What Causes Sleep Disorders, and When Should You Get Help?

What causes sleep disorders is usually a combination of factors: stress, anxiety or depression, medical conditions such as sleep apnea or pain, medicines, caffeine and alcohol, and a body clock thrown off by shift work or irregular schedules. Sometimes the cause is unknown. If poor sleep lasts weeks or affects daytime life, see a professional.

This guide is for adults and older teens with ongoing sleep trouble, bed partners who have noticed snoring or restless nights, and anyone trying to decide whether a sleep problem needs professional help. It explains the main types and causes, how to gather information, and when to seek care.

What is a sleep disorder?

A sleep disorder is a condition that disrupts normal sleep patterns. MedlinePlus, from the National Library of Medicine, defines sleep disorders as conditions that disturb your normal sleep patterns and lists types including insomnia, sleep-related breathing disorders such as sleep apnea, movement disorders such as restless legs syndrome, hypersomnia, circadian rhythm disorders and parasomnias such as sleepwalking.

Occasional bad nights are normal. A sleep disorder is more persistent and affects how you feel and function during the day. The American Academy of Sleep Medicine (AASM) describes chronic insomnia as trouble sleeping at least three times a week for at least three months. For a broader overview of types and treatments, see sleep disorders 101.

What causes sleep disorders?

Sleep disorders are caused by many overlapping factors, and often more than one is at work. MedlinePlus lists other health conditions such as heart disease, lung disease, nerve disorders or pain; mental illnesses including depression and anxiety; medicines; and genetics, and notes that sometimes the cause is unknown.

MedlinePlus also lists stress, medical conditions, medicines, other sleep disorders, caffeine, tobacco and alcohol among the causes of insomnia, and advises treating the underlying problem if possible. The sections below group the most common causes so you can spot which may apply to you.

How do stress, anxiety and depression affect sleep?

Stress, anxiety and depression are among the most common drivers of poor sleep. AASM notes that insomnia is most often associated with another problem and that depression is a frequent cause.

Anxiety tends to make it hard to fall asleep or get back to sleep, as the mind replays the day or worries about tomorrow. Depression can cause early waking or sleeping much more than usual while still feeling tired. Trauma can bring nightmares and a sense of being on alert at night. Poor sleep then makes mood and worry harder to manage. If nighttime worry is the main problem, read how to calm anxiety at night.

Which medical conditions can cause sleep problems?

Several medical conditions can cause or worsen sleep problems, and they are important to rule out. Sleep apnea is one of the most significant.

The National Heart, Lung, and Blood Institute (NHLBI) lists sleep apnea symptoms including breathing that starts and stops, loud snoring, gasping for air, daytime sleepiness, dry mouth, headaches, insomnia and waking often to urinate. Other contributors include chronic pain, reflux, asthma and other breathing problems, heart and nerve conditions, restless legs, hormonal changes such as pregnancy or perimenopause, and conditions that cause frequent nighttime urination.

Can medicines, caffeine and alcohol cause sleep disorders?

Yes, medicines and substances are common and often overlooked causes of poor sleep. Caffeine late in the day can delay sleep, nicotine is a stimulant, and alcohol may help you fall asleep but tends to break up sleep later in the night.

The Centers for Disease Control and Prevention (CDC) recommends avoiding caffeine in the afternoon and evening, avoiding large meals and alcohol before bedtime, and keeping the same bedtime and wake time each day. Some prescription and over-the-counter medicines can also affect sleep. Do not stop a prescribed medicine on your own; ask the prescriber whether it could be affecting your sleep.

How do body-clock problems and shift work disrupt sleep?

Body-clock problems disrupt sleep when your internal rhythm no longer matches your schedule. NHLBI explains that circadian rhythm disorders happen when the body clock is out of sync with the environment, causing symptoms such as extreme daytime sleepiness and decreased alertness.

Night shifts, rotating schedules, frequent travel across time zones and very late weekend nights can all shift the clock. AASM lists sleepiness, trouble sleeping, low energy, poor concentration, headaches, poor mood and irritability as symptoms of shift work disorder. Teens often have a naturally later body clock, which can clash with early school start times.

