Sleeping problems, no explination, very few symptoms

Patient: I used to have really bad insomnia. Always got paranoid when I went to sleep, and I could never sleep. It went away, but now it came back. I just took my blood pressure when I got out out of bed. After months I felt the paranoia again just now. My blood pressure was 119/88, heart rate 110. Now it’s 109/67, with heart rate 75. That’s after like 10 minutes of getting out of the bed. (I have borderline low blood pressure from my mom’s side of the family by the way, pay no concern to that)

Symptoms: Increased heart rate, blood pressure, paranoia, insomnia

Doctor: