The more I research sleep disorders and try to understand my own issues with sleep, the more I am amazed by what I sometimes discover.
I would never typically categorize myself as having a specific disorder or problem, but every once in a while I find something that literally calls out to me and speaks to me on a personal level.
The name caught my eye, so I just had to Google – “What is Psychophysiological Insomnia?”
15 articles, 7 medical publications, and one interview with a medical professional who specializes in various forms of insomnia later, and I was hooked.
Now I’m not saying that this form of insomnia has got my name written all over it, but I totally get where it is coming from, and this is a phenomenon that I have experienced time-and-time again.
What is Psychophysiological Insomnia? – The Facts
Have you ever built something up so much in your head that it starts stressing you out?
This generally occurs when you have to do something that you’re perhaps not familiar with, or that causes you some form of fear.
It could be giving a presentation at work, having to give a speech at a wedding, it could even be the first time you’re having sex with a new partner.
We refer to this as “performance anxiety”.
Who knew that the exact same paradoxical situation could arise (no pun intended) with something that we spend approximately 33% of our lives doing?
Oh yes, apparently you can get performance anxiety about going to sleep.
Well, not exactly, so allow me to explain.
Psychophysiological insomnia is when you focus excessively on sleep, so much so that this creates anxiety in your mind about going to bed.
You probably spend a lot of your day thinking about how a lack of sleep is going to affect you, and as the time for bed approaches your stress levels are going through the roof.
You’ve spent all day worrying and when bedtime finally arrives – you’re unable to “perform”.
Psychophysiological insomnia is usually triggered by stress, but once that stressful event is over and done with, your insomnia stays with you because you’ve taught yourself not to fall asleep.
A typical example of psychophysiological insomnia is that you’ll go to bed feeling tired and sleepy, but the second your head hits the pillow you’re probably more awake than you have been all day.
You will probably find that you can effortlessly fall asleep at other times of the day, especially when you’re not in your own bed. This form of insomnia is easily recognizable, as your levels of stress and anxiety will typically increase when you’re in the home environment and the closer it gets to bedtime.
My Experience with Psychophysiological Insomnia
I mentioned above that this type of insomnia “spoke to me on a personal level”.
In truth, the more I research this entire subject in general, I can see parts of me in each different category of insomnia.
I have spoken previously about stress-induced insomnia, and my overactive imagination and chattering brain definitely got the better of me as soon as I went to bed.
I would also say that I often made some poor lifestyle choices, many of which I never even considered would impact upon my sleep.
However, my experience of psychophysiological insomnia is one that crept up on me out of nowhere, much like a silent assassin, and at the time I didn’t even realize this was affecting me.
Looking back now, I can see quite clearly that I used to wind myself up as bedtime approached.
I was used to going to bed and then starting to stress about something that occurred earlier in the day, or overly worrying about something I had to do the following day.
But, without even noticing, as I made my way to bed, my mind would often say to me, “Oh well, here we go again. Time for bed. You know you’re not going to sleep. You’re going to lie awake for hours and hours, thinking about this-and-that.”
So, at first, these thoughts were nothing more than the occasional utterance of nonsense, but over time they grew, and I now recall often winding myself up into a frenzy because I was so worried about not falling asleep, or only getting 6… 5… 4… 3 hours sleep.
Who knew how much I was going to get?
I certainly didn’t, but I had got to a stage where I allowed my mind to convince me that trying to sleep was going to be a stressful event and a battle.
How Did I Deal With Psychophysiological Insomnia?
I’ve actually read a lot more about this form of insomnia since I actually managed to deal with it.
In fact, some advice I have come across, well let’s just say I could’ve done with that help a few years back.
For me, I knew everything came down to my mind, and the constant whir of negative chit-chatter.
I’m not just talking about a lack of sleep here either, I’m talking about life in general.
I knew that if I could somehow get my overactive brain to calm down and just shut that negative voice in my head up, once and for all, then life would seem a lot easier.
So, that’s exactly what I did – I worked on my mind.
I knew if I could be more positive in my daily life and somehow stop myself from overthinking every little thing, then matters would start to improve.
In a way I wasn’t dealing with my insomnia directly, but focusing on the root cause.
And that for me is what getting over any form of insomnia is all about.
