Sleep Disorders

Updated 11 August 2014

Insomnia: 10 medical causes

Tossing and turning? Your body could be trying to tell you something important. Here's what it could be.


If it’s not the neighbour’s cat yowling outside your window, there may be some internal cause that’s keeping you awake. Here are some of the many medical conditions that can cause regular bouts of broken sleep.

Below is a very short explanation, including a few possible related symptoms. To read in more detail about each condition, click on its name. And if you have any suspicion that your insomnia isn’t just a result of watching too many scary episodes of CSI at bedtime, go to the doctor.


An overactive thyroid gland is the most common cause of hyperthyroidism, in which an excess of thyroid hormones are produced. This can cause sleep disturbances because of the mental and physical changes that result from this hormone disruption.

Other possible symptoms of hyperthyroidism: tremors, anxiety, weight loss


Chronic sufferers from fibromyalgia are familiar with the aches and pain of muscles and around joints. While chronic pain obviously disrupts your peace at night, disturbed sleep patterns may be a cause rather than only a symptom of fibromyalgia.

Other possible symptoms of fibromyalgia: gastric disturbance, headaches

Gastroesophageal reflux disease

Gastro-Oesophageal Reflux (GORD) is the result of an abnormal relaxation of the muscle at the bottom of the oesophagus, which allows acid from the stomach to flow back into the oesophagus. This is often worse when lying down, causing discomfort that disturbs sleep.

Other possible symptoms of GORD: chest pain, weight loss, decreased appetite

Benign prostatic hyperplasia

If you’re an older man getting up to pee frequently at night, chances are the doctor will investigate whether you might have benign prostatic hyperplasia (BPH, an enlargement of the prostate gland.

Other symptoms of BPH: poor urine stream, feeling of bladder not emptying properly

Parkinson's disease

Thanks to Michael J Fox, we are all familiar with the body tremors that are the most obvious symptom of Parkinson's disease. The changes in the brain caused by the progression of the disease can cause sleep disturbances.

Other symptoms of Parkinson’s disease:  stiff muscle tone, slow movement (Bradykinesia)


Around 1 in 100 people is affected by epileptic seizures, described as sudden "electrical storms" in the brain. Epilepsy may disrupt sleep patterns, and lack of sleep may worsen symptoms of epilepsy.

Other symptoms of epilepsy: confusion, drowsiness, memory loss


Asthma is a chronic lung condition where the airways narrow, causing breathing to become obstructed. Some symptoms, especially coughing, can become worse at night, causing sleep disruption.

Other symptoms of asthma: coughing, wheezing, shortness of breath

Rheumatoid arthritis

Inflammation that causes aching, pain and stiffness in joints often gets worse with age. Somestatistics show that 72% of people over the age of 55 who have arthritis have some sort of sleep difficulty

Other symptoms of rheumatoid arthritis: stiffness, pain and tenderness in the joints

Urinary tract infection

Many women are familiar with the discomfort of an infection of the urinary tract, often caused by the presence of e-coli or other bacteria. Sleep can often become disrupted due to discomfort and an increased need to get up to urinate.

Other symptoms of cystitis: frequent need to urinate, abdominal pain, nausea

Heart failure

Heart failure, most often a symptom of existing heart problems, is the inability of the heart to circulate blood properly. A person who is experiencing heart failure may be disturbed at night when they wake up feeling short of breath, and may also need to urinate frequently.

Other symptoms of heart failure: shortness of breath, coughing, weakness and fluid build-up.

There are other conditions that might be associated to insomnia, so be aware that a combination of ongoing sleeplessness and any other symptoms should be investigated.

(Adele Hamilton, Health24, 2011) 


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Sleep disorders expert

Dr Alison Bentley is a general practitioner who has consulted in sleep medicine and sleep disorders, in both adults and children of all ages, for almost 30 years. She also researches and publishes on a number of sleep-related topics both in formal research journals and lay publications including as editor of Sleep Matters, an educational newsletter on sleep disorders for doctors.

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