Everyone has a bad night’s sleep every now and then, but that’s not the same thing as having insomnia. As the Mayo Clinic explains, there are three main characteristics of this sleep disorder. One, a person has problems falling asleep. Two, a person can fall asleep but cannot stay asleep. And three, a person wakes up before they’re supposed to and has problems falling back to sleep.
Now, if you’re thinking “I couldn’t fall asleep last night, so I must have insomnia,” don’t panic. According to the Mayo Clinic, even short-term insomnia typically spans days or weeks rather than a single night. It also tends to be because of something emotional like stress. With that said, there is also chronic insomnia where sleep problems continue for at least a month. And beyond feeling tired, insomnia can affect things like memory and focus, as well as one’s emotional well-being.
While insomnia can be a health condition all on its own, it also can be connected to other medical problems, per Mayo Clinic. And here’s where things can get a little tricky. As we’re about to explore, it can vary whether insomnia is the result of or the culprit behind a health problem. And sometimes, even though a health issue is the reason why someone has insomnia, the insomnia could also exacerbate that health issue, creating a cycle that further hurts one’s health. So, if you have insomnia, it’s important to speak with a healthcare professional.
Asthma
If a person has asthma, they can have difficulty breathing in part because their airways can become tighter (they also can be obstructed by higher than normal amounts of mucus), according to Cleveland Clinic. Asthma patients experience health issues like wheezing and tightness in the chest. Also, it’s not uncommon for people who have asthma to cough, in particular at night, which could interfere with sleep.
According to a 2022 study in the Journal of Asthma and Allergy, “Insomnia symptoms have been reported in approximately one-third of patients with asthma … ” In particular, if someone is either not treating/controlling their asthma or their treatments aren’t enough to properly control their asthma, that can make it harder to get a good night’s rest. Also, the Journal notes that there are “associated comorbidities” to asthma that could also be part of a person’s sleep issues. As WebMD explains, if someone has comorbidities, then they have more than one health issue. In the case of asthma patients, they might also have health problems like chronic rhinitis and gastroesophageal reflux disease (GERD), either of which could be bad for one’s sleep.
While better controlling asthma might help with insomnia (per Journal of Asthma and Allergy), it’s also important for people to know what to do in case of a severe asthma attack. As the Cleveland Clinic explains, a rescue inhaler might help but isn’t always enough. So, if a person with asthma starts to experience symptoms like severe wheezing and/or coughing, problems talking, or chest pain, seek emergency medical help.
Depression
Often people will use the word “depressed” when they really mean they’re feeling down on a particular day. This, however, is not the same thing as major depressive disorder (aka depression), which, as the American Psychiatric Association explains, is a medical illness. For one, for someone to be diagnosed with depression, they would have to experience symptoms (like problems concentrating, loss of interest in previously enjoyed activities, and thoughts of suicide) for at least two weeks. Additionally, those symptoms would have to interfere with how that person functions. And while depression can lead to getting too much sleep, it also can interfere with getting enough sleep.
According to Johns Hopkins Medicine, there’s a bit of a chicken-or-the-egg situation when it comes to insomnia and depression. Yes, it’s very common for patients with depression to have sleep issues (75% of depression patients, to be exact). But having insomnia can also greatly raise the chances of eventually having depression. “Poor sleep may create difficulties regulating emotions that, in turn, may leave you more vulnerable to depression in the future—months or even years from now,” says Johns Hopkins sleep researcher Dr. Patrick H. Finan.
Of course, it’s always important to work with a medical professional to help manage depression, but keep in mind that treating depression alone might not get rid of insomnia (per Johns Hopkins Medicine). Instead, patients might need to treat both conditions separately, and cognitive behavioral therapy for insomnia (CBT-I) could be worth exploring.
Type 2 diabetes
Our body’s cells use glucose (blood sugar) as an energy source and need the hormone insulin to take in glucose, per Mayo Clinic. But the body of a person with type 2 diabetes doesn’t make enough insulin, and their body’s cells are resistant to the insulin it does make. When this occurs, glucose levels rise, and excessive amounts of blood sugar circulate throughout the body. And this can cause health problems, including disruption of one’s sleep.
According to the Sleep Foundation, it’s common for people with type 2 diabetes to have insomnia. Elevated blood glucose levels can make one thirsty, which could interfere with getting a good night’s sleep. Also, a person with type 2 diabetes might need to urinate more than a person without this condition because increased urination is how the body tries to manage large amounts of blood sugar. And high glucose levels can trigger headaches. However, blood sugar levels that are too low can also be a reason why those with type 2 diabetes experience insomnia. As the National Institute of Diabetes and Digestive and Kidney Diseases explains, if someone with type 2 diabetes waits too long to eat, that can lower their blood sugar levels too much. Also, medications to manage type 2 diabetes can drop glucose too far if those medications aren’t taken in the correct amounts.
Besides proper blood sugar management, the Sleep Foundation notes that getting up and going to bed at the same time every day can help people with type 2 diabetes with sleep. Other tips include not consuming caffeine close to bedtime.
Bipolar disorder
There are a couple of important things to remember when it comes to bipolar disorder. First, as the American Psychiatric Association explains, it’s a type of brain disorder. Second, a person with this condition will fluctuate between what are known as “mood episodes.” Now, this doesn’t mean bipolar disorder patients won’t have times when their mood is neutral, but they also will have periods of time when they’re extremely down (depressive episodes), as well as manic/hypomanic mood episodes where they can be extremely happy but also easily irritated. And according to the Bipolar Wellness Centre, “Sleep problems are a core symptom of bipolar disorder.”
