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Causes of Insomnia

A person can have primary or secondary insomnia. Primary insomnia is sleeplessness that is not attributable to a medical or environmental cause. Secondary insomnia means that a person is having sleep problems because of something else, such as a health condition, an example of which would be generalized anxiety disorder.

Some of the most common causes of insomnia are:

Sleep Apnea is a condition that occurs when a sleeping person's breathing is interrupted, thus interrupting the normal sleep cycle. With the obstructive form of the condition, some part of the sleeper's respiratory tract loses muscle tone and partially collapses. People with obstructive sleep apnea often do not remember any of this, but they complain of excessive sleepiness during the day. Central sleep apnea interrupts the normal breathing stimulus of the central nervous system, and the individual must actually wake up to resume breathing. This form of apnea is often related to a cerebral vascular condition, congestive heart failure, and premature aging.
Circadian rhythm sleep disorders cause insomnia at some times of the day and excessive sleepiness at other times of the day. Common circadian rhythm sleep disorders include jet lag and delayed sleep phase syndrome. Jet lag is seen in people who travel through multiple time zones, as the time relative to the rising and falling of the sun no longer coincides with the body's internal concept of it. The insomnia experienced by shift workers is also a circadian rhythm sleep disorder.
Parasomnia includes a number of disorders of arousal or disruptive sleep events including nightmares, sleepwalking, violent behavior while sleeping, and REM behavior disorder, in which a person moves his/her physical body in response to events within his/her dreams. These conditions can often be treated successfully through medical intervention or through the use of a sleep specialist.
Gastroesophageal Reflux Disease causes repeated awakenings during the night due to unpleasant sensations resulting from stomach acid flowing upward into the throat while asleep.
Mania or Hypomania in bipolar disorder can cause difficulty falling asleep. A person going through a manic or hypomanic episode may feel a reduced need for sleep. Sleep deprivation can worsen a manic episode, or cause hypomania to develop into mania.

Insomnia is a common side-effect of some medications, and it can also be caused by stress, emotional upheaval, physical or mental illness, dietary allergy and poor sleep hygiene. Insomnia is a major symptom of mania in people with bipolar disorder, and it can also be a sign of hyper-thyroidism, depression, or other ailments with stimulating effects.

In addition, a rare genetic condition can cause a prion-based, permanent and eventually fatal form of insomnia called Fatal Familial Insomnia.

What is Fatal Familial Insomnia?

Fatal familial insomnia (FFI) is a very rare autosomal dominant inherited disease of the brain. The dominant gene responsible has been found in just 28 families worldwide; if only one parent has the gene, the offspring have a 50:50 chance of inheriting it and developing the disease. The disease's genesis and the patient's progression into complete sleeplessness is untreatable, and ultimately fatal.

The disease has four stages, taking 7 to 18 months to run its course:

The patient suffers increasing insomnia, resulting in panic attacks and phobias. This stage lasts about four months.
Hallucinations and panic attacks become noticeable, continuing about five months.
Complete inability to sleep is followed by rapid loss of weight. This lasts about three months.
Dementia, turning unresponsive or mute over the course of six months. This is the final progression of the disease, and the patient will subsequently die.

There is no cure or treatment for FFI; hopes rest on the so far unsuccessful gene therapy. Sleeping pills have no effect.