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7 Medical Reasons Why You Can't Get Any Sleep

 We've all experienced trouble falling asleep. And while stress may be the main cause, it might not always be the reason behind your lack of rest, and once you determine it, you will be able to sleep longer and better. Discover seven possible reasons why you may not be getting any shut-eye:

Urinary incontinence

medical reasons to not sleeping

According to Adam Ramin, MD, urological surgeon and medical director of Urology Cancer Specialists in Los Angeles, “While urinary incontinence does affect women more often than men, millions of both men and women deal with some type of bladder control issue at some point in their lives and many suffer from symptoms that significantly impact their quality of sleep.”

However, while it may be a nuisance, Dr. Ramin adds “And the truth is, if you suffer from urinary incontinence, it doesn’t have to be a condition that puts you in adult diapers for the rest of your life or prevent you from ever having a good night’s sleep again.” Furthermore, he believes that diet and lifestyle changes can help with bladder control, including reducing your intake of caffeine. “Caffeine stimulates bladder function and is also considered a diuretic,” Dr. Ramin says, adding that, “Though it can be much easier said than done, limiting or eliminating caffeine altogether has been known to be successful in diminishing and resolving issues of urinary incontinence.”


Vernon Williams, MD, neurologist, and director of the Kerlan-Jobe Center for Sports Neurology and Pain Medicine at Kerlan-Jobe Orthopedic Clinic in Los Angeles explains “As many sufferers know, it’s tough to stop that runaway migraine train once it gets moving, let alone try to get a good night’s sleep.” However, not being able to sleep is making it worse. In fact, Dr. Williams adds: “Not getting enough sleep, and sometimes getting too much, can trigger a migraine.” So stay hydrated, eat a balanced and nutritious diet and stay active to help reduce the onset of migraines.  

Magnesium deficiency

medical reasons to not sleeping

Carolyn Dean, MD, a general practitioner based in Kihei, Hawaii and a medical advisory board member with the Nutritional Magnesium Association states that “Numerous studies have shown magnesium’s effectiveness in boosting mood, lowering anxiety, and reducing stress levels as well as helping with deeper more restful sleep.” The reason why most Americans may not be getting enough sleep could be due to their low levels of magnesium. “Magnesium deficiency causes muscle tension, nerve irritability, adrenal surges, decreased production of serotonin, and muscle cramps. All of these symptoms and conditions interfere with sleep,” Dr. Dean says, and further states that magnesium a safe and important treatment for insomnia. Still, despite the benefits, not all forms of magnesium are easily absorbed by the body.  “Magnesium citrate powder is a highly absorbable form that can be mixed with hot or cold water and sipped at work or at home throughout the day,” she says.

Circadian rhythm delay

Be it alertness, or our body temperature, it all fluctuates depending on our 24-hour biological clock called circadian rhythm, says Michael Howell, MD, CEO of Sleep Performance Institute in Edina Minnesota. “Our circadian rhythms are primarily determined by when we are exposed to light, and our modern culture’s affinity to light in the evening (computer, tablet, television, and phone screens) activates a cell layer in our retina sending a signal that delays our circadian rhythm. That means that it could be 10 p.m., but the brain will think the sun is still out, so it won’t be ready to fall asleep—no matter how tired you actually are.”

A circadian rhythm delay could be another problem that occurs when the alarm clock goes off but you're not ready to wake up yet. “If you have trouble falling asleep at night but can sleep in easily in the morning, you probably have a delay in your circadian rhythm. This problem is solved with bright light (sunlight or a 10,000 lux lightbox used first thing in the morning) along with a low dose (0.5mg) of melatonin about three to four hours before bedtime.”

Stimulant medications

medical reasons to not sleeping

According to Dr. Howell, a number of medications can cause difficulty falling asleep. The most common being: steroids such as prednisone; antidepressants such as bupropion and venlafaxine; stimulants such as methylphenidate and modafinil, adrenal, thyroid replacement medications, beta agonists and theophylline used for asthma. Furthermore, according to the Mayo Clinic, “Some over-the-counter medications, such as some pain medications, allergy, and cold medications, and weight-loss products, contain caffeine and other stimulants that can disrupt sleep.” Dr. Howell suggests you talk to your doctor about the medication if you have trouble falling asleep, and consider if the benefits you are receiving from the medication outweigh the consequences of poor sleep.


COPD or chronic obstructive pulmonary disease is an umbrella term used to describe progressive lung diseases. This includes emphysema, chronic bronchitis, refractory asthma, and some forms of bronchiectasis, making it harder to get a good night’s sleep. Cedric Jaffe, associate professor of Thoracic Medicine and Surgery at the Lewis Katz School of Medicine at Temple University also adds that "many COPD patients also suffer from insomnia, obstructive sleep apnea, and depression," and this includes bronchodilators and steroids, which can cause sleep difficulties, too. So, Dr. Jaffe suggests that if you are unable to sleep and have COPD, have a solid bedtime routine and minimize distractions in the bedroom. He also advises that you “Discuss with your pulmonologist if your COPD treatment is optimized and if any of the medications prescribed are impacting your sleep problems.” 

Nasal issues

medical reasons to not sleeping
Many doctors see patients with chronic sinus conditions that contribute to poor sleeping. Houtan Chaboki, MD, a facial plastic surgeon in Washington D.C. says “Ideally, one should be breathing through their nose during sleep. For anyone who has nasal congestion, they cannot breathe through the nose and may snore, too. Patients with a deviated septum have worse symptoms during sleep due to gravity.” He adds, “Deviated nasal symptoms can occur naturally from genetics, or occur after injury. Patients may try allergy medication, but often need nasal surgery such as septoplasty or rhinoplasty for adequate nasal relief and better sleep.”
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