🕷️ Crawler Inspector

URL Lookup

Direct Parameter Lookup

Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 121 (from laksa141)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa121.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.helpguide.org/wellness/sleep/medical-causes-of-sleep-problems\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.helpguide.org/wellness/sleep/medical-causes-of-sleep-problems\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.helpguide.org\/wellness\/sleep\/medical-causes-of-sleep-problems","crawl_time":1775763541,"first_indexed_time":1719670211,"http_code":200,"src_unparsed":"org,helpguide!www,\/wellness\/sleep\/medical-causes-of-sleep-problems s443","src_root_hash":"10679577116146527521","history_drop_reason":null,"meta_title":"Medical Causes of Sleep Problems - HelpGuide.org","meta_descriptions":["Sleep problems may be caused by a variety of medical illnesses. Explore some of the more common causes."],"attrs_boilerpipe_text":"Adapted with permission from\nImproving Sleep: A Guide to a Good Night’s Rest\n, a special health report published by Harvard Health Publishing.\nIf you’re not sleeping well, there may be a medical cause\nPeople who feel they sleep perfectly well may still be troubled by excessive daytime sleepiness because of a variety of underlying medical illnesses. A sleep disturbance may be a symptom of a health issue or an adverse effect of therapy to treat the problem. The stress of chronic illness can also cause insomnia and daytime drowsiness. Common conditions often associated with sleep problems include heartburn, diabetes, cardiovascular disease, musculoskeletal disorders, kidney disease,\nmental health problems\n, neurological disorders, respiratory problems, and thyroid disease. In addition, a number of prescription and over-the-counter medications used to treat these and other health problems can impair sleep quality and quantity (see table below).\nChronic physical conditions\nHeartburn\nLying down in bed often worsens heartburn, which is caused by the backup of stomach acid into the esophagus. You may be able to avoid this problem by abstaining from heavy or fatty foods—as well as coffee and alcohol—in the evening. You can also use gravity to your advantage by elevating your upper body with an under-mattress wedge or blocks placed under the bedposts. Over-the-counter and prescription drugs that suppress stomach acid secretion can also help.\nDiabetes\nDiabetes is a common, chronic disorder marked by elevated levels of blood glucose, or sugar. It occurs when your cells don’t respond appropriately to insulin (a hormone secreted by the pancreas), and when your pancreas can’t produce more insulin in response. People with diabetes whose blood sugar levels are not well controlled may experience sleep problems due to:\nnight sweats\na frequent need to urinate, or\nsymptoms of hypoglycemia (low blood sugar)\nIf diabetes has damaged nerves in the legs, nighttime movements or pain may also disturb sleep.\nHeart failure\nHeart failure is a condition characterized by a gradual decline in the heart’s ability to “pump”, or circulate blood adequately. Heart failure can cause fluid to build up in the lungs and tissues. Patients with heart failure may awaken during the night feeling short of breath because extra body fluid accumulates around their lungs when they’re lying down. Using pillows to elevate the upper body may help. These people can also be awakened just as they are falling asleep by a characteristic breathing pattern called Cheyne-Stokes respiration, a series of increasingly deep breaths followed by a brief cessation of breathing.\nBenzodiazepine sleep medications help some people to stay asleep despite this breathing disturbance, but others may need to use supplementary oxygen or a device that increases pressure in the upper airway and chest cavity to help them breathe and sleep more normally.\nMen with heart failure frequently have obstructive sleep apnea—a breathing disorder characterized by multiple nighttime awakenings—which can disrupt sleep, cause daytime sleepiness, and worsen heart failure. In people with coronary artery disease, the natural fluctuations in circadian rhythms may trigger angina (chest pain), arrhythmia (irregular heartbeat), or even heart attack while asleep.\nMusculoskeletal disorders\nArthritis pain can make it hard for people to fall asleep and to resettle when they shift positions. In addition, treatment with steroids frequently causes insomnia. You may find it helpful to take aspirin or a nonsteroidal anti-inflammatory drug (NSAID) just before bedtime to relieve pain and swelling in your joints during the night.\n[Read: Chronic Pain and Mental Health]\nPeople with fibromyalgia—a condition characterized by painful ligaments and tendons—are likely to wake in the morning still feeling fatigued and as stiff and achy as a person with arthritis. Researchers who analyzed the sleep of fibromyalgia sufferers have found that at least half have abnormal deep sleep, in which slow brain waves are mixed with waves usually associated with relaxed wakefulness, a pattern called alpha-delta sleep.\nKidney disease\nPeople with kidney disease have kidneys that are damaged to the extent that they can no longer filter fluids, remove wastes, and keep electrolytes in balance as efficiently as they did when healthy. Kidney disease can cause waste products to build up in the blood and can result in insomnia or symptoms of restless legs syndrome. Although researchers aren’t sure why, kidney dialysis or transplant does not always return sleep to normal.\nNocturia\nNocturia is the need to get up frequently to urinate during the night. It is a common cause of sleep loss, especially among older adults. A mild case causes a person to wake up at least twice during the night; in severe cases, a person may get up as many as five or six times.\nNocturia may be a product of age, but other causes include certain medical conditions (heart failure, diabetes, urinary tract infection, an enlarged prostate, liver failure, multiple sclerosis, sleep apnea), medication (especially diuretics), and excessive fluid intake after dinner.\nTherapies for nocturia fall into three categories:\ntreatments to correct medical causes\nbehavioral interventions\nmedication\nThe first step is to try to identify the cause and correct it. If this is unsuccessful, try behavioral\napproaches such as cutting down on how much you drink in the two hours before bedtime, especially caffeine and alcohol. If the nocturia persists, your doctor may prescribe one of a growing number of medications approved to treat an overactive bladder.\nThyroid disease\nAn overactive thyroid gland (hyperthyroidism) can cause sleep problems. The disorder overstimulates the nervous system, making it hard to fall asleep, and it may cause night sweats, leading to nighttime arousals. Feeling cold and sleepy is a hallmark of an underactive thyroid (hypothyroidism).\nBecause thyroid function affects every organ and system in the body, the symptoms can be wide-ranging and sometimes difficult to decipher. Checking thyroid function requires only a simple blood test, so if you notice a variety of unexplained symptoms, ask your doctor for a thyroid test.\nBreathing problems\nCircadian-related changes in the tone of the muscles surrounding the airways can cause the airways to constrict during the night, raising the potential for nocturnal asthma attacks that rouse the sleeper abruptly.\nBreathing difficulties or fear of having an attack may make it more difficult to fall asleep, as can the use of steroids or other breathing medications that also have a stimulating effect, similar to that of caffeine.\nPeople who have emphysema or bronchitis may also have difficulty falling and staying asleep because of excess sputum production, shortness of breath, and coughing.\nSpeak to a Licensed Therapist\nBetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours.\nTake Assessment\nHelpGuide is user supported. We earn a commission if you sign up for BetterHelp’s services after clicking through from this site.\nLearn more\nMedications\nMental health disorders\nAlmost all people with anxiety or depression have trouble falling asleep and staying asleep. In turn, not being able to sleep may become a focus of some sufferers’ ongoing fear and tension, causing further sleep loss.\nGeneral anxiety\nSevere anxiety, also known as generalized anxiety disorder, is characterized by persistent, nagging feelings of worry, apprehension, or uneasiness. These feelings are either unusually intense or out of proportion to the real troubles and dangers of the person’s everyday life.\nPeople with general anxiety typically experience excessive, persistent worry every day or almost every day for a period of six months or more. Common symptoms include trouble falling asleep, trouble staying asleep, and not feeling rested after sleep.\nPhobias and panic attacks\nPhobias, which are intense fears related to a specific object or situation, rarely cause sleep problems unless the phobia is itself sleep-related (such as fear of nightmares or of the bedroom). Panic attacks, on the other hand, often strike at night. In fact, the timing of nocturnal attacks helped convince psychiatrists that these episodes are biologically based.\nSleep-related panic attacks do not occur during dreaming, but rather in stage N2 (light sleep) and stage N3 (deep sleep), which are free of psychological triggers. In many phobias and panic disorders, recognizing and treating the underlying problem—often with an anti-anxiety medication—may solve the sleep disturbance.\nDepression\nBecause almost 90% of people with serious depression experience insomnia, a physician evaluating a person with insomnia will consider depression as a possible cause. Waking up too early in the morning is a hallmark of depression, and some depressed people have difficulty falling asleep or get fitful sleep throughout the whole night.\nIn chronic, low-grade depression (also known as dysthymia), insomnia or sleepiness may be the most prominent symptom. Laboratory studies have shown that people who are depressed spend less time in slow-wave sleep and may enter REM sleep more quickly at the beginning of the night.\nBipolar disorder\nDisturbed sleep is a prominent feature of bipolar disorder (also known as manic-depressive illness). Sleep loss may exacerbate or induce manic symptoms or temporarily alleviate depression. During a manic episode, a person may not sleep at all for several days. Such occurrences are often followed by a “crash” during which the person spends most of the next few days in bed.\nSchizophrenia\nSome people with schizophrenia sleep very little in the early, most severe stage of an episode. Between episodes, their sleep patterns are likely to improve, although many people with schizophrenia rarely obtain a normal amount of deep sleep.\nNeurological disorders\nCertain brain and nerve disorders can contribute to sleeplessness.\nDementia\nAlzheimer’s disease and other forms of dementia may disrupt sleep regulation and other brain functions. Wandering, disorientation, and agitation during the evening and night, a phenomenon known as “sundowning,” can require constant supervision and place great stress on caregivers. In such cases, small doses of antipsychotic medications are more helpful than benzodiazepine drugs.\nEpilepsy\nPeople with epilepsy—a condition in which a person is prone to seizures—are twice as likely as others to suffer from insomnia. Brain wave disturbances that cause seizures can also cause deficits in slow-wave sleep or REM sleep. Antiseizure drugs can cause similar changes at first, but tend to correct these sleep disturbances when used for a long time.\nAbout one in four people with epilepsy has seizures that occur mainly at night, causing disturbed sleep and daytime sleepiness. Sleep deprivation can also trigger a seizure, a phenomenon noted in college infirmaries during exam periods, as some students suffer their first seizures after staying up late to study.\nHeadaches, strokes, and tumors\nPeople who are prone to headaches should try to avoid sleep deprivation, as lack of sleep can promote headaches. Both cluster headaches and migraines may be related to changes in the size of blood vessels leading to the cortex of the brain; pain occurs when the walls of the blood vessels dilate.\nResearchers theorize that as the body catches up on missed sleep, it spends more time in delta sleep, when vessels are most constricted, making the transition to REM sleep more dramatic and likely to induce a headache. Headaches that awaken people are often migraines, but some migraines can be relieved by sleep. Sleepiness coupled with dizziness, weakness, headache, or vision problems may signal a serious problem such as a brain tumor or stroke, which requires immediate medical attention.