I’ve read on countless occasions about there being something called primary insomnia and secondary insomnia.
Primary insomnia in my mind meant that there was no rhyme-nor-reason for the sleepless nights, it was just THERE.
Whereas, secondary insomnia is typically a knock-on effect from another condition, illness, problem, etc. be it mental or physical.
The more I thought about this, the more I wanted to confront every Doctor, medical expert, or sleep specialist and say, “There’s no such thing as primary insomnia”.
Psychophysiological insomnia is classed as a form of primary insomnia, i.e. no specific cause.
However, that’s not strictly true, is it?
The reason you can’t sleep is because you worry about not sleeping. You may not have an “official” diagnosis, but surely this is a case of anxiety on some level.
Anyway, the point I’m trying to make is that there is ALWAYS a reason for insomnia. I refuse to believe that there is no known cause for insomnia, as some may have us believe.
My belief may not make me very popular with the medical world, or even with people who claim that there is absolutely no reason they suffer from sleepless nights, but I honestly think there’s always something to it.
I mean, you could be allergic to a certain color of duvet without ever realizing it, but for me something is causing your insomnia.
And, as I say, for me, it was my own mind.
I don’t want to repeat myself, as I have spoken of my own insomnia journey in many articles on this website, but I will say one of the first things I tried (and eventually succeeded with) was mindfulness meditation.
I tried things such as affirmations and visualizations, but in all honesty, they had absolutely no affect on me. I’m sure many people swear by these two practices, but sorry, NO, not me.
I came to the conclusion that mindfulness meditation, journaling, LESS intense exercise (I exercise hard and a LOT), better nutrition, and having a routine an hour before bed every night, not only helped to fix my mind (actually it’s still a work in progress, but I’m getting there), but also to finally overcome insomnia.
How Else Can You Treat Psychophysiological Insomnia?
Sleep Schedule and Sleep Environment
Something that I talk about a lot is having a fixed sleep schedule, weekends and holidays included.
It may take a bit of getting used to, but eventually your mind and body will know EXACTLY what time you should be going to bed, and what time you should be waking up in the morning.
So, pick the times that are best for you and stick to them.
I’ve also mentioned your sleep environment many times before, and this is equally important.
The most obvious factor is that your bed should be comfortable, You also need to ensure that your bedroom is dark, quiet, and the temperature is optimal for a good night’s sleep.
Far too many people sleep in a bedroom that is too warm – the body’s core temperature does drop when we first fall asleep, but our peripheral skin temperature rises.
However, your body temperature will go through various changes during different sleep stages.
Cognitive Behavioral Therapy (CBT)
CBT is generally used to deal with anxiety and depression and is becoming far more popular way to treat insomnia.
By talking through the thought processes and beliefs you have about sleep you can actually start to see them for what they are – nothing more than your mind trying to control you.
CBT typically involves using certain techniques whenever you start getting anxious about sleeping, in order to gain control over your mind.
Here’s a strange method of treatment, but some Doctors swear by it.
However, I’m not completely sold on this method, and I’m not entirely sure of the benefits.
The aim is to restrict the number of hours you sleep – you go to bed at a later time and get up in the morning at an earlier time. A prime example of this would be a sleep time from midnight until 5am.
If for any reason you are unable to sleep, you should get out of bed until you feel tired, but don’t do anything strenuous or something that involves bright lights, and then go back to bed, but still wake up at 5am.
Then the amount of sleep time is slowly increased once you are sleeping the full 5 hours.
I’m guessing the aim is to get you to a stage where you feel so tired every night when you go to bed that you’ll definitely fall asleep.
As a short-term measure this may work, but I feel that you can never make up for lost sleep, so this method may cause health concerns or issues at some point in the future.
Psychophysiological insomnia, in short, is not being able to sleep because you are stressed and anxious about not being able to sleep – a vicious circle if you will.
As it turns out, it is a very common condition, and it is one that I remember well.
For me, I found that my mind was affecting my life in a variety of ways, and having problems with sleep was merely one of these.
It wasn’t until I started to realize that I could do things on a daily basis, that would improve my thought processes, and literally banish that negative chatterbox, that the quality of my sleep finally improved.
The human brain – we know so much, and yet so little.