How Neurological Conditions Cause Insomnia

Neurological sleep disorders

Neurological sleep disorders can affect the duration, timing, and quality of your sleep. They may interfere with your ability to sleep by causing uncomfortable sensations or movements, such as in restless legs syndrome. They may also impair your natural circadian rhythm, or sleep-wake cycle.

Sleep disorders that are considered neurological include:

• restless legs syndrome
• rapid eye movement (REM) sleep disorder
• central sleep apnea
• narcolepsy
• circadian rhythm disorders
• central nervous system hypersomnia

Changes in nerve-signaling chemicals called neurotransmitters can also affect nervous system activity and disrupt your sleep. The neurotransmitters that regulate the sleep-wake cycle include gamma aminobutyric acid (GABA), acetylcholine, cortisol, and serotonin.

Neurological conditions that cause insomnia

Insomnia is often caused by neurological diseases and conditions that impair your ability to fall and stay asleep. When this happens, it’s known as secondary insomnia.

Conditions that increase your risk of insomnia include:

Parkinson’s disease

Sleep disorders such as insomnia are common in people with Parkinson’s disease. Parkinson’s disease is a progressive nervous system disorder associated with motor symptoms such as tremors, slow movement, and imbalance.

Movements, such as tremors, may make it more difficult to fall asleep, and rarely, they can wake you up in the middle of the night. Conditions that often occur alongside Parkinson’s disease, such as restless legs syndrome, can also affect sleep.

Alzheimer’s disease and other dementias

Some studies have shown an association between insomnia and dementia, including Alzheimer’s disease. Some researchers are investigating whether insomnia could be a risk factor for dementia or even an early indicator of cognitive decline.

Researchers suggest that insomnia may speed up the progression of Alzheimer’s disease and that treating sleep disorders may help improve symptoms.

Stroke

Insomnia is very common in the aftermath of stroke. According to a 2021 study, nearly 41% of people who had strokes experienced insomnia immediately after.

It’s not clear exactly how stroke causes insomnia. But researchers believe it may be linked to where the stroke occurred in the brain. Insomnia appears to be more common in people whose strokes occur in the right hemisphere of the brain.

Insomnia following a stroke may also be due to environmental factors such as being hospitalized or sleeping in an unfamiliar environment. It could also be due to medication side effects.

Epilepsy

Studies indicate that insomnia and other sleep disorders often affect people with epilepsy, making daytime sleepiness a common symptom among people with this condition. Epilepsy has also been linked to disordered breathing, such as sleep apnea, which interferes with sleep quality.

Other factors affecting sleep include nighttime seizures, the effects of anxiety and depression, and antiseizure medications.

Treating insomnia linked to neurological disorders

If your insomnia is linked to a neurological disorder, a primary care physician may refer you to a neurologist — a doctor who specializes in diseases of the brain, spinal cord, and nerves.

Your treatment will depend on the specific neurological condition you have. A doctor may prescribe medications such as:

• doxepin
• zolpidem
• melatonin
• eszopiclone
• trazodone
• antidepressants, like venlafaxine

Other therapies

A doctor may advise cognitive behavioral therapy (CBT) to treat insomnia. This form of therapy helps you recognize unhelpful thoughts and behavior patterns and teaches you better ways of coping. This may help you get to sleep more quickly and stay asleep longer.

Bright light therapy may also be useful for treating people with insomnia who have Parkinson’s disease.

Lifestyle changes

Your healthcare team may recommend lifestyle changes such as:

• practicing relaxation techniques such as meditation or yoga
• exercising regularly
• quitting smoking and limiting alcohol intake if you smoke or drink
• avoiding coffee and other caffeine beverages late in the day
• eating balanced, nutritious meals and avoiding nighttime snacking

When to talk with a doctor

Insomnia may seem mild because it’s not acutely life threatening. But it can lead to other issues such as irritability, daytime fatigue, and a lack of coordination, which ultimately lower your quality of life.

If you’re consistently having difficulty falling and staying asleep, or you often wake up too early (even when you don’t want to), you might consider speaking with a doctor, whether you have a preexisting neurological disorder or not.

Good sleep hygiene

If you have trouble sleeping at night, these tips may help:

• Be consistent; go to sleep and wake up at the same time every day.
• Keep naps short so you can get ample sleep at night.
• Eliminate all light sources in your room or use an eye mask.
• Keep your room at a cool but comfortable temperature.
• Avoid eating large portions of food close to bedtime.
• Turn off all electronic gadgets a few hours before bed.
• Try relaxation techniques like mindfulness meditation.

Takeaway

Insomnia is a sleep disorder that has several potential causes. Many sleep disorders, such as restless legs syndrome, are neurological in nature. It’s also common for people with neurological diseases and conditions to experience trouble sleeping. Talk with a doctor if you’re experiencing excessive daytime sleepiness or other symptoms of insomnia.