\nParkinson’s disease\nAlmost all people with Parkinson’s disease have insomnia. Just getting in and out of bed can be a struggle, and the disease often disrupts sleep. Some arousals are from the tremors and movements caused by the disorder, and others seem to result from the disorder itself. As a result, daytime sleepiness is common.\nTreatment with sleeping pills may be difficult because some drugs can worsen Parkinson’s symptoms. Some patients who take drugs used to treat Parkinson’s treatment may develop severe nightmares; others experience disruption of REM sleep. However, the use of these medications at night is important to maintain the mobility needed to change positions in bed. A bed rail or an overhead bar (known as a trapeze) may make it easier for people with Parkinson’s to move about and, therefore, lead to better sleep.\nAdapted with permission from\nImproving Sleep: A Guide to a Good Night’s Rest\n, a special health report published by Harvard Health Publishing.","attrs_markdown":"[![HelpGuide.org](https:\/\/www.helpguide.org\/wp-content\/uploads\/Group-13075.svg)](https:\/\/www.helpguide.org\/)\n\n- [Español](https:\/\/www.helpguide.org\/es\/sueno\/causas-medicas-de-los-problemas-de-sueno)\n\n- [About Us](https:\/\/www.helpguide.org\/about-us)\n  - [About Us](https:\/\/www.helpguide.org\/about-us)\n  - [Meet Our Team](https:\/\/www.helpguide.org\/about-us\/meet-our-team)\n  - [Our Story](https:\/\/www.helpguide.org\/about-us\/our-story)\n  - [Jeanne Segal, Ph.D.](https:\/\/www.helpguide.org\/about-us\/jeanne-segal)\n  - [Advisory Council](https:\/\/www.helpguide.org\/professional-advisory-council)\n  - [Contact Us](https:\/\/www.helpguide.org\/contact-us)\n- [Resources](https:\/\/www.helpguide.org\/wellness\/sleep\/medical-causes-of-sleep-problems)\n  - [Harvard Health Partnership](https:\/\/www.helpguide.org\/harvard)\n  - [Audio Meditations](https:\/\/www.helpguide.org\/mental-health\/meditation)\n  - [Newsletter](https:\/\/www.helpguide.org\/newsletter)\n  - [Helplines](https:\/\/www.helpguide.org\/find-help)\n\n[Donate](https:\/\/give.helpguide.org\/give\/581002\/#!\/donation\/checkout)\n\n[![HelpGuide.org](https:\/\/www.helpguide.org\/wp-content\/uploads\/Logo-3.svg)](https:\/\/www.helpguide.org\/)\n\n[Donate](https:\/\/give.helpguide.org\/give\/581002\/#!\/donation\/checkout)\n\n- [Can’t Sleep? Insomnia Causes, Symptoms, and What You Can Do About it](https:\/\/www.helpguide.org\/wellness\/sleep\/insomnia-causes-and-cures)\n- [Sleep Disorders and Problems: Types, Causes, Treatment](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-disorders-and-problems)\n- [How to Sleep Better: Tips to Improve Sleep Quality](https:\/\/www.helpguide.org\/wellness\/sleep\/getting-better-sleep)\n- [Sleep and Mental Health](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-and-mental-health)\n- [How Sleeping Positions Can Affect Sleep Quality](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-positions-and-sleep-quality)\n- [The Connection Between Sleep and ADHD](https:\/\/www.helpguide.org\/wellness\/sleep\/adhd-and-sleep)\n- [Parasomnias: Types, Causes, and Symptoms](https:\/\/www.helpguide.org\/wellness\/sleep\/parasomnias-types-causes-and-symptoms)\n- [Sleep Statistics](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-statistics)\n- [Online Therapy: Is it Right for You?](https:\/\/www.helpguide.org\/?p=130493)\n\n- [Mental Health](https:\/\/www.helpguide.org\/mental-health)\n  [Mental Health](https:\/\/www.helpguide.org\/mental-health)\n  \n  - [ADHD](https:\/\/www.helpguide.org\/mental-health\/adhd)\n  - [Addiction](https:\/\/www.helpguide.org\/mental-health\/addiction)\n  - [Anxiety](https:\/\/www.helpguide.org\/mental-health\/anxiety)\n  - [Bipolar Disorder](https:\/\/www.helpguide.org\/mental-health\/bipolar-disorder)\n  - [Depression](https:\/\/www.helpguide.org\/mental-health\/depression)\n  - [Eating Disorders](https:\/\/www.helpguide.org\/mental-health\/eating-disorders)\n  - [Grief & Loss](https:\/\/www.helpguide.org\/mental-health\/grief)\n  \n  - [Personality Disorders](https:\/\/www.helpguide.org\/mental-health\/personality-disorders)\n  - [PTSD & Trauma](https:\/\/www.helpguide.org\/mental-health\/ptsd-trauma)\n  - [Schizophrenia](https:\/\/www.helpguide.org\/mental-health\/schizophrenia)\n  - [Stress](https:\/\/www.helpguide.org\/mental-health\/stress)\n  - [Suicide & Self-Harm](https:\/\/www.helpguide.org\/mental-health\/suicide-self-harm)\n  - [Treatment](https:\/\/www.helpguide.org\/mental-health\/treatment)\n  \n  Featured\n  \n  [Coping with Depression](https:\/\/www.helpguide.org\/mental-health\/depression\/coping-with-depression)\n  \n  Tips for overcoming depression one step at a time\n  \n  [![A woman in an orange dress strolls gracefully along a scenic path surrounded by greenery as she is coping with depression.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2023\/02\/Coping-with-Depression-384x256.jpeg)](https:\/\/www.helpguide.org\/mental-health\/depression\/coping-with-depression)\n  \n  [The Best Online Therapy Platforms](https:\/\/www.helpguide.org\/mental-health\/treatment\/best-online-therapy)\n  \n  HelpGuide’s reviews of the best services\n  \n  [![Abstract illustration of a woman sitting on the floor, a hand reaching out to her from a computer screen, symbolizing the best online therapy services.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2025\/08\/Online-Therapy-384x384.png)](https:\/\/www.helpguide.org\/mental-health\/treatment\/best-online-therapy)\n- [Health & Wellness](https:\/\/www.helpguide.org\/wellness)\n  [Health & Wellness](https:\/\/www.helpguide.org\/wellness)\n  \n  - [Exercise & Fitness](https:\/\/www.helpguide.org\/wellness\/fitness)\n  - [Nutrition](https:\/\/www.helpguide.org\/wellness\/nutrition)\n  - [Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n  - [Stress](https:\/\/www.helpguide.org\/mental-health\/stress)\n  - [Well-being & Happiness](https:\/\/www.helpguide.org\/mental-health\/wellbeing)\n  - [Pets](https:\/\/www.helpguide.org\/wellness\/pets)\n  \n  - [Weight Management](https:\/\/www.helpguide.org\/wellness\/weight-loss)\n  - [Work & Career](https:\/\/www.helpguide.org\/wellness\/career)\n  - [Illness & Disability](https:\/\/www.helpguide.org\/wellness\/health-conditions)\n  - [Heart Health](https:\/\/www.helpguide.org\/wellness\/heart-health)\n  - [Cancer](https:\/\/www.helpguide.org\/wellness\/cancer)\n  - [Sexual Health](https:\/\/www.helpguide.org\/relationships\/sexual-health)\n  \n  Featured\n  \n  [Stress Management](https:\/\/www.helpguide.org\/mental-health\/stress\/stress-management)\n  \n  How to reduce, prevent, and relieve stress\n  \n  [![A person calmly displays a colorful bunch of flowers in front of a lush green backdrop, suggesting successful stress management.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2023\/02\/Stress-Management-384x256.jpeg)](https:\/\/www.helpguide.org\/mental-health\/stress\/stress-management)\n  \n  [Insomnia: What to Do When You Can't Sleep](https:\/\/www.helpguide.org\/wellness\/sleep\/insomnia-causes-and-cures)\n  \n  The causes of insomnia, and what to do when you can’t sleep\n  \n  [![A woman in a denim shirt sits on a bed, looking out a window at city lights during the night.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2023\/02\/Insomnia-384x256.jpeg)](https:\/\/www.helpguide.org\/wellness\/sleep\/insomnia-causes-and-cures)\n- [Children & Family](https:\/\/www.helpguide.org\/family)\n  [Children & Family](https:\/\/www.helpguide.org\/family)\n  \n  - [Autism](https:\/\/www.helpguide.org\/mental-health\/autism)\n  - [Learning Disabilities](https:\/\/www.helpguide.org\/family\/learning-disabilities)\n  - [Family Caregiving](https:\/\/www.helpguide.org\/family\/caregiving)\n  \n  - [Parenting](https:\/\/www.helpguide.org\/family\/parenting)\n  - [Teen Issues](https:\/\/www.helpguide.org\/family\/young-adults)\n  \n  Featured\n  \n  [ADHD in Children](https:\/\/www.helpguide.org\/mental-health\/adhd\/adhd-in-children)\n  \n  What Attention Deficit Hyperactivity Disorder looks like in kids\n  \n  [![Two children wearing aviator goggles and hats glide on skateboards with arms outstretched, illustrating ADHD in children.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2023\/02\/ADHD-in-Children-384x256.jpeg)](https:\/\/www.helpguide.org\/mental-health\/adhd\/adhd-in-children)\n  \n  [Caregiver Stress and Caregiver Burnout](https:\/\/www.helpguide.org\/family\/caregiving\/caregiver-stress-and-burnout)\n  \n  Tips for regaining your energy, optimism, and hope\n  \n  [![Withered plant in a terracotta pot under harsh sunlight, representing caregiver burnout and depletion.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2023\/02\/Caregiver-Burnout-384x256.jpeg)](https:\/\/www.helpguide.org\/family\/caregiving\/caregiver-stress-and-burnout)\n- [Relationships](https:\/\/www.helpguide.org\/relationships)\n  [Relationships](https:\/\/www.helpguide.org\/relationships)\n  \n  - [Communication](https:\/\/www.helpguide.org\/relationships\/communication)\n  - [Emotional Intelligence](https:\/\/www.helpguide.org\/mental-health\/emotional-intelligence)\n  - [Love & Friendship](https:\/\/www.helpguide.org\/relationships\/social-connection)\n  \n  - [Domestic Abuse](https:\/\/www.helpguide.org\/relationships\/domestic-abuse)\n  - [Sexual Health](https:\/\/www.helpguide.org\/relationships\/sexual-health)\n  \n  Featured\n  \n  [Setting Healthy Boundaries in Relationships](https:\/\/www.helpguide.org\/relationships\/social-connection\/setting-healthy-boundaries-in-relationships)\n  \n  Strengthen your connections and improve your self-esteem\n  \n  [![Two people stand either side of a red line, symbolizing setting boundaries in relationships.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2022\/07\/Boundaries-384x256.png)](https:\/\/www.helpguide.org\/relationships\/social-connection\/setting-healthy-boundaries-in-relationships)\n  \n  [Improving Emotional Intelligence (EQ)](https:\/\/www.helpguide.org\/mental-health\/wellbeing\/emotional-intelligence-eq)\n  \n  Boost your EQ to help find happiness and success\n  \n  [![Two small wooden figures each walk inside their own large, circular band, representing improving emotional intelligence.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2023\/02\/Improving-Emotional-Intelligence-384x257.jpeg)](https:\/\/www.helpguide.org\/mental-health\/wellbeing\/emotional-intelligence-eq)\n- [Aging Well](https:\/\/www.helpguide.org\/aging)\n  [Aging Well](https:\/\/www.helpguide.org\/aging)\n  \n  - [Healthy Aging](https:\/\/www.helpguide.org\/aging\/healthy-aging)\n  - [Alzheimer’s Disease & Dementia](https:\/\/www.helpguide.org\/aging\/dementia)\n  \n  - [Family Caregiving](https:\/\/www.helpguide.org\/family\/caregiving)\n  - [End of Life](https:\/\/www.helpguide.org\/aging\/end-of-life)\n  \n  Featured\n  \n  [Depression in Older Adults](https:\/\/www.helpguide.org\/mental-health\/depression\/depression-in-older-adults)\n  \n  Recognizing the signs and getting the right treatment\n  \n  [![A bush adorned with a contrast of orange and white flowers, showcasing the nature of depression in older adults](https:\/\/www.helpguide.org\/wp-content\/uploads\/2023\/02\/Depression-in-Older-Adults-384x576.jpeg)](https:\/\/www.helpguide.org\/mental-health\/depression\/depression-in-older-adults)\n  \n  [Aging Well](https:\/\/www.helpguide.org\/aging\/healthy-aging\/staying-healthy-as-you-age)\n  \n  Tips to staying healthy as you get older\n  \n  [![Low-angle shot looking up into the expansive, sun-drenched canopy of a large oak tree against a clear blue sky, representing aging well.