Substance- or medication-related insomnia

After stimulants, caffeine excess, corticosteroids, antidepressant activation, withdrawal, alcohol rebound

UrgentReview due

At a glance

High-risk causes: 4
Related differentials: 6

Safety snapshot

Watch forStimulant toxicityalcohol/benzo withdrawalantidepressant-induced switchsteroid psychosis

Presentation hinge

Sleep disturbance sits inside a broader syndrome. Reduced need for sleep is one of the most decisive bipolar bedside clues.

Separates the Sleep Disturbance / Insomnia / Reduced Need for Sleep group. It is not specific to Substance- or medication-related insomnia.

Clinical review

Rows marked “Whole group”: Applies to the Sleep Disturbance / Insomnia / Reduced Need for Sleep group — not specific to Substance- or medication-related insomnia

Why it fits

After stimulants, caffeine excess, corticosteroids, antidepressant activation, withdrawal, alcohol rebound

Key features

Must-not-miss

Stimulant toxicity, alcohol/benzo withdrawal, antidepressant-induced switch, steroid psychosis.

High-risk causes4 causes

Stimulant toxicity
alcohol/benzo withdrawal
antidepressant-induced switch
steroid psychosis

Bedside question

Applies to the Sleep Disturbance / Insomnia / Reduced Need for Sleep group.

Sleep disturbance sits inside a broader syndrome. Reduced need for sleep is one of the most decisive bipolar bedside clues.

Helpful clues

Immediate action

Applies to the Sleep Disturbance / Insomnia / Reduced Need for Sleep group.

None listed

Priority steps

Investigations

Applies to the Sleep Disturbance / Insomnia / Reduced Need for Sleep group.

None listed

Core tests

Mimics / overlap

Applies to the Sleep Disturbance / Insomnia / Reduced Need for Sleep group.

None listed

Consider

Clinical reference — not validated decision support. Review before use.