Chronic insomnia, on the other hand, means you have trouble falling and staying asleep at least three times a week for three months or longer. It can also be triggered by things like never-ending stress, difficult emotions you haven’t worked through, or constant travel that’s throwing your schedule out of whack. However, this type of insomnia can present as a side effect to a deeper issue as well, like an underlying health condition, medication plan, or substance use.
What causes insomnia?
Let’s dive deeper into the most common reasons you may be missing out on sleep:
1. You’re anxious about falling asleep.
“In some ways, insomnia is like an anxiety disorder about not getting enough sleep,” Jason Ong, Ph.D., director of behavioral sleep medicine at SleepCharge by Nox Health and adjunct associate professor of sleep medicine at Northwestern Feinberg School of Medicine, tells SELF. “Anxiety about sleep and the attempts to try and make sleep happen actually perpetuate the problem by inadvertently disrupting your body’s regulation of sleep.”
A common response is to try to fix the issue by trying harder to fall asleep. However, moves like hopping in bed when you believe you should be sleepy (but aren’t) just turn up the pressure. In turn, you tend to feel even more restless and awake.
2. You have an off-kilter sleep schedule.
If you’re a jetsetter traveling across time zones for work, for example, or a shift worker trying to sleep during the day, disturbed sleep could follow. The root of the problem is known as circadian misalignment, or trying to sleep at times that don’t match your internal body clock, which regulates your sleep-wake cycle, says Dr. Ong.
3. You’re stressed to the max.
An overwhelming work schedule, looming debt, caregiving, the loss of a loved one—any number of stressful life events could trigger insomnia. That’s because chronic stress flicks on your fight-or-flight response, Ash Nadkarni, M.D., an associate psychiatrist at Brigham and Women’s Hospital and an instructor at Harvard Medical School, tells SELF. This cues a flood of stress hormones like adrenaline and cortisol into your bloodstream. When your stress doesn’t subside and that “on” switch gets stuck, these hormones keep surging through your body at night to keep you alert, blocking your ability to relax and ease into sleep.
4. You have a mental health condition.
Insomnia is a symptom of many psychiatric disorders, including depression, anxiety, obsessive-compulsive disorder (OCD), bipolar disorder, and post-traumatic stress disorder (PTSD), per the National Alliance on Mental Illness (NAMI). While the relationship is complicated and more research is needed, researchers hypothesize the link is due to changes like a heightened stress response, issues with neurotransmitters or chemical messengers like serotonin, norepinephrine, and dopamine, plus associated problems with the internal body clock and sleep cycle, says Dr. Nadkarni.
5. Or you have another underlying health condition.
This brings us back to that “canary in the coal mine” comment: Insomnia may stem from numerous health problems including other sleep disorders like restless legs syndrome, narcolepsy, or sleep apnea, chronic pain due to conditions like arthritis or headaches, cancer, gastrointestinal disorders such as heartburn or GERD, hormone fluctuations during your period or due to thyroid disease, or even neurological disorders like Parkinson’s disease, per the Cleveland Clinic.
6. You’re taking medications or drugs that keep you up.
Insomnia can also be an unwanted side effect of certain medications or drugs. Stimulants, for example, cause a release of certain neurotransmitters, which in turn may disrupt your ability to fall and stay asleep, says Dr. Nadkarni. Others cause a change or reduction in sleep quality.