Insomnia

Description

Alternative Names

Causes of Short-Term or Transient Insomnia

A reaction to change or stress is one of the most common causes of short-term and transient insomnia. This condition is sometimes referred to as adjustment sleep disorder.

The precipitating factor could be a major or traumatic event such as the following:

• An acute illness.
• Injury or surgery.
• The loss of a loved one.
• Job loss.

Temporary insomnia could also develop after a relatively minor event, including the following:

• Extremes in weather.
• An exam.
• Traveling.
• Trouble at work.

In most cases, normal sleep almost always returns when the condition resolves, the individual recovers from the event, or the person becomes acclimated to the new situation. Treatment is needed if sleepiness interferes with functioning or if it continues for more than a few weeks. It should be noted that individual responses to stress vary and some people may not experience insomnia at all, even during very stressful situations while others may suffer from insomnia in response to very mild stressors.

Female Hormonal Fluctuations

Fluctuations in female hormones play a major role in insomnia in women over their lifetimes. Such insomnia is most often temporary.

• During Menstruation. Progesterone promotes sleep, and levels of this hormone plunge during menstruation, causing insomnia. (When they rise during ovulation, women may become sleepier than usual.)
• During Pregnancy. The effects of changes in progesterone levels in the first and last trimester can disrupt normal sleep patterns.
• Menopause. Insomnia can be a major problem in the first phases of menopause, when hormones are fluctuating intensely. Insomnia during this period may be due to different factors that occur. In some women, hot flashes, sweating, and a sense of anxiety can awaken women suddenly and frequently at night during the first months of menopause. Insomnia may also be perpetuated by psychologic distress provoked by this life passage. In most cases, insomnia is temporary. Cases of chronic insomnia in women after 50 are more likely to be due to causes unrelated to gender.

Jet Lag

Air travel across time zones often causes insomnia. After long plane trips, one day of adjustment is usually needed for each time zone crossed. Traveling west to earlier times seems to be less traumatic than going east to a later time because it is easier to lengthen a circadian phase than to shorten it.

Effect of Light and Other Environmental Disruptions

In one study, 20% of adults reported that light, noise, and uncomfortable temperatures caused their sleeplessness. Depending on the time of day too much or too little light can disrupt sleep.

• Excessive Light at Night. It is well known that a person's biologic circadian clock is triggered by sunlight and very bright artificial light to maintain wakefulness. One study indicated that even dim artificial light might disrupt sleep.
• Insufficient Light During the Day. Insufficient exposure to light during the day, as occurs in some disabled elderly patients who rarely venture outside, may also be linked with sleep disturbances. One study suggests that when a person is exposed to bright daylight, melatonin levels increase in response to darkness at night, which aids sleep.

Other Causes of Short-Term or Transient Insomnia

Caffeine and Nicotine. Caffeine most commonly disrupts sleep. Nicotine can cause wakefulness. Quitting smoking can also cause transient insomnia. In fact, it has been suggested that if sleeping could be improved during withdrawal from smoking, then perhaps it would be easier to quit smoking.

Partner's Sleep Habits. In one 1999 survey, 17% of women and 5% of men reported that their partner's sleep habits impaired their own sleep. Snoring can certainly be a factor in a partner's insomnia. In fact, in the same survey 44% of men and 36% of women reported snoring a few nights a week and of those who snored, 19% could be heard through a closed door.

Medications. Insomnia is a side effect of many common medications, including over-the-counter preparations that contain caffeine. People who suspect their medications are causing them to lose sleep should check with a physician or pharmacist.