Can you prevent sleep problems once you know what causes sleep disorders?

You cannot prevent every sleep disorder, but knowing what causes sleep disorders lets you lower the risks you can control. Conditions such as sleep apnea or restless legs need medical care, while habits and stress management can protect sleep for many people.

The CDC states that adults ages 18 to 60 need at least seven hours of sleep a night. Simple steps that support that goal include:

• Keeping the same wake time every day, including weekends
• Getting daylight in the morning and dimming lights in the evening
• Putting screens away about 30 minutes before bed
• Keeping the bedroom cool, dark and quiet
• Building a short wind-down routine, such as reading or a warm shower
• Getting out of bed if you cannot sleep, and returning when drowsy

If these steps do not help within a few weeks, that is useful information for a provider, not a personal failure.

Step by step: how can you figure out what is behind your sleep problem?

A short, structured look at your sleep can point to likely causes and make a professional visit more useful. Try this for two weeks.

1. Keep a sleep diary. Track bedtime, time to fall asleep, wake-ups, final wake time and naps. See what to track in a sleep diary.
2. Log inputs. Caffeine, alcohol, nicotine, exercise, screens and late meals.
3. Note mood and stress. Rate worry, mood and energy daily.
4. Ask a bed partner. Snoring, gasping, kicking or sleep talking.
5. List medicines. Include supplements and over-the-counter sleep aids.
6. Steady your schedule. Keep the same wake time daily and limit late caffeine.
7. Review patterns. Do bad nights follow stress, alcohol or late screens?
8. Bring it to a provider. Share the diary at your appointment.

When should you seek professional help for sleep?

Seek professional help if sleep problems last more than a few weeks, keep coming back, or affect your mood, safety, work or relationships. Get help sooner for any of these red flags:

• Falling asleep while driving or at work
• Loud snoring with gasping or pauses in breathing
• Acting out dreams, sleepwalking or injuries during sleep
• Sudden, severe daytime sleepiness
• Needing alcohol or sleep aids every night
• Hopelessness, or thoughts of death or suicide

For thoughts of suicide, call or text 988. For immediate danger, call 911. If you are unsure whether it is time, see when chronic insomnia means it is time to talk to someone.

What should you tell a provider about your sleep?

Tell your provider what the problem is, how long it has lasted and how it affects your days. MedlinePlus notes that a provider will review your medical and sleep history and do a physical exam, and may order a sleep study.

• “I have trouble falling asleep most nights and it has lasted two months.”
• “My partner says I stop breathing and gasp at night.”
• “I work rotating shifts and I am exhausted on my days off.”
• “I have been anxious and low, and sleep is getting worse.”
• “Could any of my medicines be affecting my sleep?”

AASM recommends cognitive behavioral therapy for insomnia (CBT-I) for chronic insomnia in adults, and treatment for other sleep disorders depends on the cause. For more on how sleep can signal other problems, see whether poor sleep is a symptom of something bigger.

How can Texans get help for sleep problems?

In Texas, most people start with a primary care provider, who can refer to a sleep specialist or a mental health professional. Telehealth may work for many sleep and mental health visits when the clinician is licensed in Texas. The U.S. Department of Health and Human Services (HHS) explains that providers generally must be licensed or legally permitted to practice in the state where the patient is located, and rules vary by state. Sleep studies for suspected apnea usually require separate testing arranged by a medical provider.

Getting support in Texas

Lyte Psychiatry offers therapy, psychiatric evaluation and medication management in Texas. In-person visits are available at Lyte Psychiatry’s clinic in Pantego, in the Dallas–Fort Worth area. Lyte Psychiatry offers telehealth visits to patients who are physically located in Texas at the time of the visit. All Lyte Psychiatry services are available in Spanish.

Most new patients are seen within 1–2 business days. Availability, insurance and clinician fit require confirmation. Lyte Psychiatry is an outpatient practice. Learn about therapy and psychiatry at Lyte or contact the practice when stress, anxiety or mood seem tied to your sleep.

If you are in a mental-health crisis in the United States, call or text 988. Call 911 for immediate danger.

Educational information, not a diagnosis or individual treatment plan.