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2023\/02\/Aging-Well-384x256.jpeg)](https:\/\/www.helpguide.org\/aging\/healthy-aging\/staying-healthy-as-you-age)\n- [Screeners](https:\/\/www.helpguide.org\/screening-tests\/depression-test)\n  - [Depression Test](https:\/\/www.helpguide.org\/screening-tests\/depression-test)\n\n- [Mental Health](https:\/\/www.helpguide.org\/mental-health)\n- [Health & Wellness](https:\/\/www.helpguide.org\/wellness)\n- [Children & Family](https:\/\/www.helpguide.org\/family)\n- [Relationships](https:\/\/www.helpguide.org\/relationships)\n- [Aging Well](https:\/\/www.helpguide.org\/aging)\n- [Screeners](https:\/\/www.helpguide.org\/screening-tests\/depression-test)\n\n- [About Us](https:\/\/www.helpguide.org\/about-us)\n- [Resources](https:\/\/www.helpguide.org\/wellness\/sleep\/medical-causes-of-sleep-problems)\n\n- [Español](https:\/\/www.helpguide.org\/es\/sueno\/causas-medicas-de-los-problemas-de-sueno)\n\nReturn\n\n[Mental Health](https:\/\/www.helpguide.org\/mental-health)\n\n- [ADHD](https:\/\/www.helpguide.org\/mental-health\/adhd)\n- [Addiction](https:\/\/www.helpguide.org\/mental-health\/addiction)\n- [Anxiety](https:\/\/www.helpguide.org\/mental-health\/anxiety)\n- [Bipolar Disorder](https:\/\/www.helpguide.org\/mental-health\/bipolar-disorder)\n- [Depression](https:\/\/www.helpguide.org\/mental-health\/depression)\n- [Eating Disorders](https:\/\/www.helpguide.org\/mental-health\/eating-disorders)\n- [Grief & Loss](https:\/\/www.helpguide.org\/mental-health\/grief)\n- [Personality Disorders](https:\/\/www.helpguide.org\/mental-health\/personality-disorders)\n- [PTSD & Trauma](https:\/\/www.helpguide.org\/mental-health\/ptsd-trauma)\n- [Schizophrenia](https:\/\/www.helpguide.org\/mental-health\/schizophrenia)\n- [Stress](https:\/\/www.helpguide.org\/mental-health\/stress)\n- [Suicide & Self-Harm](https:\/\/www.helpguide.org\/mental-health\/suicide-self-harm)\n- [Treatment](https:\/\/www.helpguide.org\/mental-health\/treatment)\n\nReturn\n\n[Health & Wellness](https:\/\/www.helpguide.org\/wellness)\n\n- [Exercise & Fitness](https:\/\/www.helpguide.org\/wellness\/fitness)\n- [Nutrition](https:\/\/www.helpguide.org\/wellness\/nutrition)\n- [Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n- [Stress](https:\/\/www.helpguide.org\/mental-health\/stress)\n- [Well-being & Happiness](https:\/\/www.helpguide.org\/mental-health\/wellbeing)\n- [Pets](https:\/\/www.helpguide.org\/wellness\/pets)\n- [Weight Management](https:\/\/www.helpguide.org\/wellness\/weight-loss)\n- [Work & Career](https:\/\/www.helpguide.org\/wellness\/career)\n- [Illness & Disability](https:\/\/www.helpguide.org\/wellness\/health-conditions)\n- [Heart Health](https:\/\/www.helpguide.org\/wellness\/heart-health)\n- [Cancer](https:\/\/www.helpguide.org\/wellness\/cancer)\n- [Sexual Health](https:\/\/www.helpguide.org\/relationships\/sexual-health)\n\nReturn\n\n[Children & Family](https:\/\/www.helpguide.org\/family)\n\n- [Autism](https:\/\/www.helpguide.org\/mental-health\/autism)\n- [Learning Disabilities](https:\/\/www.helpguide.org\/family\/learning-disabilities)\n- [Family Caregiving](https:\/\/www.helpguide.org\/family\/caregiving)\n- [Parenting](https:\/\/www.helpguide.org\/family\/parenting)\n- [Teen Issues](https:\/\/www.helpguide.org\/family\/young-adults)\n\nReturn\n\n[Relationships](https:\/\/www.helpguide.org\/relationships)\n\n- 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If you sign up for therapy after clicking through from this site, HelpGuide will earn a commission. This helps us continue our nonprofit mission and continue to be there as a free mental health resource for everyone.\n\nNeed to talk to someone now? [Find a crisis helpline](https:\/\/www.helpguide.org\/find-help)\n\nIf you're a BetterHelp therapist with questions about your directory listing, please contact [therapists@betterhelp.com](mailto:therapists@betterhelp.com)\n\nNeed to talk to someone now? [Find a crisis helpline](https:\/\/www.helpguide.org\/find-help)\n\n[Are You Feeling Suicidal? How to Cope with Thoughts of Suicide](https:\/\/www.helpguide.org\/mental-health\/suicide-self-harm\/are-you-feeling-suicidal)\n\n[![depression-helpline](https:\/\/www.helpguide.org\/wp-content\/plugins\/helpguide-core-functionality\/assets\/images\/svg\/depression-helpline.svg) Coping with depression Tips for overcoming depression one step at a time](https:\/\/www.helpguide.org\/mental-health\/depression\/coping-with-depression)\n\n[![generalized-helpline](https:\/\/www.helpguide.org\/wp-content\/plugins\/helpguide-core-functionality\/assets\/images\/svg\/generalized-helpline.svg) Generalized Anxiety Disorder Symptoms, treatment, and self-help for chronic anxiety](https:\/\/www.helpguide.org\/mental-health\/anxiety\/generalized-anxiety-disorder-gad)\n\n[Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n\n# Medical Causes of Sleep Problems\nLast updated on February 18, 2026\n\nNot sleeping well or experiencing excessive daytime fatigue? Many common health conditions and medications can disrupt your sleep. Here’s how to spot if a medical cause is keeping you up at night.\n\n![A digital alarm clock displaying 11:56 sits on a wooden nightstand cluttered with books, a lamp, and headphones next to a bed.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2023\/02\/Medical-Causes-of-Sleep-Problems-1200x800.jpeg)\n\nBy  [Harvard Health](https:\/\/www.helpguide.org\/bio\/harvard-health)\n\n- If you're not sleeping well, there may be a medical cause\n- Chronic physical conditions\n- Medications\n- Mental health disorders\n- Neurological disorders\n\n***Adapted with permission from [Improving Sleep: A Guide to a Good Night’s Rest](https:\/\/www.health.harvard.edu\/staying-healthy\/improving-sleep-a-guide-to-a-good-nights-rest), a special health report published by Harvard Health Publishing.***\n\n## If you’re not sleeping well, there may be a medical cause\nPeople who feel they sleep perfectly well may still be troubled by excessive daytime sleepiness because of a variety of underlying medical illnesses. A sleep disturbance may be a symptom of a health issue or an adverse effect of therapy to treat the problem. The stress of chronic illness can also cause insomnia and daytime drowsiness. Common conditions often associated with sleep problems include heartburn, diabetes, cardiovascular disease, musculoskeletal disorders, kidney disease, [mental health problems](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-and-mental-health), neurological disorders, respiratory problems, and thyroid disease. In addition, a number of prescription and over-the-counter medications used to treat these and other health problems can impair sleep quality and quantity (see table below).\n\n## Chronic physical conditions\n### Heartburn\nLying down in bed often worsens heartburn, which is caused by the backup of stomach acid into the esophagus. You may be able to avoid this problem by abstaining from heavy or fatty foods—as well as coffee and alcohol—in the evening. You can also use gravity to your advantage by elevating your upper body with an under-mattress wedge or blocks placed under the bedposts. Over-the-counter and prescription drugs that suppress stomach acid secretion can also help.\n\n### Diabetes\nDiabetes is a common, chronic disorder marked by elevated levels of blood glucose, or sugar. It occurs when your cells don’t respond appropriately to insulin (a hormone secreted by the pancreas), and when your pancreas can’t produce more insulin in response. People with diabetes whose blood sugar levels are not well controlled may experience sleep problems due to:\n\n- night sweats\n- a frequent need to urinate, or\n- symptoms of hypoglycemia (low blood sugar)\n\nIf diabetes has damaged nerves in the legs, nighttime movements or pain may also disturb sleep.\n\n### Heart failure\nHeart failure is a condition characterized by a gradual decline in the heart’s ability to “pump”, or circulate blood adequately. Heart failure can cause fluid to build up in the lungs and tissues. Patients with heart failure may awaken during the night feeling short of breath because extra body fluid accumulates around their lungs when they’re lying down. Using pillows to elevate the upper body may help. These people can also be awakened just as they are falling asleep by a characteristic breathing pattern called Cheyne-Stokes respiration, a series of increasingly deep breaths followed by a brief cessation of breathing.\n\nBenzodiazepine sleep medications help some people to stay asleep despite this breathing disturbance, but others may need to use supplementary oxygen or a device that increases pressure in the upper airway and chest cavity to help them breathe and sleep more normally.\n\nMen with heart failure frequently have obstructive sleep apnea—a breathing disorder characterized by multiple nighttime awakenings—which can disrupt sleep, cause daytime sleepiness, and worsen heart failure. In people with coronary artery disease, the natural fluctuations in circadian rhythms may trigger angina (chest pain), arrhythmia (irregular heartbeat), or even heart attack while asleep.\n\n### Musculoskeletal disorders\nArthritis pain can make it hard for people to fall asleep and to resettle when they shift positions. In addition, treatment with steroids frequently causes insomnia. You may find it helpful to take aspirin or a nonsteroidal anti-inflammatory drug (NSAID) just before bedtime to relieve pain and swelling in your joints during the night.\n\n[\\[Read: Chronic Pain and Mental Health\\]](https:\/\/www.helpguide.org\/wellness\/sleep\/%20https:\/\/www.helpguide.org\/wellness\/health-conditions\/chronic-pain-and-mental-health)\n\nPeople with fibromyalgia—a condition characterized by painful ligaments and tendons—are likely to wake in the morning still feeling fatigued and as stiff and achy as a person with arthritis. Researchers who analyzed the sleep of fibromyalgia sufferers have found that at least half have abnormal deep sleep, in which slow brain waves are mixed with waves usually associated with relaxed wakefulness, a pattern called alpha-delta sleep.\n\n### Kidney disease\nPeople with kidney disease have kidneys that are damaged to the extent that they can no longer filter fluids, remove wastes, and keep electrolytes in balance as efficiently as they did when healthy. Kidney disease can cause waste products to build up in the blood and can result in insomnia or symptoms of restless legs syndrome. Although researchers aren’t sure why, kidney dialysis or transplant does not always return sleep to normal.\n\n### Nocturia\nNocturia is the need to get up frequently to urinate during the night. It is a common cause of sleep loss, especially among older adults. A mild case causes a person to wake up at least twice during the night; in severe cases, a person may get up as many as five or six times.\n\nNocturia may be a product of age, but other causes include certain medical conditions (heart failure, diabetes, urinary tract infection, an enlarged prostate, liver failure, multiple sclerosis, sleep apnea), medication (especially diuretics), and excessive fluid intake after dinner.\n\nTherapies for nocturia fall into three categories:\n\n- treatments to correct medical causes\n- behavioral interventions\n- medication\n\nThe first step is to try to identify the cause and correct it. If this is unsuccessful, try behavioral  \napproaches such as cutting down on how much you drink in the two hours before bedtime, especially caffeine and alcohol. If the nocturia persists, your doctor may prescribe one of a growing number of medications approved to treat an overactive bladder.\n\n### Thyroid disease\nAn overactive thyroid gland (hyperthyroidism) can cause sleep problems. The disorder overstimulates the nervous system, making it hard to fall asleep, and it may cause night sweats, leading to nighttime arousals. Feeling cold and sleepy is a hallmark of an underactive thyroid (hypothyroidism).\n\nBecause thyroid function affects every organ and system in the body, the symptoms can be wide-ranging and sometimes difficult to decipher. Checking thyroid function requires only a simple blood test, so if you notice a variety of unexplained symptoms, ask your doctor for a thyroid test.\n\n### Breathing problems\nCircadian-related changes in the tone of the muscles surrounding the airways can cause the airways to constrict during the night, raising the potential for nocturnal asthma attacks that rouse the sleeper abruptly.\n\nBreathing difficulties or fear of having an attack may make it more difficult to fall asleep, as can the use of steroids or other breathing medications that also have a stimulating effect, similar to that of caffeine.\n\nPeople who have emphysema or bronchitis may also have difficulty falling and staying asleep because of excess sputum production, shortness of breath, and coughing.\n\n#### Speak to a Licensed Therapist\nBetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours.\n\n[Take Assessment](https:\/\/hasofferstracking.betterhelp.com\/aff_c?offer_id=2&aff_id=2729&source=helpguide)\n\nHelpGuide is user supported. We earn a commission if you sign up for BetterHelp’s services after clicking through from this site.  [Learn more](https:\/\/www.helpguide.org\/affiliate-disclosure)\n## Medications\n![Medications that may impact sleep](https:\/\/www.helpguide.org\/wp-content\/uploads\/medications-that-may-impact-sleep-700.jpg)\n\n## Mental health disorders\nAlmost all people with anxiety or depression have trouble falling asleep and staying asleep. In turn, not being able to sleep may become a focus of some sufferers’ ongoing fear and tension, causing further sleep loss.