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   [Ask a Doctor Online Now](https://www.icliniq.com/ask-a-doctor-online/general-medicine-physician) [Home](https://www.icliniq.com/) [Answers](https://www.icliniq.com/qa) [General Medicine](https://www.icliniq.com/qa/specialities/general-medicine-physician) [sleep disturbances](https://www.icliniq.com/qa/sleep-disturbances) # What could cause difficulty in sleeping? This [Premium Q\&A,](https://www.icliniq.com/p/editorial-policy#premium-qa) reviewed and published, features a real conversation between an iCliniq user and a physician. Answered by[Dr. Aremu Olumide Moses](https://www.icliniq.com/doctor/dr-moses-o-aremu) Medically reviewed by[iCliniq medical review team](https://www.icliniq.com/medical-team) April 5, 2024 Published on July 2, 2024 Last reviewed on Patient's Query Hello doctor, I am 44 years old, and for the past several months, I have been dealing with constant sleep deprivation. I lie in bed for hours, unable to shut my mind off, and even when I do manage to fall asleep, I wake up multiple times during the night. I am constantly fatigued, and irritable, and my ability to concentrate during the day is practically non-existent. I have tried all the over-the-counter sleep aids, established a bedtime routine, and even eliminated caffeine, but nothing seems to be working. Could this be a symptom of a more serious issue? What steps should I take to identify the root cause, and what treatment options are available? Kindly suggest. Ad [Answered by Dr. Aremu Olumide Moses](https://www.icliniq.com/doctor/dr-moses-o-aremu) Verified by iCliniq Hello, Welcome to icliniq.com. I understand your concern. Kindly answer the following for better suggestions: 1\. Do you check your blood pressure regularly? 2\. Are you hypertensive? 3\. Any history of excessive alcohol consumption or use of hard drugs, caffeine, or tobacco? 4\. Any significant incident before the onset of insomnia? 5\. How long have you been unable to sleep? 6\. Do you sleep during the day? 7\. Are you on any medications presently? 8\. Any shortness of breath? 9\. What over-the-counter sedative-hypnotics have you been consuming and for how long? 10\. What does your daily food intake consist of? I would suggest you keep a sleep log for two weeks, which consists of the time you go to bed when you get out of bed, and how long you are unable to sleep. This should be documented. Insomnia is a very common symptom and requires further medical evaluation when it becomes chronic. Thank you. The Probable causes Schizophrenia, high blood pressure, or COPD (chronic obstructive pulmonary disease). Investigations to be done Studies for hypoxemia, and monitoring blood pressure. Treatment plan Tablet Bromazepam 1.5mg at night for five days. Exercise at least six hours before sleep. Avoid gadgets and technological appliances before bedtime. Eat at least three hours before bedtime. Check blood pressure once a day and document. Was this conversation helpful? Share Same symptoms don't mean you have the same problem. 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Hello, Welcome to icliniq.com. I understand your concern. Kindly answer the following for better suggestions: 1\. Do you check your blood pressure regularly? 2\. Are you hypertensive? 3\. Any history of excessive alcohol consumption or use of hard drugs, caffeine, or tobacco? 4\. Any significant incident before the onset of insomnia? 5\. How long have you been unable to sleep? 6\. Do you sleep during the day? 7\. Are you on any medications presently? 8\. Any shortness of breath? 9\. What over-the-counter sedative-hypnotics have you been consuming and for how long? 10\. What does your daily food intake consist of? I would suggest you keep a sleep log for two weeks, which consists of the time you go to bed when you get out of bed, and how long you are unable to sleep. This should be documented. Insomnia is a very common symptom and requires further medical evaluation when it becomes chronic. Thank you. The Probable causes Schizophrenia, high blood pressure, or COPD (chronic obstructive pulmonary disease). Investigations to be done Studies for hypoxemia, and monitoring blood pressure. Treatment plan Tablet Bromazepam 1.5mg at night for five days. Exercise at least six hours before sleep. Avoid gadgets and technological appliances before bedtime. Eat at least three hours before bedtime. Check blood pressure once a day and document.