Acute stress and life events

Sudden stress triggers cortisol and adrenaline release, making it hard for the body to unwind.
Example: Losing a job or going through a breakup can cause sleepless nights filled with racing thoughts.

Generalized anxiety and hyperarousal

Constant worry keeps the brain’s alert system active long after bedtime.
Example: Lying in bed replaying “what if” scenarios about work or finances.

Major depressive disorder

Changes in serotonin, melatonin, and cortisol disrupt normal sleep cycles.
Example: Falling asleep easily but waking at 3 a.m. with low mood and hopeless thoughts.

Post-traumatic stress disorder (PTSD)

Flashbacks and nightmares activate the fear centers of the brain during sleep.
Example: A trauma survivor wakes in panic after reliving events in dreams.

Chronic pain conditions

Pain signals prevent deep rest and increase awakenings.
Example: Arthritis or back pain flaring at night, making it hard to find a comfortable position.

Obstructive sleep apnea

Breathing pauses during sleep reduce oxygen levels and wake the person repeatedly.
Example: Loud snoring followed by gasping or choking during the night.

Restless legs syndrome (RLS)

Uncontrollable leg movements cause discomfort and an urge to move at night.
Example: Tingling or crawling sensations in the legs that worsen when lying down.

Circadian rhythm disorders

Disruption in the internal body clock delays or advances sleep timing.
Example: Feeling wide awake at midnight and struggling to wake up for work.

Shift work and rotating schedules

Irregular work hours confuse the biological clock and melatonin release.
Example: A nurse alternating between day and night shifts feels constantly jet-lagged.

Jet lag and irregular travel

Crossing time zones disrupts melatonin and cortisol balance.
Example: Traveling from South Africa to Europe and lying awake at night for days afterward.

Excess screen time and blue light exposure

Blue light from devices suppresses melatonin production.
Example: Scrolling through the phone before bed keeps the brain stimulated.

Caffeine consumption late in the day

Caffeine blocks adenosine, the sleep pressure chemical.
Example: Having coffee or energy drinks after 3 p.m. delays sleep onset.

Nicotine use

Nicotine is a stimulant that increases heart rate and brain activity.
Example: Smoking before bed keeps the body alert and restless.

Alcohol close to bedtime

Alcohol induces drowsiness but fragments REM sleep later in the night.
Example: Falling asleep quickly after wine but waking up multiple times during the night.

Recreational stimulants

Substances like cocaine or amphetamines overstimulate the nervous system.
Example: Party drugs cause sleeplessness for days after use.

Prescription medication side effects

Certain drugs—like steroids, antidepressants, or decongestants—interfere with sleep cycles.
Example: Taking corticosteroids for inflammation and staying awake all night.

Thyroid imbalance

Hyperthyroidism increases metabolism and nervous system activity.
Example: A racing heart, sweating, and restlessness prevent deep sleep.

Perimenopause and menopause

Fluctuating estrogen and progesterone disrupt temperature regulation and sleep quality.
Example: Hot flashes and night sweats wake women multiple times a night.

Pregnancy-related discomfort and hormones

Rising progesterone and physical discomfort make it hard to find restful positions.
Example: A pregnant mother waking repeatedly due to back pain or frequent urination.

Gastroesophageal reflux disease (GERD)

Stomach acid rises when lying flat, causing burning sensations.
Example: A person with heartburn wakes up coughing or choking at night.

Asthma and nighttime cough

Wheezing and mucus buildup worsen when lying down.
Example: A person with asthma wakes due to shortness of breath during sleep

Poor sleep environment

Noise, light, or temperature extremes disturb deep rest.
Example: Street noise or a bright digital clock interrupting sleep cycles.

Irregular sleep schedules

Sleeping at inconsistent times weakens circadian rhythm regulation.
Example: Going to bed at 9 p.m. one night and 1 a.m. the next confuses the body clock.

Daytime napping

Long or late naps reduce nighttime sleep pressure.
Example: A person naps for two hours in the evening and then lies awake at midnight.

Sedentary lifestyle

Lack of physical activity decreases the adenosine buildup needed for sleepiness.
Example: Working long hours at a desk with minimal movement.

Overtraining or excessive exercise

Intense evening workouts elevate adrenaline and delay recovery.
Example: A gym session ending at 9 p.m. leaves the body too stimulated to sleep.

Heavy or spicy evening meals

Late, rich meals cause indigestion and discomfort.
Example: Eating curry or fried food close to bedtime leads to heartburn.

Vitamin D deficiency

Low vitamin D levels affect serotonin and melatonin synthesis.
Example: People who get little sunlight often struggle with daytime fatigue and poor sleep quality.

Iron deficiency (linked to restless legs)

Low ferritin levels disrupt dopamine signaling in the brain.
Example: Leg discomfort at night that eases with movement or massage.

Psychological conditioning and learned insomnia

The bed becomes associated with frustration instead of rest.
Example: Going to bed early but lying awake, anxious about not being able to fall asleep again.

The Mind

• Impairs attention and focus through reduced prefrontal cortex efficiency.
• Weakens short-term and long-term memory consolidation.
• Slows processing speed and executive function.
• Increases cognitive errors and poor judgment.
• Heightens threat perception and worry bias.

The Emotions

• Increases irritability and emotional reactivity.
• Raises the risk of anxiety disorders.
• Increases the likelihood of depressive symptoms and loss of pleasure.
• Lowers frustration tolerance.
• Leads to emotional exhaustion and burnout.

The Body

• Elevates blood pressure and cardiovascular strain.
• Raises systemic inflammation and pain sensitivity.
• Disrupts glucose regulation and appetite hormones.
• Weakens immune responses and increases infection risk.
• Contributes to headaches, body aches, and gastrointestinal discomfort.

Academically

• Reduces learning efficiency and exam performance.
• Increases absenteeism and class disengagement.
• Impairs working memory during lectures and study.
• Causes procrastination and incomplete assignments.
• Decreases academic confidence and motivation.

Career

• Reduces learning efficiency and exam performance.
• Increases absenteeism and class disengagement.
• Impairs working memory during lectures and study.
• Causes procrastination and incomplete assignments.
• Decreases academic confidence and motivation.

Relationships

• Reduces empathy and emotional availability.
• Increases conflict and miscommunication.
• Decreases intimacy and bonding due to fatigue.
• Causes withdrawal from family roles and social connections.
• Diminishes overall relationship satisfaction and patience.