Primary insomnia (i.e. no reason)

Poor sleep hygiene (i.e. no regular bedtime, watching bright screens too late, not winding down before bedtime, not sleeping in same location/ bed, falling asleep in front of a TV, then having to wake up to move to bed)

Shift work sleep disorder

Coming off of sedating medicines (i.e. rebound insomnia)

Prescribed stimulants which are long-acting or are taken too late in the day (e.g. Ritalin, Adderall, Vyvanse)

Over-the-counter stimulating medications and herbals

Drinking caffeine WITHIN 12 HOURS IF BEDTIME.

Drinking alcohol too late, leading to initial sedation, but then the sedation wears off a few hours later, allowing the brain pops awake a few hours into sleep

Restless leg syndrome (RLS) or periodic limb movements (PLMS)

Neurological disorders: dementias, Parkinson’s Disease, seizure disorders

REM sleep behavior disorder

Parasomnias: sleep walk, sleep talk, sleep eat, nightmare disorder, and sleep paralysis

Nocturia (i.e. having to urinate at night), then not being able to get back to sleep

Shortness of breath or nocturnal cough (e.g. with asthma, emphysema, congestive heart failure, reflux of stomach acid)

Racing thoughts (e.g. with anxiety, mania, obsessivenes)


Panic disorder



Obstructive sleep apnea

Central sleep apnea

Loud environment (e.g. bed partner snores, children come into bedroom, pets moving around, outdoor noises)

Charles Tadros, M.D.

August 4, 2021

Saint Louis, Missouri

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