Many medical conditions are often associated with impaired or altered sleep. The bed-wetting associated with incontinence and the hot flashes and palpitations associated with menopause have been linked to recurrent awakenings throughout the sleeping hours. Diseases that seem to be exacerbated by a supine position, such as gastroesophageal reflux disease, peptic ulcer disease, chronic obstructive pulmonary disease, prostatic hypertrophy, and congestive heart failure have been linked to insomnia. Patients with chronic pain due to rheumatoid arthritis, back injury, or other conditions also report an increase in insomnia. Some of the most common psychiatric disorders that contribute to insomnia are depression, anxiety disorder, panic disorder, mania, and acute psychosis.
Some patients suffer from conditioned insomnia.
This is a type of insomnia that occurs when the patient experiences anxiety as the result of preparing to go to bed. Over the counter medications and products such as alcohol, decongestants, nicotine, and caffeine have also been linked to insomnia. Due to these potential contributing factors, a urine drug screen should be done on patients who present with insomnia complaints. In addition to the etiologies discussed above, insomnia may also result from some less common causes. Most cases of insomnia that are linked to breathing disorders are attributed to sleep apnea.