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A few primary causes that have been identified are fluctuation of hormones or being pregnant, genes (especially if the condition starts before age 40), and certain medical conditions (3)

This work received support from the National Natural Science Foundation of China (82374321), the Tianjin-Hebei-Beijing Key Industry Chain Achievement Transformation Project (246Z2403G), and the Jie-Bang-Gua-Shuai Project of the Beijing University of Chinese Medicine (2023-JYB-JBZD-035)

Zhang Y, Jiang L, Wang J, et al

Consistent with this hypothesis, sleep deprivation culminates in maladaptive metabolic and mitochondrial adjustments, including impaired neuronal ETC activity [223]