If a patient has bipolar disorder, then they can experience insomnia during both depressive and manic/hypomanic mood episodes (via Bipolar Wellness Centre). However, sleep problems can also occur during neutral mood times. And it’s worth noting that sometimes sleep issues can precede an episode. If the patient recognizes this, they can better prepare for the episode, which could help cut down on the likelihood of a relapse.
In addition to working with a medical professional to treat/manage their bipolar disorder, a patient can make simple changes that might help improve their sleep (per Bipolar Wellness Centre). For example, they might want to cut back on caffeine. Also, they should try to stick to a regular bedtime and get up at the same time every day.
Alzheimer’s disease
Alzheimer’s disease can greatly impact the life of not just the patient but also the people around them. Not only can someone with Alzheimer’s experience memory issues but also can behave out of character and have trouble thinking and functioning (via Alzheimers.gov). Additionally, the Mayo Clinic notes that it’s common for someone with Alzheimer’s disease to experience insomnia.
Although we understand that Alzheimer’s can be the reason why someone has issues with sleep, we are still at this time learning why this is the case (per Alzheimer’s Association). However, there are some observations. For instance, let’s say you have two people — one with Alzheimer’s and one without — who both go to bed around the same time. While the person without Alzheimer’s might sleep the entire night and not wake up once, the person with Alzheimer’s is more likely to wake up multiple times and have a harder time falling back to sleep. Also, Alzheimer’s patients might reverse a typical sleep schedule, so they’re napping during the day and not sleeping at night. Sleeping issues can also occur if the patient is experiencing sundowning, also known as “sundowner’s syndrome,” where they are confused and/or agitated either later in the day or at night, according to Alzheimer’s Association.
Beyond getting an Alzheimer’s patient proper medical help, the Alzheimer’s Association notes that there are some simple ways to try to help them get a good night’s rest. These include scheduling not just a consistent bedtime and wake-up time but also regular mealtimes.
Cancer
According to the National Cancer Institute, “As many as half of people with cancer have problems sleeping,” and one of the most common sleep issues for cancer patients is insomnia. Now, of course, just knowing one has cancer can cause enough emotional stress to interfere with sleep. But there can be other factors behind having cancer and not being able to get a good night’s rest.
For example, the National Cancer Institute notes that tumors can interfere with sleep. Reasons why include pain, problems with breathing, fevers, and itchiness. Having a tumor can also make one feel nauseous and can have a negative impact on normal bowel movements, ranging from diarrhea to constipation. Additionally, tumors can also cause issues with one’s bladder. Also, certain medications (especially ones used on a long-term basis) can be the reason why a cancer patient is experiencing insomnia. With that said, cancer patients should always speak with a medical professional before cutting back on or stopping any drugs used to treat cancer. Not only because this could be dangerous, but also because it could interfere with sleep.
In addition, some of the ailments caused by tumors are the same as some of the side effects of different medications used to treat cancer (via National Cancer Institute). These include bowel and bladder issues, nausea, problems with breathing, and pain. Also, it’s possible to experience anxiety and/or hot flashes because of cancer drugs and treatments, both of which can impact sleep.
Anxiety
According to the National Institute of Mental Health (NIMH), having an anxiety disorder goes well beyond everyday worries or fears. For instance, let’s say you’ve emailed your boss asking for time off. You’re probably going to feel worried until you get a reply that your request has been approved. However, with an anxiety disorder, worries, fears, and anxiousness are constant and severe enough that they can interfere with someone’s quality of life. But what about their quality of sleep?
As The American Institute of Stress explains, anxiety and insomnia can be connected. First, let’s discuss anxiety causing insomnia. Yes, anxiety can be draining; but, despite this, it can still be difficult for someone to fall asleep simply because they’re feeling anxious. On the other hand, not getting enough good quality sleep leaves one more vulnerable to experiencing anxiety. So, anxiety can cause sleep problems, which can cause more anxiety, which can cause more sleep problems. Additionally, insomnia and anxiety can technically be two separate health concerns in the same person. In other words, they’re not causing each other, but they can make each other worse.
The bottom line is that figuring out the relationship between insomnia and anxiety can be difficult, but that doesn’t mean there aren’t treatments available (per The American Institute of Stress). Of course, it’s important to work with a medical professional. And one final note: There could be patterns to your insomnia that you’re not away of, so you might want to keep a sleep log.
Schizophrenia
It’s possible for two patients with the mental illness schizophrenia to exhibit different symptoms (via NIMH). One patient, for example, might hallucinate and hear voices while the other might have trouble communicating because they’re creating their own words. And, while not all schizophrenia patients have insomnia, according to a 2018 study in the journal Medicines, around 80% of professionally diagnosed schizophrenia patients have said that they experience this symptom.
To fully understand the connection between schizophrenia and insomnia, we need to discuss a chemical found in the body called “dopamine.” As Healthline explains, dopamine — and more specifically the right amount of dopamine — is essential for things like coordination and memory. But when a person has schizophrenia, their dopamine levels might be abnormal. However, abnormal amounts of dopamine can also be present in people with insomnia. And, to make matters worse, the study in Medicines notes that sleep disturbances can increase the likelihood of a schizophrenia patient having a relapse.
Although only a medical professional can diagnose someone with schizophrenia, being aware of possible symptoms of this mental illness is important. Besides the aforementioned hallucinations and thought disorder, NIMH also states that a schizophrenic can have other psychotic symptoms like repeating motions as if stuck in a loop. Patients with schizophrenia might also have difficulty with things like focus and decision-making. Additionally, their voice might sound dull, they might become less social, and they could become catatonic.
Photo by Mental Health America (MHA)
BY MEREDITH COOPER
