Transient insomnia is often caused by a temporary situation in a person's life, such as an argument with a loved one, a brief medical illness, or jet lag. When the situation is resolved or the precipitating factor disappears, the condition goes away, usually without medical treatment.

Chronic insomnia usually has different causes, and there may be more than one. These include:
  • a medical condition or its treatment, including sleep apnea
  • use of substances such as caffeine, alcohol, and nicotine
  • psychiatric conditions such as mood or anxiety disorders
  • stress, such as sadness caused by the loss of a loved one or a job
  • disturbed sleep cycles caused by a change in work shift
  • sleep-disordered breathing, such as snoring
  • periodic jerky leg movements (nocturnal myoclonus), which happen just as the individual is falling asleep
  • repeated nightmares or panic attacks during sleep
Another cause is excessive worrying about whether or not a person will be able to go to sleep, which creates so much anxiety that the individual's bedtime rituals and behavior actually trigger insomnia. The more one worries about falling asleep, the harder it becomes. This is called psychophysiological insomnia.

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