Insomnia can have a significant impact on everyday life. Overall health, lifestyle, relationships, and work-productivity can all suffer from inadequate sleep. If you have difficulty sleeping, it is important to determine whether or not an underlying issue or medical condition is causing the problem. Secondary insomnia is the most common type of sleeplessness, and is most frequently caused as a result of anxiety or on-going stress. Some common factors leading to insomnia include:

Stress and anxiety

Worries about work, school, health, finances, or family can keep your mind active at night, making it difficult and sometimes impossible to sleep. Traumatic events, such as the death of a loved one, divorce, or a job loss often cause long-lasting stress and anxiety, which can lead to chronic (long-term) sleeplessness.


Depression can make you sleep too much or too little. This may be due to chemical imbalances in your brain, or because fears that accompany depression may keep you from relaxing enough to sleep. It is not unusual for insomnia to accompany other mood disorders such as bipolar disorder, anxiety, or post-traumatic stress disorder.

Learn more about depression by visiting the Depression Health Center.


A number of over-the-counter medications can contribute to insomnia. These include some pain medications, decongestants, and weight-loss products that contain caffeine or other stimulants. Antihistamines may make you drowsy initially but can lead to more frequent urination, causing more nighttime trips to the bathroom. In addition, certain prescription drugs can interfere with sleep. Potential culprits include antidepressants, heart and blood pressure medicines, allergy drugs, stimulants, and corticosteroids.

Caffeine, nicotine, and alcohol

Coffee, tea, soft drinks, and energy drinks containing caffeine are stimulants that can interfere with sleep. Drinking coffee in the late afternoon can keep you from falling asleep at night. Nicotine in tobacco is another stimulant that can inhibit sleep.

Alcohol is a sedative that may help you fall asleep initially, but it prevents deeper stages of sleep, so you end up tossing and turning.

Medical conditions

A host of medical conditions can contribute to insomnia. Some of these include chronic pain, breathing difficulties, sleep apnea, or arthritis. Insufficient sleep is also associated with a number of chronic medical conditions, such as diabetes, cardiovascular disease, and obesity.

Other medical conditions that can lead to insomnia include:

  • Frequent urination
  • Cancer
  • Gastroesophageal reflux disease (GERD)
  • Overactive thyroid
  • Stroke

Sleep disorders

Common sleep disorders, such as restless leg syndrome (a crawling sensation often felt in the lower part of the legs that can only be relieved with movement) can inhibit sleep. Sleep apnea—a breathing disorder accompanied by loud snoring and periods of time when breathing stops—can also lead to insomnia.

Learn about sleep disorders and get tips to sleep better at the Sleep Health Learning Center.

Changes in environment or schedule

Working the late or early shifts, or travelling long-distances, can disrupt the body's circadian rhythms (24-hour biochemical, physiological, and behavioral cycle), making sleep difficult. These rhythms act as internal clocks, regulating sleep cycles, body temperature, and metabolism.

Worries about sleep and bad sleep habits

Unfortunately, the strain of worrying about not getting enough sleep can lead to even more sleep deprivation. If this is the case for you, try changing your usual bedtime routine. Save your bed for sleep by avoiding bad habits like watching TV or working in bed.

Eating too late

Consuming too much food too late in the evening may make lying down uncomfortable. Late meals can also contribute to heartburn or a backflow of acid and food from the stomach to your esophagus. Not surprisingly, this can keep you awake.