?
   
   
3. Do you have at least one of the following problems? You have:

• Low energy
• Lack of motivation
• Attention, concentration or memory problems
• Poor performance at school or work
• Extreme mood changes
• Daytime sleepiness
• Trouble making errors at work or while driving
• Tension, headaches or stomach aches
• Frustration or worry about your sleep

If your answer to each of these questions is yes, then you might have insomnia. Now continue to see if you might have insomnia due to medical condition:

1. Have you had these problems for at least one month?
   
   
2. Do you have a coexisting medical or physical condition that is known to disrupt sleep?
   
   
3. Is the insomnia clearly related to the medical or physical condition? Did it begin near the time when the medical condition began or progressed? Does the intensity of your insomnia vary along with the severity of the medical condition?

If you also answered yes to these questions, then you may have insomnia due to medical condition.

It is also important to know if there is something else that is causing your sleep problems. They may be a result of one of the following:

• Another sleep disorder
• A mental health disorder
• Medication use
• Substance abuse

Do I need to see a sleep specialist?

The first step is to talk with your primary care doctor. You should visit him or her if the insomnia has lasted for more than one month. If it fails to improve with your doctor’s help, then you may want to see a sleep specialist.

What will the doctor need to know?

A sleep doctor will want to know when your insomnia began. He or she will ask questions to see how your insomnia may be related to your other medical conditions. A complete medical history is important. You will need to provide a list of the medications that you take. This includes over the counter and herbal medications.

It will be useful if you keep a sleep diary to track your typical sleep and wake patterns. This will help reveal any unusual sleep patterns. It may also suggest approaches to correct the problem.

Will I need to take any tests?

You should not need an overnight sleep study. A sleep study would only be considered if your doctor suspects that you also may have another type of sleep disorder. This may be the case if you have certain problems with either your heart or your brain and spine. Sometimes a blood test is used to see if you may have a certain type of sleep disorder.

How is it treated?

The course of insomnia is likely to change as your medical condition improves. If the insomnia is disruptive or severe, then it may require separate treatment. The first step is to talk to the doctor or specialist who manages your medical condition.

Most people can improve how they sleep simply by following the practices of good sleep hygiene. Sleep hygiene consists of basic habits and tips that help you develop a pattern of healthy sleep.

If changing your habits does not work, then your primary care doctor may have you try a medication. Sleep medications are also called hypnotics. Most often they are used for short periods of time when a medical problem worsens and disturbs your sleep. The medications may not work well for you. You may need to take more of them. They also may have negative side effects.

Behavioral therapy might be your best approach to treat the insomnia. It involves changing what you do at bedtime. It might limit the amount of time spent in bed each night. You will also learn to go to bed only when sleepy. It’s important to get out of bed if you can’t sleep. Instead of tossing and turning, you should do something that is relaxing for you.

Relaxation strategies might also be useful to help manage stress, frustration, and anxiety. Cognitive approaches help you change how you think about sleep. For many people with a history of poor sleep quality, sleep itself can provoke anxiety.

By Donald R. Townsend, PhD
Updated February 3, 2006