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Insomnia in Special Populations

Reviewed by: HU Medical Review Board | Last reviewed: June 2020

Doctors know that some groups of people are more likely to develop insomnia. These groups include women, people with certain chronic conditions, some children, and people recovering from substance abuse. Rates of insomnia also vary by age, gender, job type, and ethnicity.


Women are more likely to experience insomnia than men. Doctors believe this is because the many hormone changes during a woman’s life often lead to problems getting to sleep and staying asleep.1

Many women report having trouble with sleep in the days leading up to the start of their menstrual cycle (period). And, women with premenstrual dysphoric disorder have high rates of insomnia.2

Insomnia is common during pregnancy, especially in the third trimester. This can be caused by back pain, the baby moving, heartburn, and needing to go to the bathroom at night.1,2

Menopause and perimenopause are well known to cause hot flashes and night sweats that disrupt sleep.2


Insomnia is the most common sleep disorder in children, just like in adults. Insomnia in children is most often related to sleep habits. For example, many children may refuse to go to bed or cannot fall asleep unless a certain routine is in place. This is called behavioral insomnia of childhood.3

Older adults

People need less sleep as they get older. In fact, people over age 65 need 7 to 8 hours per night on average. However, it may be harder to get restful sleep due to the chronic health conditions that appear with age. Sometimes, the drugs used to treat those conditions make good sleep more difficult.4

People with other chronic conditions

Certain health conditions seem to increase the chances of developing chronic insomnia. These conditions include:5,6

What’s more, many of the drugs used to treat several chronic health conditions can cause insomnia, including certain antidepressants, sedatives, beta-blockers, steroids, and nasal decongestants.5

People in recovery

People who are recovering from substance abuse are another group that often have problems sleeping. In fact, studies have found that insomnia is common in the early stages of recovery from alcohol dependence and may last for several months. Insomnia is worse for people in recovery who are also over age 55, African American, or who also have depression.7

Untreated sleep problems also increase the chances of relapse, making it important to find help for sleep issues during recovery.7

People with a rare genetic disorder

A genetic condition called fatal familial insomnia (FFI) results in someone being completely unable to sleep. It usually starts in middle-age and becomes progressively worse. It is caused by a change in the PRNP gene on chromosome 20p13. This gene controls how the PrP prion protein is shaped.8

In FFI, this toxic protein misfolds and builds up in the brain. Eventually, the lack of sleep causes serious physical and mental complications that lead to coma and death. Fatal familial insomnia is extremely rare.8

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