What are the Common Causes of Sleep Problems?

Each evening, millions of Americans experience the very real struggle to fall asleep — or to remain asleep — in order to get an adequate amount of rest our human physiology and emotional well-being requires every day. With as much as 30 percent of the population facing insomnia for at least short periods of time and 1 in 10 having to live with the far-fetching effects of chronic sleep deprivation, it is no wonder that lack of energy, fatigue, and a general deterioration of life quality and low performance physically or mentally are such common complaints when one is visiting a primary care physician.

Not being able to get enough sleep (approximately 8-10 hours for adults or at least 11-12 hours for children, each night) is detrimental to one's health, especially over an extended period of time. Treating perceived symptoms is not enough to fix sleep problems. Integrative medicine focuses on discovering the common causes of sleep problems in order to understand each individual's unique needs for medical treatment in order to restore the balance required for getting the optimal amount of sleep.

The Most Common Causes of Sleep Problems Include:

Pain, Trouble Breathing, Frequent Urination, and Other Chronic Medical Conditions

Acute — and more frequently, chronic and prolonged pain — is one of the primary physical reasons why many people lose sleep for extended periods of time. Medical conditions that cause physical discomfort in sleeping positions, the inability to breathe, or frequent nighttime urination wreak havoc on normal sleep patterns.


Medications containing caffeine (i.e., decongestants, weight loss products), painkillers, allergy medications, mood stabilizers, stimulants (i.e., ADHD meds), and medication for high blood pressure and other heart conditions can cause insomnia as a common but unpleasant side effect.

Caffeine, Nicotine, and Alcohol

Caffeine and nicotine are stimulants which remain in the bloodstream for a minimum of 14 hours to over 21 + hours.  Great quality sleep is often difficult to acquire for those regularly consuming caffeinated products (i.e., coffee, decaf, green tea, chai, soda, energy drinks, chocolate, hot chocolate) and/or nicotine.

Alcohol is initially a sedative.  It subsequently interrupts deep sleep and causes restlessness and frequent awakenings, especially during the second half of the night.


A deep emotional trauma, the loss of a partner, economic and financial problems, health worries, or other serious life crises are well-known to cause prolonged sleep disturbances and inability to sufficiently rest. Various mood disorders, such as bipolar depression, also present themselves cyclically, with recurring periods of overstimulation and wakefulness.


Chronic stress is affecting the vast majority of our modern society and manifests either as constant, ongoing anxiety or the inability to wind down at night. This is often a result of an overstimulated and overextended lifestyle, the lack of pre-planned time for mental relaxation during the daytime, or improper daily planning.  It leads to an increasing feeling of anxiety which often presents at the first quiet time of the day (a.k.a, at bedtime).  Learning how to reduce stress is one way to help with anxiety, and your primary care physician can help by assessing what is causing stress in your life.

Poor Bedtime Habits

An irregular bedtime schedule, prolonged naps during the day, and electronic exposure (i.e., TV, computer, smartphone, Kindle, IPad) at night is incredibly disruptive for creating regular cycles of wakefulness and sleep.  Our brain begins to misinterpret nighttime for daytime. 

An uncomfortable bed or unsafe sleeping arrangements can also keep one tossing and turning, instead of getting that much-needed sleep at night.

Frequent Changes in Sleep Schedule

Shift work is notorious for causing disruptive patterns, hormonal imbalances, and other unfavorable chemical changes within the body. Never being able to adapt completely to these frequent modifications of one's natural bodily cycles, homeostasis is completely interrupted, and the body and brain are confused. This leads to the inability to keep a healthy sleep schedule and get the required hours of sleep needed for optimal health.

Dietary Habits

Whether it's too much, too little, or too spicy, food is another significant cause that leads to many waking hours at night. Dietary choices can cause uncomfortable physical sensations, wakefulness, or the inability to rest comfortably for long periods of time.


As a result of various hormonal and other biochemical changes, insomnia generally tends to get worse with aging, especially over the age of 60. Urinary frequency or other bothersome physical symptoms are also likely to increase at this age, leading to many interruptions of the normal sleep pattern every night.


Sleep problems can be aggravated by hereditary factors such as those who predisposed to experience an increased level of stress reactivity, frequent wakefulness and insomnia. Circadian genes — responsible for setting our internal biological processes, including sleep cycle — can also vary for each individual, causing great differences between people's unique sleep patterns.

Treatment Options for the Most Common Causes of Sleep Problems

Regardless of the origin of your sleeplessness, the implementation of all treatment plans offered by integrative medicine always begins with a thorough evaluation of your overall health and medical history.

All common causes of sleep problems can be effectively managed by developing a comprehensive, holistic, and custom-made strategy that addresses lifestyle factors and existing chronic health problems. An integrative health approach finds alternative prescription medications, reinforces mental and emotional well-being with the help of various mind-body medicine methods, and focuses on making conscious choices to restore the optimal working of your body, regardless of stressful life circumstances and other, diverse causes of insomnia.

An Integrative Primary Care Physician in San Francisco

Dr. Payal N. Bhandari, M.D., a San Francisco-based integrative functional medicine specialist, urges you to seek expert help when suffering from insomnia for prolonged periods of time. With her extensive knowledge,  compassionate, and personalized care provided by Dr. Bhandari and her medical team, you can rest assured that the root cause of your sleeplessness can be uncovered, adequately addressed, and your well-being restored.

Contact Dr. Bhandari's office today to discuss all the available treatment options to improve your sleep and life quality today!

Dr. Payal Bhandari Dr. Payal Bhandari M.D. is a leading practitioner of integrative and functional medicine in San Francisco.

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