Secondary insomnia occurs when you cannot fall asleep or stay asleep at night due to another underlying medical condition.
Insomnia is a common type of sleep disorder in which you have trouble falling or staying asleep at night. It can be chronic (long-lasting) or acute (short-term), and is further broken down as onset insomnia if you have trouble falling asleep or maintenance insomnia if you wake often at night.
Furthermore, some medical professionals and researchers categorize insomnia as either primary or secondary. This terminology was more commonly used in past years, while more recent terminology has broken down the condition into short-term insomnia, chronic insomnia, and other insomnia.
This article covers the causes, symptoms, diagnosis, and treatment of secondary insomnia.
What differentiates between primary and secondary insomnia?
Primary insomnia is caused by:
- significant life changes
- new mental stress or anxiety
- irregular or interrupted schedules
- actions taken as a result of a lack of sleep, such as daytime naps that keep you alert later into the night
Secondary insomnia is when you have trouble falling or staying asleep as a side effect of another medical condition. We’ll cover those in more detail below.
Most cases of chronic insomnia are secondary. Chronic insomnia is insomnia that
Many types of conditions can lead to secondary insomnia. Some keep your mind alert and prevent you from falling asleep, while others affect you physically and can wake you. Causes include:
- depression, stress and anxiety, posttraumatic stress disorder, and other psychological conditions
- Alzheimer’s disease, Parkinson’s disease, and other neurological disorders
- headaches, arthritis and other conditions that cause physical pain
- gastroesophageal reflux disease (GERD) and other gastrointestinal disorders
- sleep apnea, restless leg syndrome and other sleep disorders
- respiratory conditions like
asthma or chronic obstructive pulmonary disease (COPD) - other conditions like heart disease, overactive thyroid, diabetes, or menopause
- side effect of certain medications, such as stimulants, antidepressants, and corticosteroids
Any of the conditions listed above, as well as factors that can cause them—such as being overweight—are risk factors for secondary insomnia.
Additional
- older age
- female sex
- genetics (insomnia runs in families)
- your environment at work and at home
- long periods of inactivity during the day
- prolonged mental stress, anxiety, or depression
Symptoms of insomnia are similar across types. They include:
- prolonged periods of wakefulness as you go to sleep, during which time it can feel like your mind is racing with thoughts related to stress or anxiety in your life
- waking up once or more during the course of a night
- waking up too early in the morning and not being able to fall back asleep
- daytime drowsiness or brain fog, anxiety, stress, or depression
A lack of sleep from secondary insomnia can exacerbate the symptoms of the existing underlying condition and its symptoms, such as pain, emotional stress, and depression.
One 2019 review of studies determined that the relationship between neurodegenerative conditions like Alzheimer’s and insomnia is bidirectional. This means that each one can contribute to the development of the other.
Insomnia has also been
Insomnia can also increase your risk of:
- worsened performance at school or work
- vehicle collisions
- difficulty with memory and comprehension
Contact a medical professional if you regularly have trouble falling asleep at night or frequently wake up at night. Also contact a doctor if your lack of sleep is affecting you during the day and preventing you from working or causing you to fall asleep during daytime.
The National Institutes of Health
A medical professional will begin by asking about your:
- symptoms
- history of potential underlying medical conditions
- existing medications
- sleep habits
You’ll receive a diagnosis of chronic insomnia if you have problems falling and staying asleep at least 3 nights a week for 3 months or more. The goal is to determine what underlying condition is responsible.
The doctor may listen to your heart and lungs and look for signs of any sleep disorder like sleep apnea. They may order diagnostic tests, such as:
- blood tests for signs of underlying medical conditions
- a sleep study to look for various sleep disorders
- an actigraphy, a test in which you wear a monitor for several days that tracks your activity levels
Addressing the underlying cause of your secondary insomnia is the best way to treat it. This can
- lifestyle additions, such as:
- stress management techniques, including meditation and mindfulness
- eating a healthy diet
- creating an inviting sleep environment
- cognitive behavior therapy, which a 2024 study recommended as a first-line treatment for chronic insomnia
- medications for the insomnia, or adjusting the schedule or dosage of existing medications
- physical therapy
- surgical procedures
Because secondary insomnia occurs due to an underlying condition, treating that condition is the best way to prevent it.
Preventing insomnia in general also includes the lifestyle factors mentioned above, such as getting regular exercise, managing your stress, and adopting a healthy nighttime routine. This includes:
- avoiding screens and meals close to bedtime
- installing blackout curtains
- limiting loud noises at night
- decreasing your intake of alcohol, caffeine, and nicotine
Secondary insomnia is a term for trouble falling asleep or repeatedly waking up at night due to an underlying medical condition or medication. Treating secondary insomnia has been shown to lead to better physical and mental health.
Arrange to see a medical professional if you are experiencing the symptoms of long-term insomnia. They will be able to determine the underlying cause and provide a treatment plan.