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Table 1 Factors related to chronic insomnia

From: Sleep disturbances in an arctic population: The Tromsø Study

Specific sleep disturbances:
   • Circadian rhythm disorders:
◦ Advanced sleep-phase syndrome
◦ Delayed sleep-phase syndrome
   • Sleep apnea (obstructive, central, or mixed)
   • Restless leg syndrome
   • Periodic limb movement disorders (nocturnal myoclonus)
   • Parasomnias, i.e. REM-sleep-behavior-disorder
Physical illness:
   • Pain: arthritis, musculoskeletal pain, other painful conditions
   • Cardiovascular: heart failure, nocturnal breathlessness, nocturnal angina
   • Pulmonary: chronic obstructive pulmonary disease, allergic rhinitis (nasal obstruction)
   • Gastrointestinal: gastroesophageal reflux disease, peptic ulcer disease, constipation, diarrhea, pruritus ani
   • Urinary: nocturia, incomplete bladder emptying, incontinence
   • Central nervous system: stroke, Parkinson disease, Alzheimer disease, seizure disorder
   • Psychiatric illness: anxiety, depression, psychosis, dementia, delirium
   • Pruritus
   • Menopause (hot flushes)
Behavioral: daytime nap, early retirement to bed, use of bed for other activities (eg, reading and watching television), heavy meals, lack of exercise, and sedentary lifestyle
Environmental: noise, light and other disturbances, extreme temperatures, uncomfortable bedding, and lack of exposure to sunlight
Medications:
   • Central nervous system stimulants: sympathomimetics, caffeine, nicotine, amphetamines, ephedrine, phenytoin
   • Antidepressants: bupropion, selective serotonin reuptake inhibitors, venlafaxine
   • Anti-Parkinsonian agents: levodopa
   • Bronchodilators: theophylline
   • Cardiovascular: B-blockers, diuretics
   • Histamines, H2 blockers: cimetidine
   • Anticholinergics
   • Corticosteroids
   • Alcohol
   • Herbal remedies
   • Stimulant laxative
  1. REM = rapid eye movement.