\n\n### General anxiety\nSevere anxiety, also known as generalized anxiety disorder, is characterized by persistent, nagging feelings of worry, apprehension, or uneasiness. These feelings are either unusually intense or out of proportion to the real troubles and dangers of the person’s everyday life.\n\nPeople with general anxiety typically experience excessive, persistent worry every day or almost every day for a period of six months or more. Common symptoms include trouble falling asleep, trouble staying asleep, and not feeling rested after sleep.\n\n### Phobias and panic attacks\nPhobias, which are intense fears related to a specific object or situation, rarely cause sleep problems unless the phobia is itself sleep-related (such as fear of nightmares or of the bedroom). Panic attacks, on the other hand, often strike at night. In fact, the timing of nocturnal attacks helped convince psychiatrists that these episodes are biologically based.\n\nSleep-related panic attacks do not occur during dreaming, but rather in stage N2 (light sleep) and stage N3 (deep sleep), which are free of psychological triggers. In many phobias and panic disorders, recognizing and treating the underlying problem—often with an anti-anxiety medication—may solve the sleep disturbance.\n\n### Depression\nBecause almost 90% of people with serious depression experience insomnia, a physician evaluating a person with insomnia will consider depression as a possible cause. Waking up too early in the morning is a hallmark of depression, and some depressed people have difficulty falling asleep or get fitful sleep throughout the whole night.\n\nIn chronic, low-grade depression (also known as dysthymia), insomnia or sleepiness may be the most prominent symptom. Laboratory studies have shown that people who are depressed spend less time in slow-wave sleep and may enter REM sleep more quickly at the beginning of the night.\n\n### Bipolar disorder\nDisturbed sleep is a prominent feature of bipolar disorder (also known as manic-depressive illness). Sleep loss may exacerbate or induce manic symptoms or temporarily alleviate depression. During a manic episode, a person may not sleep at all for several days. Such occurrences are often followed by a “crash” during which the person spends most of the next few days in bed.\n\n### Schizophrenia\nSome people with schizophrenia sleep very little in the early, most severe stage of an episode. Between episodes, their sleep patterns are likely to improve, although many people with schizophrenia rarely obtain a normal amount of deep sleep.\n\n## Neurological disorders\nCertain brain and nerve disorders can contribute to sleeplessness.\n\n### Dementia\nAlzheimer’s disease and other forms of dementia may disrupt sleep regulation and other brain functions. Wandering, disorientation, and agitation during the evening and night, a phenomenon known as “sundowning,” can require constant supervision and place great stress on caregivers. In such cases, small doses of antipsychotic medications are more helpful than benzodiazepine drugs.\n\n### Epilepsy\nPeople with epilepsy—a condition in which a person is prone to seizures—are twice as likely as others to suffer from insomnia. Brain wave disturbances that cause seizures can also cause deficits in slow-wave sleep or REM sleep. Antiseizure drugs can cause similar changes at first, but tend to correct these sleep disturbances when used for a long time.\n\nAbout one in four people with epilepsy has seizures that occur mainly at night, causing disturbed sleep and daytime sleepiness. Sleep deprivation can also trigger a seizure, a phenomenon noted in college infirmaries during exam periods, as some students suffer their first seizures after staying up late to study.\n\n### Headaches, strokes, and tumors\nPeople who are prone to headaches should try to avoid sleep deprivation, as lack of sleep can promote headaches. Both cluster headaches and migraines may be related to changes in the size of blood vessels leading to the cortex of the brain; pain occurs when the walls of the blood vessels dilate.\n\nResearchers theorize that as the body catches up on missed sleep, it spends more time in delta sleep, when vessels are most constricted, making the transition to REM sleep more dramatic and likely to induce a headache. Headaches that awaken people are often migraines, but some migraines can be relieved by sleep. Sleepiness coupled with dizziness, weakness, headache, or vision problems may signal a serious problem such as a brain tumor or stroke, which requires immediate medical attention.\n\n### Parkinson’s disease\nAlmost all people with Parkinson’s disease have insomnia. Just getting in and out of bed can be a struggle, and the disease often disrupts sleep. Some arousals are from the tremors and movements caused by the disorder, and others seem to result from the disorder itself. As a result, daytime sleepiness is common.\n\nTreatment with sleeping pills may be difficult because some drugs can worsen Parkinson’s symptoms. Some patients who take drugs used to treat Parkinson’s treatment may develop severe nightmares; others experience disruption of REM sleep. However, the use of these medications at night is important to maintain the mobility needed to change positions in bed. A bed rail or an overhead bar (known as a trapeze) may make it easier for people with Parkinson’s to move about and, therefore, lead to better sleep.\n\n***Adapted with permission from [Improving Sleep: A Guide to a Good Night’s Rest](https:\/\/www.health.harvard.edu\/staying-healthy\/improving-sleep-a-guide-to-a-good-nights-rest), a special health report published by Harvard Health Publishing.***\n\n[Copy Link](https:\/\/www.helpguide.org\/wellness\/sleep\/medical-causes-of-sleep-problems)\n\nLink copied\\!\n\nShare\n\nPrint\n\nDownload PDF\n\n## More in Sleep\n[Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n\n### [Insomnia: What to Do When You Can't Sleep](https:\/\/www.helpguide.org\/wellness\/sleep\/insomnia-causes-and-cures)\nThe causes of insomnia, and what to do when you can’t sleep\n\n[![A woman in a denim shirt sits on a bed, looking out a window at city lights during the night.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2023\/02\/Insomnia-384x256.jpeg)](https:\/\/www.helpguide.org\/wellness\/sleep\/insomnia-causes-and-cures)\n\n[Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n\n### [Sleep Disorders and Problems](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-disorders-and-problems)\nTypes, causes, symptoms, and treatment for common sleep problems\n\n[![Silhouette of a person with long hair looking at a small, bright moon in a dark blue twilight sky.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2023\/02\/Sleep-Disorders-384x216.jpeg)](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-disorders-and-problems)\n\n[Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n\n### [How to Sleep Better](https:\/\/www.helpguide.org\/wellness\/sleep\/getting-better-sleep)\nTips to improve sleep quality\n\n[![Fuzzy pink blanket on a bed with grey pillows and warm string lights glowing in the background.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2023\/02\/How-to-Sleep-Better-384x256.jpeg)](https:\/\/www.helpguide.org\/wellness\/sleep\/getting-better-sleep)\n\n[Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n\n### [Sleep and Mental Health](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-and-mental-health)\nHow they’re closely connected\n\n[![A woman is seated rigidly on the edge of a bed after a restless night, staring at a window, illustrating the link between sleep and mental health.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2024\/11\/Sleep-and-Mental-Health-384x256.png)](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-and-mental-health)\n\n[Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n\n### [Sleeping Positions and Sleep Quality](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-positions-and-sleep-quality)\nHow sleep position can impact how well you rest\n\n[![A man and woman sleep side by side in a cosy, comfortable bed, illustrating how sleeping positions can affect sleep quality.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2024\/10\/How-Sleeping-Positions-Can-Affect-Sleep-Quality-384x255.jpg)](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-positions-and-sleep-quality)\n\n[Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n\n### [The Connection Between Sleep and ADHD](https:\/\/www.helpguide.org\/wellness\/sleep\/adhd-and-sleep)\nHow sleep impacts ADHD\n\n[![A woman struggles to sleep in a cozy bed, surrounded by soft pillows and blankets, illustrating the connection between sleep and ADHD.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2024\/09\/The-Connection-Between-Sleep-and-ADHD-384x258.jpg)](https:\/\/www.helpguide.org\/wellness\/sleep\/adhd-and-sleep)\n\n[Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n\n### [Parasomnias](https:\/\/www.helpguide.org\/wellness\/sleep\/parasomnias-types-causes-and-symptoms)\nTypes, causes, and symptoms\n\n[![A man standing in front of a cloud-filled doorway.](https:\/\/www.helpguide.org\/wp-content\/uploads\/2024\/07\/Parasomnias-Types-Causes-And-Symptoms-384x256.jpg)](https:\/\/www.helpguide.org\/wellness\/sleep\/parasomnias-types-causes-and-symptoms)\n\n[Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n\n### [Sleep Statistics](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-statistics)\nHow sleep impacts health and well-being\n\n[![Alarm clock resting on a bed side table](https:\/\/www.helpguide.org\/wp-content\/uploads\/2024\/06\/Sleep-Statistics-384x256.jpeg)](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-statistics)\n\nShare\n\nDownload PDF\n\n### More in Sleep\n[Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n\n### [Insomnia: What to Do When You Can't Sleep](https:\/\/www.helpguide.org\/wellness\/sleep\/insomnia-causes-and-cures)\nThe causes of insomnia, and what to do when you can’t sleep\n\n[Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n\n### [Sleep Disorders and Problems](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-disorders-and-problems)\nTypes, causes, symptoms, and treatment for common sleep problems\n\n[Sleep](https:\/\/www.helpguide.org\/wellness\/sleep)\n\n### [How to Sleep Better](https:\/\/www.helpguide.org\/wellness\/sleep\/getting-better-sleep)\nTips to improve sleep quality\n\n![](https:\/\/www.helpguide.org\/wp-content\/uploads\/2024\/02\/therapy-sidebar-384x229.jpg)\n\n#### Professional therapy, done online\nBetterHelp makes starting therapy easy. Take the assessment and get matched with a professional, licensed therapist.\n\n[Take Assessment](https:\/\/hasofferstracking.betterhelp.com\/aff_c?offer_id=2&aff_id=2729&source=helpguide)\n\n[HelpGuide is user supported. We may earn a commission from links you follow.](https:\/\/www.helpguide.org\/affiliate-disclosure)\n\n## Help us *help others*\nMillions of readers rely on HelpGuide.org for free, evidence-based resources to understand and navigate mental health challenges. 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Find helplines and other resources around the world.\n\n[Get Help](https:\/\/www.helpguide.org\/find-help)\n\n©1999-2026 HelpGuide.org   \n All rights reserved. HELPGUIDE.ORG INTERNATIONAL is a tax-exempt 501(c)3 organization (ID \\#45-4510670). Our content does not constitute a medical or psychological consultation. See a certified medical or mental health professional for diagnosis. [Learn more](https:\/\/www.helpguide.org\/terms-of-use).\n\n- [Terms of Use](https:\/\/www.helpguide.org\/terms-of-use)\n- [Privacy Policy](https:\/\/www.helpguide.org\/privacy-policy)\n- [Cookies Policy](https:\/\/www.helpguide.org\/cookie-policy)\n- [Affiliate Policy](https:\/\/www.helpguide.org\/affiliate-disclosure)","attrs_readable_markdown":"***Adapted with permission from [Improving Sleep: A Guide to a Good Night’s Rest](https:\/\/www.health.harvard.edu\/staying-healthy\/improving-sleep-a-guide-to-a-good-nights-rest), a special health report published by Harvard Health Publishing.***\n\n## If you’re not sleeping well, there may be a medical cause\nPeople who feel they sleep perfectly well may still be troubled by excessive daytime sleepiness because of a variety of underlying medical illnesses. A sleep disturbance may be a symptom of a health issue or an adverse effect of therapy to treat the problem. The stress of chronic illness can also cause insomnia and daytime drowsiness. Common conditions often associated with sleep problems include heartburn, diabetes, cardiovascular disease, musculoskeletal disorders, kidney disease, [mental health problems](https:\/\/www.helpguide.org\/wellness\/sleep\/sleep-and-mental-health), neurological disorders, respiratory problems, and thyroid disease. In addition, a number of prescription and over-the-counter medications used to treat these and other health problems can impair sleep quality and quantity (see table below).