Complications of Insomnia

Reviewed by: HU Medical Review Board | Last reviewed: February 2023

Insomnia makes it hard to fall asleep and stay asleep. Getting enough good-quality sleep is essential to your health. So insomnia has many bad effects on your mental and physical health. These effects are called complications.1,2

Health problems that occur together can worsen each other. For example, insomnia and pain are often present at the same time. And they can make each other worse. Health problems that occur together are called comorbidities.2

It can be challenging to diagnose and treat complications and comorbidities. Some of the most common are discussed below.

Pain

Poor sleep can worsen pain. And pain can lead to poor sleep. This link between the 2 conditions worsens both problems. Your body shares certain pathways used by your nervous system and hormones. These shared pathways may explain the close relationship between pain and sleep.1-4

Insomnia disrupts the normal stages of sleep. One of those stages is called rapid eye movement (REM). People with insomnia spend less time in REM sleep. Decreased REM sleep can make you more sensitive to pain.5

Conditions linked to both chronic (long-term) pain and insomnia include:2,3

  • Osteoarthritis
  • Rheumatoid arthritis
  • Fibromyalgia
  • Low-back pain
  • Headaches

Mental health

Mental health disorders are the most common comorbidity of insomnia. About 4 out of 10 people with insomnia also have a mental health disorder. The relationship between mental health and insomnia is complex.2,4

Mental health disorders linked to insomnia include:2,4

  • Depression
  • Anxiety
  • Post-traumatic stress disorder (PTSD)
  • Suicide risk

Adding cognitive behavioral therapy for insomnia (CBT-I) to standard therapy improves symptoms of depression. CBT-I can help reduce suicidal thoughts by 50 percent.6,7

Sleep disorders

If you are experiencing problems sleeping, there are several possible sleep disorders that could be affecting you. The treatment of each of these sleep disorders is different:2,8

High blood pressure and heart disease

Sleep disorders, including insomnia, are a risk factor for high blood pressure. Blood pressure naturally gets lower while you sleep. When sleep is disrupted, this process is interrupted.9

High blood pressure has been linked to:9

  • Heart attack
  • Stroke
  • Heart failure

Migraine

People with insomnia often have worse migraines. Many of the same pathways in your brain control both migraines and sleep. This link may explain why the 2 disorders are often seen together.10

Diabetes

According to the Centers for Disease Control and Prevention, lack of sleep increases your risk for type 2 diabetes. Improving your sleep improves your body's ability to control blood sugar.7,11

Neurologic (nervous system) disorders

Sleep is critical for healthy brain function. Processes that control learning, memory, hormones, and healing take place as you sleep. Lack of sleep interferes with these processes.12

The following nervous system disorders often coexist with insomnia:12-14

  • Alzheimer’s disease
  • Parkinson’s disease
  • Multiple sclerosis (MS)

Alzheimer’s disease is an example of a brain disorder closely tied to insomnia. Insomnia also affects 6 out of 10 people with Parkinson’s disease.12,13

People with MS are 3 to 5 times more likely to have a sleep disorder than people without MS. Studies show that treating insomnia in people with MS improves fatigue and other mental and physical symptoms.14

Other conditions

Insomnia is also linked to the following conditions:1,2

  • Cancer
  • Asthma
  • Chronic obstructive pulmonary disease (COPD)
  • Gastroesophageal reflux disease
  • Obesity
  • Overactive thyroid
  • Prostate or bladder problems
  • Substance use disorders

Treatment

In addition to improving sleep, treating insomnia has been shown to improve:5,7,10

  • Pain tolerance
  • Blood sugar control
  • Blood pressure
  • Headaches
  • Migraines
  • Depression

The first treatment doctors usually suggest for insomnia is CBT-I. But finding a qualified CBT-I therapist can be challenging. Below are links to help you find sleep centers and therapists who offer CBT-I.5,7

Accredited Sleep Centers

American Academy of Sleep Medicine: Find a Healthcare Center

Adult Behavioral Sleep Medicine Services / Providers

The International Directory of CBT-I Providers

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