• More common than primary insomnia.
• Occurs when insomnia is caused by a psychiatric disorder (most often depression) or a medical disorder (most often chronic pain
• Underlying disorder needs to be treated appropriately. E.G. many people sleep much better after taking anti-depressants even though these have no effect on sleep patterns of people who are not depressed.
Causes of secondary insomnia
• Hormonal changes in women, e.g. premenstrual syndrome, menstruation, pregnancy and menopause.
• Decreased melatonin production: levels of melatonin, decrease as a person ages. By age 60, the body produces very little melatonin.
• Medical conditions: e.g. allergies, arthritis, asthma, heart disease, high blood pressure and Parkinson’s disease.
Psychiatric conditions: secondary insomnia is a common symptom of depression. It is also associated with anxiety disorders, PTSD and dementia.
• Overuse of stimulants – caffeine, alcohol, nicotine
• Parasomnias – events that disrupt sleep but don’t cause daytime sleepiness, e.g. Sleep apnoea, restless leg syndrome
• Genetics: Watson et al 2006, genetic vulnerability makes it more likely a person will develop insomnia if they experience any of the pre-disposing things.
• Personality: high levels of neuroticism increases vulnerability as linked to increased arousal & anxiety (Heath et al 1998)
• Gender: women diagnosed more with both primary & secondary - ? Have higher levels of neuroticism & anxiety, ? Seek help…