\n\n## Chronic physical conditions\n### Heartburn\nLying down in bed often worsens heartburn, which is caused by the backup of stomach acid into the esophagus. You may be able to avoid this problem by abstaining from heavy or fatty foods—as well as coffee and alcohol—in the evening. You can also use gravity to your advantage by elevating your upper body with an under-mattress wedge or blocks placed under the bedposts. Over-the-counter and prescription drugs that suppress stomach acid secretion can also help.\n\n### Diabetes\nDiabetes is a common, chronic disorder marked by elevated levels of blood glucose, or sugar. It occurs when your cells don’t respond appropriately to insulin (a hormone secreted by the pancreas), and when your pancreas can’t produce more insulin in response. People with diabetes whose blood sugar levels are not well controlled may experience sleep problems due to:\n\n- night sweats\n- a frequent need to urinate, or\n- symptoms of hypoglycemia (low blood sugar)\n\nIf diabetes has damaged nerves in the legs, nighttime movements or pain may also disturb sleep.\n\n### Heart failure\nHeart failure is a condition characterized by a gradual decline in the heart’s ability to “pump”, or circulate blood adequately. Heart failure can cause fluid to build up in the lungs and tissues. Patients with heart failure may awaken during the night feeling short of breath because extra body fluid accumulates around their lungs when they’re lying down. Using pillows to elevate the upper body may help. These people can also be awakened just as they are falling asleep by a characteristic breathing pattern called Cheyne-Stokes respiration, a series of increasingly deep breaths followed by a brief cessation of breathing.\n\nBenzodiazepine sleep medications help some people to stay asleep despite this breathing disturbance, but others may need to use supplementary oxygen or a device that increases pressure in the upper airway and chest cavity to help them breathe and sleep more normally.\n\nMen with heart failure frequently have obstructive sleep apnea—a breathing disorder characterized by multiple nighttime awakenings—which can disrupt sleep, cause daytime sleepiness, and worsen heart failure. In people with coronary artery disease, the natural fluctuations in circadian rhythms may trigger angina (chest pain), arrhythmia (irregular heartbeat), or even heart attack while asleep.\n\n### Musculoskeletal disorders\nArthritis pain can make it hard for people to fall asleep and to resettle when they shift positions. In addition, treatment with steroids frequently causes insomnia. You may find it helpful to take aspirin or a nonsteroidal anti-inflammatory drug (NSAID) just before bedtime to relieve pain and swelling in your joints during the night.\n\n[\\[Read: Chronic Pain and Mental Health\\]](https:\/\/www.helpguide.org\/wellness\/health-conditions\/chronic-pain-and-mental-health)\n\nPeople with fibromyalgia—a condition characterized by painful ligaments and tendons—are likely to wake in the morning still feeling fatigued and as stiff and achy as a person with arthritis. Researchers who analyzed the sleep of fibromyalgia sufferers have found that at least half have abnormal deep sleep, in which slow brain waves are mixed with waves usually associated with relaxed wakefulness, a pattern called alpha-delta sleep.\n\n### Kidney disease\nPeople with kidney disease have kidneys that are damaged to the extent that they can no longer filter fluids, remove wastes, and keep electrolytes in balance as efficiently as they did when healthy. Kidney disease can cause waste products to build up in the blood and can result in insomnia or symptoms of restless legs syndrome. Although researchers aren’t sure why, kidney dialysis or transplant does not always return sleep to normal.\n\n### Nocturia\nNocturia is the need to get up frequently to urinate during the night. It is a common cause of sleep loss, especially among older adults. A mild case causes a person to wake up at least twice during the night; in severe cases, a person may get up as many as five or six times.\n\nNocturia may be a product of age, but other causes include certain medical conditions (heart failure, diabetes, urinary tract infection, an enlarged prostate, liver failure, multiple sclerosis, sleep apnea), medication (especially diuretics), and excessive fluid intake after dinner.\n\nTherapies for nocturia fall into three categories:\n\n- treatments to correct medical causes\n- behavioral interventions\n- medication\n\nThe first step is to try to identify the cause and correct it. If this is unsuccessful, try behavioral  \napproaches such as cutting down on how much you drink in the two hours before bedtime, especially caffeine and alcohol. If the nocturia persists, your doctor may prescribe one of a growing number of medications approved to treat an overactive bladder.\n\n### Thyroid disease\nAn overactive thyroid gland (hyperthyroidism) can cause sleep problems. The disorder overstimulates the nervous system, making it hard to fall asleep, and it may cause night sweats, leading to nighttime arousals. Feeling cold and sleepy is a hallmark of an underactive thyroid (hypothyroidism).\n\nBecause thyroid function affects every organ and system in the body, the symptoms can be wide-ranging and sometimes difficult to decipher. Checking thyroid function requires only a simple blood test, so if you notice a variety of unexplained symptoms, ask your doctor for a thyroid test.\n\n### Breathing problems\nCircadian-related changes in the tone of the muscles surrounding the airways can cause the airways to constrict during the night, raising the potential for nocturnal asthma attacks that rouse the sleeper abruptly.\n\nBreathing difficulties or fear of having an attack may make it more difficult to fall asleep, as can the use of steroids or other breathing medications that also have a stimulating effect, similar to that of caffeine.\n\nPeople who have emphysema or bronchitis may also have difficulty falling and staying asleep because of excess sputum production, shortness of breath, and coughing.\n\n#### Speak to a Licensed Therapist\nBetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours.\n\n[Take Assessment](https:\/\/hasofferstracking.betterhelp.com\/aff_c?offer_id=2&aff_id=2729&source=helpguide) HelpGuide is user supported. We earn a commission if you sign up for BetterHelp’s services after clicking through from this site.  [Learn more](https:\/\/www.helpguide.org\/affiliate-disclosure)\n## Medications\n![Medications that may impact sleep](https:\/\/www.helpguide.org\/wp-content\/uploads\/medications-that-may-impact-sleep-700.jpg)\n\n## Mental health disorders\nAlmost all people with anxiety or depression have trouble falling asleep and staying asleep. In turn, not being able to sleep may become a focus of some sufferers’ ongoing fear and tension, causing further sleep loss.\n\n### General anxiety\nSevere anxiety, also known as generalized anxiety disorder, is characterized by persistent, nagging feelings of worry, apprehension, or uneasiness. These feelings are either unusually intense or out of proportion to the real troubles and dangers of the person’s everyday life.\n\nPeople with general anxiety typically experience excessive, persistent worry every day or almost every day for a period of six months or more. Common symptoms include trouble falling asleep, trouble staying asleep, and not feeling rested after sleep.\n\n### Phobias and panic attacks\nPhobias, which are intense fears related to a specific object or situation, rarely cause sleep problems unless the phobia is itself sleep-related (such as fear of nightmares or of the bedroom). Panic attacks, on the other hand, often strike at night. In fact, the timing of nocturnal attacks helped convince psychiatrists that these episodes are biologically based.\n\nSleep-related panic attacks do not occur during dreaming, but rather in stage N2 (light sleep) and stage N3 (deep sleep), which are free of psychological triggers. In many phobias and panic disorders, recognizing and treating the underlying problem—often with an anti-anxiety medication—may solve the sleep disturbance.\n\n### Depression\nBecause almost 90% of people with serious depression experience insomnia, a physician evaluating a person with insomnia will consider depression as a possible cause. Waking up too early in the morning is a hallmark of depression, and some depressed people have difficulty falling asleep or get fitful sleep throughout the whole night.\n\nIn chronic, low-grade depression (also known as dysthymia), insomnia or sleepiness may be the most prominent symptom. Laboratory studies have shown that people who are depressed spend less time in slow-wave sleep and may enter REM sleep more quickly at the beginning of the night.\n\n### Bipolar disorder\nDisturbed sleep is a prominent feature of bipolar disorder (also known as manic-depressive illness). Sleep loss may exacerbate or induce manic symptoms or temporarily alleviate depression. During a manic episode, a person may not sleep at all for several days. Such occurrences are often followed by a “crash” during which the person spends most of the next few days in bed.\n\n### Schizophrenia\nSome people with schizophrenia sleep very little in the early, most severe stage of an episode. Between episodes, their sleep patterns are likely to improve, although many people with schizophrenia rarely obtain a normal amount of deep sleep.\n\n## Neurological disorders\nCertain brain and nerve disorders can contribute to sleeplessness.\n\n### Dementia\nAlzheimer’s disease and other forms of dementia may disrupt sleep regulation and other brain functions. Wandering, disorientation, and agitation during the evening and night, a phenomenon known as “sundowning,” can require constant supervision and place great stress on caregivers. In such cases, small doses of antipsychotic medications are more helpful than benzodiazepine drugs.\n\n### Epilepsy\nPeople with epilepsy—a condition in which a person is prone to seizures—are twice as likely as others to suffer from insomnia. Brain wave disturbances that cause seizures can also cause deficits in slow-wave sleep or REM sleep. Antiseizure drugs can cause similar changes at first, but tend to correct these sleep disturbances when used for a long time.\n\nAbout one in four people with epilepsy has seizures that occur mainly at night, causing disturbed sleep and daytime sleepiness. Sleep deprivation can also trigger a seizure, a phenomenon noted in college infirmaries during exam periods, as some students suffer their first seizures after staying up late to study.\n\n### Headaches, strokes, and tumors\nPeople who are prone to headaches should try to avoid sleep deprivation, as lack of sleep can promote headaches. Both cluster headaches and migraines may be related to changes in the size of blood vessels leading to the cortex of the brain; pain occurs when the walls of the blood vessels dilate.\n\nResearchers theorize that as the body catches up on missed sleep, it spends more time in delta sleep, when vessels are most constricted, making the transition to REM sleep more dramatic and likely to induce a headache. Headaches that awaken people are often migraines, but some migraines can be relieved by sleep. Sleepiness coupled with dizziness, weakness, headache, or vision problems may signal a serious problem such as a brain tumor or stroke, which requires immediate medical attention.\n\n### Parkinson’s disease\nAlmost all people with Parkinson’s disease have insomnia. Just getting in and out of bed can be a struggle, and the disease often disrupts sleep. Some arousals are from the tremors and movements caused by the disorder, and others seem to result from the disorder itself. As a result, daytime sleepiness is common.\n\nTreatment with sleeping pills may be difficult because some drugs can worsen Parkinson’s symptoms. Some patients who take drugs used to treat Parkinson’s treatment may develop severe nightmares; others experience disruption of REM sleep. However, the use of these medications at night is important to maintain the mobility needed to change positions in bed. A bed rail or an overhead bar (known as a trapeze) may make it easier for people with Parkinson’s to move about and, therefore, lead to better sleep.\n\n***Adapted with permission from [Improving Sleep: A Guide to a Good Night’s Rest](https:\/\/www.health.harvard.edu\/staying-healthy\/improving-sleep-a-guide-to-a-good-nights-rest), a special health report published by Harvard Health Publishing.***","meta_canonical":null}

