Insomnia or lack of sleep is a very common complaint which many of us experience in day to day life. The pattern of insomnia vary from person to person. Some people experience difficulty in falling asleep or repeated awakening from sleep, very early morning awakening and unable to fall back to sleep. As a result of poor sleep at night person experience increased daytime sleepiness and fatigue. Following are the common causes of lack of sleep.
- Stress - is associated with lack of sleep during that period.
- Drugs - there are certain drugs which stimulate the brain such as caffeine, amphetamines, xanthines, nicotine, and phenylpropanolamine .They are well known to produce insomnia.
- Medical disorders - Pain ,increased thyroid hormone,heart failure COPD, increased urinary frequency at night all can disturb.
- Phase shift - Occur when the sleep wake cycle is reset,this is commonly seen in alternating shift work or international travel.
- Sleep apnea - Condition seen in obese and patient with thick neck. During sleep there will be heavy snoring interruption of breathing and disturbed sleep, this is followed by increased daytime sleepiness.
- Conditioned insomnia - Person may become frustrated and anxious at bedtime due to certain learned behavior ,such people will get adequate sleep if they change their bed and bedroom.
- Depression Insomnia - may be the chief complaint, manifesting as difficulty falling asleep or early awakening with inability to fall back to sleep. The manic phase of bipolar disorder will exhibit hyperactivity, racing thoughts, and speech with grandiosity.
- Restless leg syndrome - in this syndrome patient experience a crawling sensation within the muscles, this is relieved by by movement.
- Nocturnal myoclonus - repetitive jerking of the legs. will awaken the patient from sleep.
- Nightmares (dream anxiety attacks) - the patient will awaken from sleep with increased sweating.