The Link Between Chronic Insomnia And Many Medical Conditions

2012-07-19 | |
Last updated: 2019-10-21

Suffering a poor night’s sleep is a very common experience, but one that we can generally tolerate well enough even though it can make the subsequent day a tough one. After a few nights of poor sleep, however, we will often start to feel much worse with symptoms that can include feeling physically ill and mentally foggy. If those few nights of poor sleep persist to become chronic insomnia, then daily life can become truly miserable.

In many situations, chronic insomnia can result from mental behaviors and difficulties in managing stress, anxiety and depression. But, there are other causes of insomnia that can arise. In particular, the symptoms and effects of numerous chronic health conditions can lead to chronic insomnia. For people who suffer from chronic illness, such lasting sleep issues can serve to compound the difficulties that already arise from being ill.

While many of the causes of insomnia that accompany illness are well known and well understood, some of the reasons for such sleeping difficulties are talked about less often. This makes it important for those suffering from insomnia to become aware so they might have a better chance to sleep more normally and become better rested.

What Can Make Sleeping Difficult?

To better understand what might be causing sleep loss, we have to consider what is necessary to be able to sleep. Firstly, it has to be the right time of the day according to our body. Our bodies have a natural rhythm driven by light levels, the brain and by hormones. Called the circadian rhythm, a disruption of this cycle means that we will not be tired when we should be. This in turn means that as much as we might try, we will have difficulty falling asleep when we would like to do so.

Secondly, to be able to sleep, we must be free of distractions. While this might make us think about anxiety and depression where we lay in bed thinking and worrying, there are other ways in which the brain can be distracted from sleep. For example, some internal distractions are hunger, discomfort and pain. External distractions that can make sleeping difficult include overly bright lights, high sounds levels or uncomfortable temperatures.

When any of these factors is present, sleep can be elusive.

What Are Some Medical Conditions That Can Lead To Insomnia?

Chronic Insomnia Due To Pain

Taking into account the factors that can affect our sleep, one of the most obvious reasons for sleep loss is because of pain. In the case of people suffering from Acid Reflux or GERD for example, pain is a significant cause of chronic insomnia. In 2005 research from the Lynn Health Science Institute, researchers found that 1 in 4 patients who had problems sleeping were suffering from heartburn. Worse still, the researchers found that many patients with mild daytime reflux were actually experiencing nighttime symptoms that would arouse them from sleep.

Another condition associated with pain that often affects sleep is Rheumatoid Arthritis. In a study from the University of Pittsburgh, scientists studying women with the disease found that 71% of patients without depression reported problems sleeping. The research determined that several factors predicted quality of sleep, but two of them were the duration of time that a patient had the disease and the level of pain experienced. A related 2011 study from the same university found that 1 in 3 patients experienced 3 or more nights per week where pain disturbed their sleep.

Clearly, the presence of regular pain makes being able to sleep and being rested more difficult.

Distractions That Lead To Chronic Insomnia

While pain is one distraction to preventing sleep, other forms of distraction can also lead to insomnia. An example of this is the bladder disorder Interstitial Cystitis. For patients who experience the strong urge to urinate associated with this condition, sleep can be very difficult to attain. Though the condition can be painful, it is also the urge to urinate that poses problems. In a 2011 study of more than 400 women with the condition by Drexel University, 100% reported poor sleep quality.

In related research from the National Yang-Ming University, scientists found that 75% of the people with the condition would awaken in the night to have to visit the toilet. Among the patients in the study, more than 50% had difficulties falling asleep within 30 minutes once they had awakened. Such results demonstrate how ongoing sleep disruptions can lead to chronic insomnia.

A different form of distraction that can also lead to problems sleeping is from the condition known as Tinnitus. Tinnitus affects more than 10% of the population causing those affected to hear ringing, buzzing, clicking or hissing sounds all the time. Tinnitus is a symptom of numerous known medical conditions and unknown causes.

Not surprisingly, a study from the University of East London found that patients who experienced the most annoyance from Tinnitus in the evening were the most likely to have disturbances in falling and staying asleep. Similar research from the University of Regensburg found that people with Tinnitus took longer to fall asleep. Most recently, research from Henry Ford Hospital found that patients who experienced the most emotional distress from their symptoms were the ones with the greatest risk to suffer from insomnia.

Persistent Insomnia From Changes In Brain Function

Though the previous causes of insomnia are likely to be straightforward, other causes of chronic sleeping problems are less so. An example is insomnia as a result of a stroke. In research from the Helsinki University Central Hospital, analysis of more than 250 stroke patients found that almost 20% had developed insomnia following their stroke.

Research looking deeper into the relationship between strokes and insomnia found a likely explanation. In the study from Monash University, scientists found that stroke patients had much lower levels of the hormone melatonin in their system than the average person. Melatonin is the hormone that regulates when we are awake and when we feel sleepy. It is part of what controls our circadian rhythm so poor levels of this hormone would mean that many stroke patients would have difficulties falling and staying asleep.

Also caused by changes in the brain, insomnia may occur as a result of a heart attack. While we would usually only associate a heart attack with the heart, 2010 research from the University of Montreal has found that brain is damaged during a heart attack. In particular, the part of the brain that connects to the spinal cord actually loses some specific brain nerve cells due to inflammation caused by the heart attack. The cells that are lost are those involved in regulation of sleep.

For patients who have suffered a heart attack, the ability of the brain to enter the deepest level of sleep is affected.


Living with insomnia is difficult at the best of times, but when coupled with a medical condition, it can have serious effects on health. Though insomnia is often associated with anxiety and depression, numerous medical conditions can themselves be the reason for the insomnia, whether or not we are aware of the condition. As a result, it is important that we make the effort to investigate the possible medical causes when sleep is elusive.

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Category: Disease Information, General Health, Symptom Information

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  1. kole says:

    The connection is more and more obvious these days, people need to get more sleep!