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Boilerpipe Text	Adapted with permission from Improving Sleep: A Guide to a Good Night’s Rest , a special health report published by Harvard Health Publishing. If you’re not sleeping well, there may be a medical cause People who feel they sleep perfectly well may still be troubled by excessive daytime sleepiness because of a variety of underlying medical illnesses. A sleep disturbance may be a symptom of a health issue or an adverse effect of therapy to treat the problem. The stress of chronic illness can also cause insomnia and daytime drowsiness. Common conditions often associated with sleep problems include heartburn, diabetes, cardiovascular disease, musculoskeletal disorders, kidney disease, mental health problems , neurological disorders, respiratory problems, and thyroid disease. In addition, a number of prescription and over-the-counter medications used to treat these and other health problems can impair sleep quality and quantity (see table below). Chronic physical conditions Heartburn Lying down in bed often worsens heartburn, which is caused by the backup of stomach acid into the esophagus. You may be able to avoid this problem by abstaining from heavy or fatty foods—as well as coffee and alcohol—in the evening. You can also use gravity to your advantage by elevating your upper body with an under-mattress wedge or blocks placed under the bedposts. Over-the-counter and prescription drugs that suppress stomach acid secretion can also help. Diabetes Diabetes is a common, chronic disorder marked by elevated levels of blood glucose, or sugar. It occurs when your cells don’t respond appropriately to insulin (a hormone secreted by the pancreas), and when your pancreas can’t produce more insulin in response. People with diabetes whose blood sugar levels are not well controlled may experience sleep problems due to: night sweats a frequent need to urinate, or symptoms of hypoglycemia (low blood sugar) If diabetes has damaged nerves in the legs, nighttime movements or pain may also disturb sleep. Heart failure Heart failure is a condition characterized by a gradual decline in the heart’s ability to “pump”, or circulate blood adequately. Heart failure can cause fluid to build up in the lungs and tissues. Patients with heart failure may awaken during the night feeling short of breath because extra body fluid accumulates around their lungs when they’re lying down. Using pillows to elevate the upper body may help. These people can also be awakened just as they are falling asleep by a characteristic breathing pattern called Cheyne-Stokes respiration, a series of increasingly deep breaths followed by a brief cessation of breathing. Benzodiazepine sleep medications help some people to stay asleep despite this breathing disturbance, but others may need to use supplementary oxygen or a device that increases pressure in the upper airway and chest cavity to help them breathe and sleep more normally. Men with heart failure frequently have obstructive sleep apnea—a breathing disorder characterized by multiple nighttime awakenings—which can disrupt sleep, cause daytime sleepiness, and worsen heart failure. In people with coronary artery disease, the natural fluctuations in circadian rhythms may trigger angina (chest pain), arrhythmia (irregular heartbeat), or even heart attack while asleep. Musculoskeletal disorders Arthritis pain can make it hard for people to fall asleep and to resettle when they shift positions. In addition, treatment with steroids frequently causes insomnia. You may find it helpful to take aspirin or a nonsteroidal anti-inflammatory drug (NSAID) just before bedtime to relieve pain and swelling in your joints during the night. [Read: Chronic Pain and Mental Health] People with fibromyalgia—a condition characterized by painful ligaments and tendons—are likely to wake in the morning still feeling fatigued and as stiff and achy as a person with arthritis. Researchers who analyzed the sleep of fibromyalgia sufferers have found that at least half have abnormal deep sleep, in which slow brain waves are mixed with waves usually associated with relaxed wakefulness, a pattern called alpha-delta sleep. Kidney disease People with kidney disease have kidneys that are damaged to the extent that they can no longer filter fluids, remove wastes, and keep electrolytes in balance as efficiently as they did when healthy. Kidney disease can cause waste products to build up in the blood and can result in insomnia or symptoms of restless legs syndrome. Although researchers aren’t sure why, kidney dialysis or transplant does not always return sleep to normal. Nocturia Nocturia is the need to get up frequently to urinate during the night. It is a common cause of sleep loss, especially among older adults. A mild case causes a person to wake up at least twice during the night; in severe cases, a person may get up as many as five or six times. Nocturia may be a product of age, but other causes include certain medical conditions (heart failure, diabetes, urinary tract infection, an enlarged prostate, liver failure, multiple sclerosis, sleep apnea), medication (especially diuretics), and excessive fluid intake after dinner. Therapies for nocturia fall into three categories: treatments to correct medical causes behavioral interventions medication The first step is to try to identify the cause and correct it. If this is unsuccessful, try behavioral approaches such as cutting down on how much you drink in the two hours before bedtime, especially caffeine and alcohol. If the nocturia persists, your doctor may prescribe one of a growing number of medications approved to treat an overactive bladder. Thyroid disease An overactive thyroid gland (hyperthyroidism) can cause sleep problems. The disorder overstimulates the nervous system, making it hard to fall asleep, and it may cause night sweats, leading to nighttime arousals. Feeling cold and sleepy is a hallmark of an underactive thyroid (hypothyroidism). Because thyroid function affects every organ and system in the body, the symptoms can be wide-ranging and sometimes difficult to decipher. Checking thyroid function requires only a simple blood test, so if you notice a variety of unexplained symptoms, ask your doctor for a thyroid test. Breathing problems Circadian-related changes in the tone of the muscles surrounding the airways can cause the airways to constrict during the night, raising the potential for nocturnal asthma attacks that rouse the sleeper abruptly. Breathing difficulties or fear of having an attack may make it more difficult to fall asleep, as can the use of steroids or other breathing medications that also have a stimulating effect, similar to that of caffeine. People who have emphysema or bronchitis may also have difficulty falling and staying asleep because of excess sputum production, shortness of breath, and coughing. Speak to a Licensed Therapist BetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours. Take Assessment HelpGuide is user supported. We earn a commission if you sign up for BetterHelp’s services after clicking through from this site. Learn more Medications Mental health disorders Almost all people with anxiety or depression have trouble falling asleep and staying asleep. In turn, not being able to sleep may become a focus of some sufferers’ ongoing fear and tension, causing further sleep loss. General anxiety Severe anxiety, also known as generalized anxiety disorder, is characterized by persistent, nagging feelings of worry, apprehension, or uneasiness. These feelings are either unusually intense or out of proportion to the real troubles and dangers of the person’s everyday life. People with general anxiety typically experience excessive, persistent worry every day or almost every day for a period of six months or more. Common symptoms include trouble falling asleep, trouble staying asleep, and not feeling rested after sleep. Phobias and panic attacks Phobias, which are intense fears related to a specific object or situation, rarely cause sleep problems unless the phobia is itself sleep-related (such as fear of nightmares or of the bedroom). Panic attacks, on the other hand, often strike at night. In fact, the timing of nocturnal attacks helped convince psychiatrists that these episodes are biologically based. Sleep-related panic attacks do not occur during dreaming, but rather in stage N2 (light sleep) and stage N3 (deep sleep), which are free of psychological triggers. In many phobias and panic disorders, recognizing and treating the underlying problem—often with an anti-anxiety medication—may solve the sleep disturbance. Depression Because almost 90% of people with serious depression experience insomnia, a physician evaluating a person with insomnia will consider depression as a possible cause. Waking up too early in the morning is a hallmark of depression, and some depressed people have difficulty falling asleep or get fitful sleep throughout the whole night. In chronic, low-grade depression (also known as dysthymia), insomnia or sleepiness may be the most prominent symptom. Laboratory studies have shown that people who are depressed spend less time in slow-wave sleep and may enter REM sleep more quickly at the beginning of the night. Bipolar disorder Disturbed sleep is a prominent feature of bipolar disorder (also known as manic-depressive illness). Sleep loss may exacerbate or induce manic symptoms or temporarily alleviate depression. During a manic episode, a person may not sleep at all for several days. Such occurrences are often followed by a “crash” during which the person spends most of the next few days in bed. Schizophrenia Some people with schizophrenia sleep very little in the early, most severe stage of an episode. Between episodes, their sleep patterns are likely to improve, although many people with schizophrenia rarely obtain a normal amount of deep sleep. Neurological disorders Certain brain and nerve disorders can contribute to sleeplessness. Dementia Alzheimer’s disease and other forms of dementia may disrupt sleep regulation and other brain functions. Wandering, disorientation, and agitation during the evening and night, a phenomenon known as “sundowning,” can require constant supervision and place great stress on caregivers. In such cases, small doses of antipsychotic medications are more helpful than benzodiazepine drugs. Epilepsy People with epilepsy—a condition in which a person is prone to seizures—are twice as likely as others to suffer from insomnia. Brain wave disturbances that cause seizures can also cause deficits in slow-wave sleep or REM sleep. Antiseizure drugs can cause similar changes at first, but tend to correct these sleep disturbances when used for a long time. About one in four people with epilepsy has seizures that occur mainly at night, causing disturbed sleep and daytime sleepiness. Sleep deprivation can also trigger a seizure, a phenomenon noted in college infirmaries during exam periods, as some students suffer their first seizures after staying up late to study. Headaches, strokes, and tumors People who are prone to headaches should try to avoid sleep deprivation, as lack of sleep can promote headaches. Both cluster headaches and migraines may be related to changes in the size of blood vessels leading to the cortex of the brain; pain occurs when the walls of the blood vessels dilate. Researchers theorize that as the body catches up on missed sleep, it spends more time in delta sleep, when vessels are most constricted, making the transition to REM sleep more dramatic and likely to induce a headache. Headaches that awaken people are often migraines, but some migraines can be relieved by sleep. Sleepiness coupled with dizziness, weakness, headache, or vision problems may signal a serious problem such as a brain tumor or stroke, which requires immediate medical attention. Parkinson’s disease Almost all people with Parkinson’s disease have insomnia. Just getting in and out of bed can be a struggle, and the disease often disrupts sleep. Some arousals are from the tremors and movements caused by the disorder, and others seem to result from the disorder itself. As a result, daytime sleepiness is common. Treatment with sleeping pills may be difficult because some drugs can worsen Parkinson’s symptoms. Some patients who take drugs used to treat Parkinson’s treatment may develop severe nightmares; others experience disruption of REM sleep. However, the use of these medications at night is important to maintain the mobility needed to change positions in bed. A bed rail or an overhead bar (known as a trapeze) may make it easier for people with Parkinson’s to move about and, therefore, lead to better sleep. Adapted with permission from Improving Sleep: A Guide to a Good Night’s Rest , a special health report published by Harvard Health Publishing.
