vulnerability to insomnia depends on several thingsWhen I set out to write my book about insomnia, I asked dozens of insomniacs what they thought had caused their insomnia. Several mentioned constitutional factors.

There are certainly grounds for thinking that a genetic component is involved. People who have a first-degree relative with insomnia are 7 times as likely to suffer insomnia as people without insomnia in the immediate family.

Other people I interviewed attributed their insomnia to stress at work or to family problems. Still others blamed their insomnia on an inability to quiet their mind at night.

The causes of insomnia are still unknown, but many factors can make people more and less vulnerable to it. A prospective study of Norwegian nurses offers new evidence of several factors, some well known and others that have gotten less attention in the past.

Anxiety and Depression

There’s plenty of evidence pointing to a relationship between insomnia and mood disorders. In the nurses’ study, where investigators reviewed data on 799 nurses collected at 2 time points 2 years apart, nurses higher on anxiety and depression measures in 2009 were significantly more likely to report insomnia symptoms in 2011.

The reverse relationship also held for insomnia and anxiety: nurses reporting insomnia in 2009 were more likely to have developed anxiety 2 years later. Surprisingly, although insomnia is widely understood to be a causal factor in depression, the nurses’ study found no evidence of this.

Morningness and Eveningness

The nurses in this study were all shift workers. Other research has suggested that people who dislike getting up early in the morning have an easier time adapting to shift work, where work at night is required.

In the current study, though, the nurses who disliked getting up early in the morning were actually more inclined to develop insomnia than the early risers. Other research has shown that people who like to get up early tend to have better lifestyle regularity and more regular sleep habits. Both these things tend to protect people from developing insomnia.

Personality Traits

Some people function quite well despite sleep loss while others feel drowsy and lethargic. (This is largely determined by genetic factors and is thus a stable trait.) Languidity—the tendency to experience drowsiness and lethargy after losing sleep—was found in the nurses’ study to predict an increase in insomnia symptoms over the 2-year period. No surprises here. Impairments in daytime functioning are classic symptoms of insomnia.

Another personality trait—flexibility, or the ability to sleep or stay awake at odd hours—has generally been known to protect against the development of insomnia. Among shift workers, this would be an especially useful trait. But in this study, a high score on flexibility had no positive or negative relationship with insomnia.

Smoking, Drinking, and Caffeine

The overall harmful effects of tobacco, alcohol, and caffeine on sleep are now well known. For many years insomnia was attributed to people drinking too much scotch or too much coffee.

More recently, studies have shown that people with insomnia do not typically drink more alcohol or caffeinated drinks than people who sleep well, and the nurses’ study supports this finding. None of these lifestyle factors predicted an increase in insomnia over time. In fact, nurses reporting insomnia symptoms in 2009 actually reported drinking less caffeine in 2011.

Bullying at Work

Several work-related stressors are known to increase the risk of poor quality sleep, and bullying—persistent exposure to negative actions from others—is one. Day-to-day contact with tyrannical bosses and manipulative supervisors often leads to psychological distress.

Nurses subjected to bullying at work reported more insomnia symptoms over time than the nurses working under better conditions. No surprises here: the worry and stress that result from bullying are two of the leading causes of sleep problems among workers.

Spillover Between Work and Family

Stress in one domain can affect another. In the nurses’ study, negative spillover from work to family and from family to work predicted an increase in insomnia symptoms over time. Conversely, insomnia led to reports of more work-to-family conflicts over time.

Shift Work

Finally, shift work, involving night work and rotating shifts, is known to precipitate insomnia. But in this group of nurses, the association did not hold. This unexpected result might be due to the young age of the nurses (average age 33) and their overall good health compared with shift-working nurses overall, many of whom likely self-selected out of the study.

What factors do you think led to your insomnia?

