Sleeping difficulty

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Depression and insomnia

Insomnia may cause a reduced energy level, irritability, disorientation, dark circles under the eyes, posture changes, and fatigue.

It may help to consult a psychiatrist, another physician, or another mental health practitioner for evaluating psychiatric disorders that can lead to insomnia. If you are depressed, antidepressants can help both the sleeping problem and the depression. These medications do not carry the same concerns about tolerance and dependence as sedatives.

Nightmares and dreams that interfere with sleep may also respond to counseling.

• jet lag
• shift work
• wake-sleep pattern disturbances
• grief
• depression or major depression
• worry
• anxiety or stress
• exhilaration or excitement
• bed or bedroom not conducive to sleep
• nicotine, alcohol, caffeine, food, or stimulants at bedtime
• aging
• excessive sleep during the day
• excessive physical or intellectual stimulation at bedtime
• overactive thyroid
• side effect of a new medication
• alcoholism or abruptly stopping alcohol after long-term use
• not getting enough bright-light exposure during waking hours
• abruptly stopping a medication (such as sleeping pills)
• medications or illicit "street drugs" (for example, excessive thyroid replacement hormone, amphetamines, caffeine-containing beverages, cocaine, ephedrine, phenylpropanolamine, theophylline derivatives)
• withdrawal of medications (such as sedatives or hypnotics)
• interference with sleep by various diseases, including an enlarged prostate (men), cystitis (women), COPD, pain of arthritis, heartburn, and heart or lung problems
• restless leg syndrome

IN INFANTS

Most newborn babies wake several times during the night, but by the age of 6 months they typically sleep through the night. At one year, babies will sleep an average of about 16 hours in every 24. Two to three hours of this sleep will be during the day. Causes of sleeplessness in infants may include:

• desire for parental attention
• infantile colic or other digestive problems
• indigestion
• hunger
• teething
• fever or other illness

Review Date: 05/16/2006
Reviewed By: Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.