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Here’s how to spot if a medical cause is keeping you up at night. ![A digital alarm clock displaying 11:56 sits on a wooden nightstand cluttered with books, a lamp, and headphones next to a bed.](https://www.helpguide.org/wp-content/uploads/2023/02/Medical-Causes-of-Sleep-Problems-1200x800.jpeg) By [Harvard Health](https://www.helpguide.org/bio/harvard-health) - If you're not sleeping well, there may be a medical cause - Chronic physical conditions - Medications - Mental health disorders - Neurological disorders *Adapted with permission from [Improving Sleep: A Guide to a Good Night’s Rest](https://www.health.harvard.edu/staying-healthy/improving-sleep-a-guide-to-a-good-nights-rest), a special health report published by Harvard Health Publishing.* ## If you’re not sleeping well, there may be a medical cause People who feel they sleep perfectly well may still be troubled by excessive daytime sleepiness because of a variety of underlying medical illnesses. A sleep disturbance may be a symptom of a health issue or an adverse effect of therapy to treat the problem. The stress of chronic illness can also cause insomnia and daytime drowsiness. Common conditions often associated with sleep problems include heartburn, diabetes, cardiovascular disease, musculoskeletal disorders, kidney disease, [mental health problems](https://www.helpguide.org/wellness/sleep/sleep-and-mental-health), neurological disorders, respiratory problems, and thyroid disease. In addition, a number of prescription and over-the-counter medications used to treat these and other health problems can impair sleep quality and quantity (see table below). ## Chronic physical conditions ### Heartburn Lying down in bed often worsens heartburn, which is caused by the backup of stomach acid into the esophagus. You may be able to avoid this problem by abstaining from heavy or fatty foods—as well as coffee and alcohol—in the evening. You can also use gravity to your advantage by elevating your upper body with an under-mattress wedge or blocks placed under the bedposts. Over-the-counter and prescription drugs that suppress stomach acid secretion can also help. ### Diabetes Diabetes is a common, chronic disorder marked by elevated levels of blood glucose, or sugar. It occurs when your cells don’t respond appropriately to insulin (a hormone secreted by the pancreas), and when your pancreas can’t produce more insulin in response. People with diabetes whose blood sugar levels are not well controlled may experience sleep problems due to: - night sweats - a frequent need to urinate, or - symptoms of hypoglycemia (low blood sugar) If diabetes has damaged nerves in the legs, nighttime movements or pain may also disturb sleep. ### Heart failure Heart failure is a condition characterized by a gradual decline in the heart’s ability to “pump”, or circulate blood adequately. Heart failure can cause fluid to build up in the lungs and tissues. Patients with heart failure may awaken during the night feeling short of breath because extra body fluid accumulates around their lungs when they’re lying down. Using pillows to elevate the upper body may help. These people can also be awakened just as they are falling asleep by a characteristic breathing pattern called Cheyne-Stokes respiration, a series of increasingly deep breaths followed by a brief cessation of breathing. Benzodiazepine sleep medications help some people to stay asleep despite this breathing disturbance, but others may need to use supplementary oxygen or a device that increases pressure in the upper airway and chest cavity to help them breathe and sleep more normally. Men with heart failure frequently have obstructive sleep apnea—a breathing disorder characterized by multiple nighttime awakenings—which can disrupt sleep, cause daytime sleepiness, and worsen heart failure. In people with coronary artery disease, the natural fluctuations in circadian rhythms may trigger angina (chest pain), arrhythmia (irregular heartbeat), or even heart attack while asleep. ### Musculoskeletal disorders Arthritis pain can make it hard for people to fall asleep and to resettle when they shift positions. In addition, treatment with steroids frequently causes insomnia. You may find it helpful to take aspirin or a nonsteroidal anti-inflammatory drug (NSAID) just before bedtime to relieve pain and swelling in your joints during the night. [\[Read: Chronic Pain and Mental Health\]](https://www.helpguide.org/wellness/sleep/%20https://www.helpguide.org/wellness/health-conditions/chronic-pain-and-mental-health) People with fibromyalgia—a condition characterized by painful ligaments and tendons—are likely to wake in the morning still feeling fatigued and as stiff and achy as a person with arthritis. Researchers who analyzed the sleep of fibromyalgia sufferers have found that at least half have abnormal deep sleep, in which slow brain waves are mixed with waves usually associated with relaxed wakefulness, a pattern called alpha-delta sleep. ### Kidney disease People with kidney disease have kidneys that are damaged to the extent that they can no longer filter fluids, remove wastes, and keep electrolytes in balance as efficiently as they did when healthy. Kidney disease can cause waste products to build up in the blood and can result in insomnia or symptoms of restless legs syndrome. Although researchers aren’t sure why, kidney dialysis or transplant does not always return sleep to normal. ### Nocturia Nocturia is the need to get up frequently to urinate during the night. It is a common cause of sleep loss, especially among older adults. A mild case causes a person to wake up at least twice during the night; in severe cases, a person may get up as many as five or six times. Nocturia may be a product of age, but other causes include certain medical conditions (heart failure, diabetes, urinary tract infection, an enlarged prostate, liver failure, multiple sclerosis, sleep apnea), medication (especially diuretics), and excessive fluid intake after dinner. Therapies for nocturia fall into three categories: - treatments to correct medical causes - behavioral interventions - medication The first step is to try to identify the cause and correct it. If this is unsuccessful, try behavioral approaches such as cutting down on how much you drink in the two hours before bedtime, especially caffeine and alcohol. If the nocturia persists, your doctor may prescribe one of a growing number of medications approved to treat an overactive bladder. ### Thyroid disease An overactive thyroid gland (hyperthyroidism) can cause sleep problems. The disorder overstimulates the nervous system, making it hard to fall asleep, and it may cause night sweats, leading to nighttime arousals. Feeling cold and sleepy is a hallmark of an underactive thyroid (hypothyroidism). Because thyroid function affects every organ and system in the body, the symptoms can be wide-ranging and sometimes difficult to decipher. Checking thyroid function requires only a simple blood test, so if you notice a variety of unexplained symptoms, ask your doctor for a thyroid test. ### Breathing problems Circadian-related changes in the tone of the muscles surrounding the airways can cause the airways to constrict during the night, raising the potential for nocturnal asthma attacks that rouse the sleeper abruptly. Breathing difficulties or fear of having an attack may make it more difficult to fall asleep, as can the use of steroids or other breathing medications that also have a stimulating effect, similar to that of caffeine. People who have emphysema or bronchitis may also have difficulty falling and staying asleep because of excess sputum production, shortness of breath, and coughing. #### Speak to a Licensed Therapist BetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours. [Take Assessment](https://hasofferstracking.betterhelp.com/aff_c?offer_id=2&aff_id=2729&source=helpguide) HelpGuide is user supported. We earn a commission if you sign up for BetterHelp’s services after clicking through from this site. [Learn more](https://www.helpguide.org/affiliate-disclosure) ## Medications ![Medications that may impact sleep](https://www.helpguide.org/wp-content/uploads/medications-that-may-impact-sleep-700.jpg) ## Mental health disorders Almost all people with anxiety or depression have trouble falling asleep and staying asleep. In turn, not being able to sleep may become a focus of some sufferers’ ongoing fear and tension, causing further sleep loss. ### General anxiety Severe anxiety, also known as generalized anxiety disorder, is characterized by persistent, nagging feelings of worry, apprehension, or uneasiness. These feelings are either unusually intense or out of proportion to the real troubles and dangers of the person’s everyday life. People with general anxiety typically experience excessive, persistent worry every day or almost every day for a period of six months or more. Common symptoms include trouble falling asleep, trouble staying asleep, and not feeling rested after sleep. ### Phobias and panic attacks Phobias, which are intense fears related to a specific object or situation, rarely cause sleep problems unless the phobia is itself sleep-related (such as fear of nightmares or of the bedroom). Panic attacks, on the other hand, often strike at night. In fact, the timing of nocturnal attacks helped convince psychiatrists that these episodes are biologically based. Sleep-related panic attacks do not occur during dreaming, but rather in stage N2 (light sleep) and stage N3 (deep sleep), which are free of psychological triggers. In many phobias and panic disorders, recognizing and treating the underlying problem—often with an anti-anxiety medication—may solve the sleep disturbance. ### Depression Because almost 90% of people with serious depression experience insomnia, a physician evaluating a person with insomnia will consider depression as a possible cause. Waking up too early in the morning is a hallmark of depression, and some depressed people have difficulty falling asleep or get fitful sleep throughout the whole night. In chronic, low-grade depression (also known as dysthymia), insomnia or sleepiness may be the most prominent symptom. Laboratory studies have shown that people who are depressed spend less time in slow-wave sleep and may enter REM sleep more quickly at the beginning of the night. ### Bipolar disorder Disturbed sleep is a prominent feature of bipolar disorder (also known as manic-depressive illness). Sleep loss may exacerbate or induce manic symptoms or temporarily alleviate depression. During a manic episode, a person may not sleep at all for several days. Such occurrences are often followed by a “crash” during which the person spends most of the next few days in bed. ### Schizophrenia Some people with schizophrenia sleep very little in the early, most severe stage of an episode. Between episodes, their sleep patterns are likely to improve, although many people with schizophrenia rarely obtain a normal amount of deep sleep. ## Neurological disorders Certain brain and nerve disorders can contribute to sleeplessness. ### Dementia Alzheimer’s disease and other forms of dementia may disrupt sleep regulation and other brain functions. Wandering, disorientation, and agitation during the evening and night, a phenomenon known as “sundowning,” can require constant supervision and place great stress on caregivers. In such cases, small doses of antipsychotic medications are more helpful than benzodiazepine drugs. ### Epilepsy People with epilepsy—a condition in which a person is prone to seizures—are twice as likely as others to suffer from insomnia. Brain wave disturbances that cause seizures can also cause deficits in slow-wave sleep or REM sleep. Antiseizure drugs can cause similar changes at first, but tend to correct these sleep disturbances when used for a long time. About one in four people with epilepsy has seizures that occur mainly at night, causing disturbed sleep and daytime sleepiness. Sleep deprivation can also trigger a seizure, a phenomenon noted in college infirmaries during exam periods, as some students suffer their first seizures after staying up late to study. ### Headaches, strokes, and tumors People who are prone to headaches should try to avoid sleep deprivation, as lack of sleep can promote headaches. Both cluster headaches and migraines may be related to changes in the size of blood vessels leading to the cortex of the brain; pain occurs when the walls of the blood vessels dilate. Researchers theorize that as the body catches up on missed sleep, it spends more time in delta sleep, when vessels are most constricted, making the transition to REM sleep more dramatic and likely to induce a headache. Headaches that awaken people are often migraines, but some migraines can be relieved by sleep. Sleepiness coupled with dizziness, weakness, headache, or vision problems may signal a serious problem such as a brain tumor or stroke, which requires immediate medical attention. ### Parkinson’s disease Almost all people with Parkinson’s disease have insomnia. Just getting in and out of bed can be a struggle, and the disease often disrupts sleep. Some arousals are from the tremors and movements caused by the disorder, and others seem to result from the disorder itself. As a result, daytime sleepiness is common. Treatment with sleeping pills may be difficult because some drugs can worsen Parkinson’s symptoms. Some patients who take drugs used to treat Parkinson’s treatment may develop severe nightmares; others experience disruption of REM sleep. However, the use of these medications at night is important to maintain the mobility needed to change positions in bed. A bed rail or an overhead bar (known as a trapeze) may make it easier for people with Parkinson’s to move about and, therefore, lead to better sleep. *Adapted with permission from [Improving Sleep: A Guide to a Good Night’s Rest](https://www.health.harvard.edu/staying-healthy/improving-sleep-a-guide-to-a-good-nights-rest), a special health report published by Harvard Health Publishing.