Posted by Lois Maharg, The Savvy Insomniac

Lois Maharg has worked with language for many years. She taught ESL, coauthored two textbooks, and then became a reporter, writing about health, education, government, Latino affairs, and food. Her lifelong struggle with insomnia and interest in investigative reporting motivated her to write a book, The Savvy Insomniac: A Personal Journey through Science to Better Sleep. She now freelances as an editor and copy writer at On the Mark Editing.

5 Comments

  1. My insomnia only started with the hormonal ups and downs of the menopause and hot flushes in my late 40’s. No history of insomnia before then, although always a light sleeper. Prior to the menopause I was an 8 hours per night girl. Oh the power of those hormones!

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    1. Hi Lesley,

      So many women DO start having trouble sleeping in their mid-forties and fifties. No doubt some of it—and probably most of it—is related to those hormonal changes!

      I’ve written a few blog posts about insomnia and menopause. The first is mainly informational, but the other two present solutions that could possibly help. Here they are:

      https://thesavvyinsomniac.com/insomnia-in-midlife-and-older-women/

      https://thesavvyinsomniac.com/menopause-insomnia-and-pycnogenol/

      https://thesavvyinsomniac.com/relief-for-hot-flashes-and-menopausal-insomnia/

      Thanks, Lesley, for writing in.

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    2. Lesley,

      I can relate my insomnia to childhood. For some reason it is constitutional. Anxiety and depression also run in my family.

      However, I can relate to the hormonal fluctuations and the power of hormones. When I was 38 I went off the pill. In hindsight, and my doctor agreed with me, I should have stayed on the pill for as long as possible. I had no risk factors for staying on the pill. After the pill, for the first time in my life I had sugar cravings and waking up after a few hours of sleep for juice or something. I also gained a lot of weight.

      Around when I turned 51 I started having terrible hot flashes that always started just before bed. I had terrible restless leg, all day long, especially in the summer. I am not a fan of herbals, it was a desperate shot in the dark, but I found great relief from the hot flashes and restless leg with black cohosh (I use the purified extract in Remifemin to be specific). I would not change now even though other companies have the purified extract in pill form. I’m not pushing this particular brand. Estroven is probably the same. I don’t want any other herbals or extracts in my supplement.

      As far as insomnia goes, I consider myself to be a work in progress.

      I would consider HRT even now. For some reason, although I am sensitive to everything; after I went off the pill, I couldn’t tolerate getting back on it. I was conflicted b/c they do say there is more risk the older you get. Maybe I wasn’t dogged enough at the time. I was definitely conflicted and my Doctor and I tried several pills. The estrogen is the same but can vary in dose the difference in the progestin component of the pill can be huge in terms of tolerance, side effects, etc.

      By the way, I am 54 and begging for my menses to stop. I am regular as an atomic clock so there has’nt been much gyn concern. I need to see my gynecologist.

      Good luck to you and I love this website, the community and the info it provides. Thank You All.

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      1. Thank you, Maggie, for taking time to write about your experience and what’s worked for you.

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  2. Gerard Tango May 7, 2016 at 1:03 pm

    My insomnia began in June of 1993, when for severe financial reasons, I had to cease seeing all doctors and psychiatrists, and perforce had to cease taking all medications, including Tofranil and Ativan.
    Within a month of this forced ‘cold turkey’ of Rx, I could not fall asleep at all until almost dawn. This lasted 3.5 years until I got Social Security Disability and Medicare and began to be put on a never ending cocktail of sleep Rx/tranquillizers/Rx with sleepiness as a side effect. Except for a large dose of Klonopin, also for panic attacks, none of these Rx had any positive effect. (Neither herbs, supplements, hypnosis, deep breathing, quiet music, light exposure, and any but the most grueling and long lasting aerobic exercise, which because of podiatric problems and arthritis is very hard and temporarily counter-indicated for me).
    This is a cautionary note, to re-consider carefully, and Never, suddenly stop, without replacement, Any psychiatric Rx. You may be very sorry in the long run if you do. I hope this helps someone.

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