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Risk Factors and Causes


Dr. Patel
There are many biopsychosocial risk factors and causes of sleep disorders. Dr. Phillips, what can you tell us about common risk factors for sleep disorders?

Dr. Phillips
Well, Dr. Patel, the risk factors for sleep disorders can be categorized as predisposing, precipitating, and perpetuating factors.

Predisposing factors are those biopsychosocial factors that exist prior to the development of a sleep disorder. They don't cause the sleep disorders, but they do make it more likely that a person will develop a sleep problem at some point. Predisposing factors that are associated with sleep disorders include:

  • Family history of sleep problems
  • Elevated anxiety
  • A tendency to be overly concerned with personal well-being, and
  • Metabolic rate, or the amount of energy a person needs to keep the body functioning at rest

Precipitating factors are situations or events that can trigger the onset of a sleep disorder. Common precipitating factors include:

  • Acute stress and traumatic experiences
  • Interpersonal conflict
  • Changes in job or location
  • Medical problems, such as pain or discomfort, extended hospitalization, or conditions that cause frequent nighttime urination, and
  • Working irregular shifts

Perpetuating factors are biopsychosocial components that keep the disorder ongoing and often make it worse over time. These can include:

  • Going to bed at a different time each night
  • Waking up at a different time each morning
  • Spending too much time in bed for anything other than sleep or intimacy, for example, using the television, computer, or a mobile device in bed
  • Daytime napping
  • Not getting enough exercise
  • Untreated physical health problems
  • Medications that cause sleep problems
  • Unhelpful thoughts about sleep, such as, "I need eight hours of sleep no matter what"
  • A busy lifestyle
  • Inadequate sleeping environment, which can be affected by lighting, noise, pets, and children, and
  • Working swing shifts

Finally, there are some medications and substances that can negatively affect sleep, including:

  • Alcohol and other drugs
  • Products that contain nicotine, such as cigarettes and smokeless tobacco
  • Caffeine
  • Certain cold medicines and diet pills, and
  • Other medicines, herbs, or supplements