* [Copy Link](https://www.helpguide.org/wellness/sleep/medical-causes-of-sleep-problems) Link copied\! 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Readable Markdown	*Adapted with permission from [Improving Sleep: A Guide to a Good Night’s Rest](https://www.health.harvard.edu/staying-healthy/improving-sleep-a-guide-to-a-good-nights-rest), a special health report published by Harvard Health Publishing.* ## If you’re not sleeping well, there may be a medical cause People who feel they sleep perfectly well may still be troubled by excessive daytime sleepiness because of a variety of underlying medical illnesses. A sleep disturbance may be a symptom of a health issue or an adverse effect of therapy to treat the problem. The stress of chronic illness can also cause insomnia and daytime drowsiness. Common conditions often associated with sleep problems include heartburn, diabetes, cardiovascular disease, musculoskeletal disorders, kidney disease, [mental health problems](https://www.helpguide.org/wellness/sleep/sleep-and-mental-health), neurological disorders, respiratory problems, and thyroid disease. In addition, a number of prescription and over-the-counter medications used to treat these and other health problems can impair sleep quality and quantity (see table below). ## Chronic physical conditions ### Heartburn Lying down in bed often worsens heartburn, which is caused by the backup of stomach acid into the esophagus. You may be able to avoid this problem by abstaining from heavy or fatty foods—as well as coffee and alcohol—in the evening. You can also use gravity to your advantage by elevating your upper body with an under-mattress wedge or blocks placed under the bedposts. Over-the-counter and prescription drugs that suppress stomach acid secretion can also help. ### Diabetes Diabetes is a common, chronic disorder marked by elevated levels of blood glucose, or sugar. It occurs when your cells don’t respond appropriately to insulin (a hormone secreted by the pancreas), and when your pancreas can’t produce more insulin in response. People with diabetes whose blood sugar levels are not well controlled may experience sleep problems due to: - night sweats - a frequent need to urinate, or - symptoms of hypoglycemia (low blood sugar) If diabetes has damaged nerves in the legs, nighttime movements or pain may also disturb sleep. ### Heart failure Heart failure is a condition characterized by a gradual decline in the heart’s ability to “pump”, or circulate blood adequately. Heart failure can cause fluid to build up in the lungs and tissues. Patients with heart failure may awaken during the night feeling short of breath because extra body fluid accumulates around their lungs when they’re lying down. Using pillows to elevate the upper body may help. These people can also be awakened just as they are falling asleep by a characteristic breathing pattern called Cheyne-Stokes respiration, a series of increasingly deep breaths followed by a brief cessation of breathing. Benzodiazepine sleep medications help some people to stay asleep despite this breathing disturbance, but others may need to use supplementary oxygen or a device that increases pressure in the upper airway and chest cavity to help them breathe and sleep more normally. Men with heart failure frequently have obstructive sleep apnea—a breathing disorder characterized by multiple nighttime awakenings—which can disrupt sleep, cause daytime sleepiness, and worsen heart failure. In people with coronary artery disease, the natural fluctuations in circadian rhythms may trigger angina (chest pain), arrhythmia (irregular heartbeat), or even heart attack while asleep. ### Musculoskeletal disorders Arthritis pain can make it hard for people to fall asleep and to resettle when they shift positions. In addition, treatment with steroids frequently causes insomnia. You may find it helpful to take aspirin or a nonsteroidal anti-inflammatory drug (NSAID) just before bedtime to relieve pain and swelling in your joints during the night. [\[Read: Chronic Pain and Mental Health\]](https://www.helpguide.org/wellness/health-conditions/chronic-pain-and-mental-health) People with fibromyalgia—a condition characterized by painful ligaments and tendons—are likely to wake in the morning still feeling fatigued and as stiff and achy as a person with arthritis. Researchers who analyzed the sleep of fibromyalgia sufferers have found that at least half have abnormal deep sleep, in which slow brain waves are mixed with waves usually associated with relaxed wakefulness, a pattern called alpha-delta sleep. ### Kidney disease People with kidney disease have kidneys that are damaged to the extent that they can no longer filter fluids, remove wastes, and keep electrolytes in balance as efficiently as they did when healthy. Kidney disease can cause waste products to build up in the blood and can result in insomnia or symptoms of restless legs syndrome. Although researchers aren’t sure why, kidney dialysis or transplant does not always return sleep to normal. ### Nocturia Nocturia is the need to get up frequently to urinate during the night. It is a common cause of sleep loss, especially among older adults. A mild case causes a person to wake up at least twice during the night; in severe cases, a person may get up as many as five or six times. Nocturia may be a product of age, but other causes include certain medical conditions (heart failure, diabetes, urinary tract infection, an enlarged prostate, liver failure, multiple sclerosis, sleep apnea), medication (especially diuretics), and excessive fluid intake after dinner. Therapies for nocturia fall into three categories: - treatments to correct medical causes - behavioral interventions - medication The first step is to try to identify the cause and correct it. If this is unsuccessful, try behavioral approaches such as cutting down on how much you drink in the two hours before bedtime, especially caffeine and alcohol. If the nocturia persists, your doctor may prescribe one of a growing number of medications approved to treat an overactive bladder. ### Thyroid disease An overactive thyroid gland (hyperthyroidism) can cause sleep problems. The disorder overstimulates the nervous system, making it hard to fall asleep, and it may cause night sweats, leading to nighttime arousals. Feeling cold and sleepy is a hallmark of an underactive thyroid (hypothyroidism). Because thyroid function affects every organ and system in the body, the symptoms can be wide-ranging and sometimes difficult to decipher. Checking thyroid function requires only a simple blood test, so if you notice a variety of unexplained symptoms, ask your doctor for a thyroid test. ### Breathing problems Circadian-related changes in the tone of the muscles surrounding the airways can cause the airways to constrict during the night, raising the potential for nocturnal asthma attacks that rouse the sleeper abruptly. Breathing difficulties or fear of having an attack may make it more difficult to fall asleep, as can the use of steroids or other breathing medications that also have a stimulating effect, similar to that of caffeine. People who have emphysema or bronchitis may also have difficulty falling and staying asleep because of excess sputum production, shortness of breath, and coughing. #### Speak to a Licensed Therapist BetterHelp is an online therapy service that matches you to licensed, accredited therapists who can help with depression, anxiety, relationships, and more. Take the assessment and get matched with a therapist in as little as 48 hours. [Take Assessment](https://hasofferstracking.betterhelp.com/aff_c?offer_id=2&aff_id=2729&source=helpguide) HelpGuide is user supported. We earn a commission if you sign up for BetterHelp’s services after clicking through from this site. [Learn more](https://www.helpguide.org/affiliate-disclosure) ## Medications ![Medications that may impact sleep](https://www.helpguide.org/wp-content/uploads/medications-that-may-impact-sleep-700.jpg) ## Mental health disorders Almost all people with anxiety or depression have trouble falling asleep and staying asleep. In turn, not being able to sleep may become a focus of some sufferers’ ongoing fear and tension, causing further sleep loss. ### General anxiety Severe anxiety, also known as generalized anxiety disorder, is characterized by persistent, nagging feelings of worry, apprehension, or uneasiness. These feelings are either unusually intense or out of proportion to the real troubles and dangers of the person’s everyday life. People with general anxiety typically experience excessive, persistent worry every day or almost every day for a period of six months or more. Common symptoms include trouble falling asleep, trouble staying asleep, and not feeling rested after sleep. ### Phobias and panic attacks Phobias, which are intense fears related to a specific object or situation, rarely cause sleep problems unless the phobia is itself sleep-related (such as fear of nightmares or of the bedroom). Panic attacks, on the other hand, often strike at night. In fact, the timing of nocturnal attacks helped convince psychiatrists that these episodes are biologically based. Sleep-related panic attacks do not occur during dreaming, but rather in stage N2 (light sleep) and stage N3 (deep sleep), which are free of psychological triggers. In many phobias and panic disorders, recognizing and treating the underlying problem—often with an anti-anxiety medication—may solve the sleep disturbance. ### Depression Because almost 90% of people with serious depression experience insomnia, a physician evaluating a person with insomnia will consider depression as a possible cause. Waking up too early in the morning is a hallmark of depression, and some depressed people have difficulty falling asleep or get fitful sleep throughout the whole night. In chronic, low-grade depression (also known as dysthymia), insomnia or sleepiness may be the most prominent symptom. Laboratory studies have shown that people who are depressed spend less time in slow-wave sleep and may enter REM sleep more quickly at the beginning of the night. ### Bipolar disorder Disturbed sleep is a prominent feature of bipolar disorder (also known as manic-depressive illness). Sleep loss may exacerbate or induce manic symptoms or temporarily alleviate depression. During a manic episode, a person may not sleep at all for several days. Such occurrences are often followed by a “crash” during which the person spends most of the next few days in bed. ### Schizophrenia Some people with schizophrenia sleep very little in the early, most severe stage of an episode. Between episodes, their sleep patterns are likely to improve, although many people with schizophrenia rarely obtain a normal amount of deep sleep. ## Neurological disorders Certain brain and nerve disorders can contribute to sleeplessness. ### Dementia Alzheimer’s disease and other forms of dementia may disrupt sleep regulation and other brain functions. Wandering, disorientation, and agitation during the evening and night, a phenomenon known as “sundowning,” can require constant supervision and place great stress on caregivers. In such cases, small doses of antipsychotic medications are more helpful than benzodiazepine drugs. ### Epilepsy People with epilepsy—a condition in which a person is prone to seizures—are twice as likely as others to suffer from insomnia. Brain wave disturbances that cause seizures can also cause deficits in slow-wave sleep or REM sleep. Antiseizure drugs can cause similar changes at first, but tend to correct these sleep disturbances when used for a long time. About one in four people with epilepsy has seizures that occur mainly at night, causing disturbed sleep and daytime sleepiness. Sleep deprivation can also trigger a seizure, a phenomenon noted in college infirmaries during exam periods, as some students suffer their first seizures after staying up late to study. ### Headaches, strokes, and tumors People who are prone to headaches should try to avoid sleep deprivation, as lack of sleep can promote headaches. Both cluster headaches and migraines may be related to changes in the size of blood vessels leading to the cortex of the brain; pain occurs when the walls of the blood vessels dilate. Researchers theorize that as the body catches up on missed sleep, it spends more time in delta sleep, when vessels are most constricted, making the transition to REM sleep more dramatic and likely to induce a headache. Headaches that awaken people are often migraines, but some migraines can be relieved by sleep. Sleepiness coupled with dizziness, weakness, headache, or vision problems may signal a serious problem such as a brain tumor or stroke, which requires immediate medical attention. ### Parkinson’s disease Almost all people with Parkinson’s disease have insomnia. Just getting in and out of bed can be a struggle, and the disease often disrupts sleep. Some arousals are from the tremors and movements caused by the disorder, and others seem to result from the disorder itself. As a result, daytime sleepiness is common. Treatment with sleeping pills may be difficult because some drugs can worsen Parkinson’s symptoms. Some patients who take drugs used to treat Parkinson’s treatment may develop severe nightmares; others experience disruption of REM sleep. However, the use of these medications at night is important to maintain the mobility needed to change positions in bed. A bed rail or an overhead bar (known as a trapeze) may make it easier for people with Parkinson’s to move about and, therefore, lead to better sleep. *Adapted with permission from [Improving Sleep: A Guide to a Good Night’s Rest](https://www.health.harvard.edu/staying-healthy/improving-sleep-a-guide-to-a-good-nights-rest), a special health report published by Harvard Health Publishing.*
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