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What causes difficulty sleeping? 25 possible conditions

What Is Sleeping Difficulty?

Sleeping difficulty is when you have trouble sleeping at night. You may have problems falling asleep or you make wake up several times throughout the night. Also called insomnia, sleep difficulty can affect your physical and mental health. Lack of sleep can cause you to have trouble concentrating during the day or give you frequent headaches.

Most people experience insomnia at some point in their lives. According to the National Institutes of Health, approximately 25 percent of Americans complain of occasional sleep problems. (NLH) Most adults need about eight hours of sleep every night to feel rested. However, some adults are able to feel refreshed after only six or seven hours of sleep.

Signs of sleep difficulty, or insomnia, may include:

  • inability to focus during the day
  • frequent headaches
  • irritability
  • daytime fatigue
  • waking up too early
  • waking up throughout the night
  • taking several hours to fall asleep
  • low energy during the day
  • dark circles under the eyes

Causes of Sleeping Difficulty

There are many possible reasons for sleeplessness, including your sleeping habits, lifestyle choices, and medical conditions. Some causes are minor and may improve with self-care, while others may require you to seek medical attention.

Causes of sleeplessness may include:

  • aging
  • too much stimulation before bedtime (such as watching television, playing video games, or exercising)
  • consuming too much caffeine
  • noise disturbances
  • an uncomfortable bedroom
  • excitement
  • sleeping too much during the day
  • lack of exposure to sunlight
  • frequent urination
  • physical pain
  • stress and worry
  • work schedules
  • depression
  • prescription medications, such as thyroid medications and drugs containing ephedrine or phenylpropanolamine
  • jet lag

In some people, insomnia is caused by a sleep disorder. Sleep apnea is a disorder in which a blockage in your upper airways creates pauses in your breathing throughout the night, causing you to wake up frequently with a choking sound.

Restless leg syndrome can also trigger sleeping difficulty. This condition causes uncomfortable sensations in your legs, such as tingling or aching. These sensations make your legs move constantly when resting, which can interrupt your sleep.

Delayed sleep phase disorder is another condition that can affect sleep. This disorder causes a delay in your 24-hour cycle of sleep and wakefulness. You may not feel sleepy or fall sleep until the middle of the night—between 2 and 6 a.m. This sleep cycle makes it harder for you to wake up in the early morning for work and school and leads to daytime fatigue.

Sleeplessness can also occur in infants. It is normal for newborns to wake up multiple times throughout the night. However, most infants will sleep through the night after they are six months old. If an older infant is showing signs of sleeplessness, it may be a sign that he or she is:

  • sick
  • hungry
  • bothered by gas or digestive problems
  • teething

Diagnosing Sleeping Difficulty

You should see a doctor if your sleeping troubles are ongoing and affecting your quality of life. He or she will attempt to find the underlying cause of your sleeplessness by conducting a physical examination and asking questions about your sleep patterns.

During your appointment, be sure to tell your doctor about any prescription medications, over-the-counter products and herbal supplements that you take. Some medications and supplements cause overstimulation, and can disrupt your sleep if taken too close to bedtime.

You should also mention if you are experiencing other problems, such as depression, anxiety, or chronic pain. These factors can also affect your ability to sleep.

To determine the cause of sleeplessness, your doctor may recommend that you keep a sleep diary. You should record your entire day’s activities and sleep habits, such as:

  • the time you went to bed and woke up
  • the amount of food and drinks you consumed
  • your mood
  • any medications you took
  • your activity level
  • your quality of sleep

Keeping a sleep record helps your doctor pinpoint habits that may trigger insomnia.

If your doctor suspects you may have sleep apnea, restless leg syndrome, or another sleep disorder, he or she may schedule a sleep study test. For this test, you will spend the night in the hospital or a sleep center, under the observation and care of a sleep specialist. Your blood pressure, heart rate, breathing, and brain waves will be monitored throughout the night for any signs of a sleep disorder.

Sleeping Difficulty Treatments

Treatment for your sleeplessness depends on its cause. In some cases, at-home remedies or simple lifestyle changes can improve the quality of your sleep. You may want to:

  • avoid caffeine and alcohol for at least eight hours before bed
  • limit any daytime napping to 30 minutes
  • keep your bedroom dark and cool
  • avoid stimulating activity before bedtime
  • allow seven to eight hours for sleep each night
  • listen to soothing music before bedtime
  • take a hot bath before bedtime
  • keep a regular sleep schedule

You can purchase some sleep aids without a prescription. Remember to always read the packaging closely and take the medication as directed. Sleep aids can cause daytime drowsiness if you do not get a full seven or eight hours of sleep. You should not use sleeping pills on a daily basis, in order to avoid developing a dependency.

If a medical condition or sleep disorder is causing your insomnia, the underlying condition will need to be treated in order for your sleep to improve. For example, if your sleep suffers because of an anxiety disorder or depression, your doctor may prescribe anti-anxiety or antidepressant medication to help you cope with worry, stress, and feelings of hopelessness.

Complications of Sleeping Difficulty

If left untreated, chronic sleep problems can greatly affect your qualify of life. Your reaction time when driving may decrease, which increases your risk of an accident. Poor sleep quality can also reduce your performance levels on the job or at school and weaken your immune system—resulting in more colds and illnesses.

According to the National Sleep Foundation, those with insomnia miss work more often, have an elevated risk of depression, and have higher overall rates of illness and poorer health in general. (National Sleep Foundation)

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See a list of possible causes in order from the most common to the least.



Sleeplessness, or insomnia, is a serious sleep disorder. It can mean the inability to fall asleep or stay asleep throughout the night, or the tendency to wake too early before having gotten enough sleep.

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Restless Leg Syndrome (RLS)

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Disorder of sleep-wake cycle

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Tension Headaches

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Generalized Anxiety Disorder

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Low Blood Sugar (Hypoglycemia)

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Teething Syndrome

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Chronic Bronchitis

People often develop acute bronchitis after a viral chest infection. Blue-colored lips ankle or foot swelling can result.

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Post Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is an anxiety disorder that occurs after experiencing or witnessing a traumatic event. PTSD can cause disruptive symptoms of panic, increased arousal, and mental/emotional problems.

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Childhood Obesity

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Pinworm Infection

Pinworms are tiny, narrow worms less than half an inch long that can infect the intestines. Pinworm infections are easily spread, and are most common in children between the ages of five and 10.

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Caffeine Overdose

The recommended amount of caffeine is usually 400 mg per day for healthy adults. Caffeine overdose may occur if you ingest more than this amount.

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Post Concussion Syndrome

Post-concussion syndrome, or post-concussive syndrome (PCS), refers to the lingering symptoms following a concussion or a mild traumatic brain injury. Symptoms vary but include headache, dizziness, and depression.

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Middle Ear Infection

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.