Secondary Causes of Insomnia

HealthCare

Differential diagnosis of chronic insomnia

Psychiatric conditions.

  1. Depression,
  2. Anxiety.
  3. Mania/hypomania
  4. Adjustment disorders
  5. PTSD
  6. Substance abuse.

Neurologic Conditions.

  1. Neurodegenerative disease
  2. Alzheimer disease
  3. Parkinson disease
  4. Neuromuscular disorders including painful peripheral neuropathies
  5. Cerebral hemispheric and brainstem strokes
  6. Brain tumors
  7. Traumatic brain injury causing post-traumatic insomnia
  8. Headache syndromes (Migraine, cluster, hypnic headache, and exploding head syndromes)
  9. Fatal familial insomnia, a rare prion disease

Medical Conditions

  1. Lungs: COPD, OSA, Asthma
  2. Heart: CHF, Ischemic heart disease, Nocturnal Angina, Hypertension
  3. Gastrointestinal: GERD
  4. Rheumatologic, and related: Arthritis, Fibromyalgia, Chronic Pain, Chronic fatigue syndrome
  5. Endocrine: Hyperthyroidism, Diabetes
  6. Urinary: Nocturia
  7. Dermatologic (eg, pruritus)
  8. Cancer
  9. Menopause
  10. Lyme disease
  11. HIV / AIDs
  12. Restless legs syndrome
  13. Periodic limb movement disorder
  14. Sleep-disordered breathing
  15. Circadian rhythm disorders
  16. Shift work disorder

Medications

  1. CNS stimulants
  2. CNS depressants
  3. Benzodiazepine / Alcohol withdrawal
  4. Bronchodilators
  5. Antidepressants
  6. Beta antagonists
  7. Steroids
  8. Levothyroxine

 

References

Am Fam Physician. 2013 Aug 15;88(4):231-238. Management of Common Sleep Disorders. http://www.aafp.org/afp/2013/0815/p231.html

www.uptodate.com/contents/treatment-of-insomnia-in-adults

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