How insomnia becomes chronic
How insomnia starts
Insomnia, inability to fall and/or stay asleep that lasts for weeks, months, and sometimes years, usually starts with an episode of poor sleep. It can be a significant life event, a period of high stress and anxiety, a surgery, birth of a child. Often, when the initial situation that triggered sleep problems is resolved, sleep returns to normal on its own. But sometimes people get stuck with inability to sleep even though nothing stresses them out any longer. Apart from their poor sleep that is.
Why do people get stuck?
Ironically, they often get stuck because they start worrying about their inability to sleep and try to do something about it. For example, they may try to compensate for their inadequate night sleep by napping or going to bed early, thereby disrupting their circadian rhythms. Or they drink coffee excessively, thereby overstimulating their nervous system. Or they try different techniques to fall asleep -- relaxation exercises, listening to the radio, meditating, or drinking chamomile tea, none of which works reliably.
The insomnia paradox
Sleep is beyond our conscious control and there is no proven method to put oneself to sleep. So when you try different "methods" to fall asleep and they fail, you lose the confidence in your ability to sleep and anxiety starts to mount. Anxiety is a state of agitation, it prevents sleep from happening… The more you try to sleep, the more elusive sleep becomes. Anticipating being woken up, thinking about a busy day ahead only adds to the worrying. The more important you think it is for you to sleep, the harder it is to get there. In other words, thinking and worrying about sleep, trying to control it, and unwillingness to experience insomnia is what contributes to maintaining insomnia. This is the paradox of sleeplessness.
Psychotherapeutic approach to insomnia
... is about working with those thoughts and worries about sleep, which keep you awake. It is also about shifting focus away from insomnia, learning to be ok with not sleeping when you cannot, and trusting that the body will regulate itself and regain its ability to sleep. And it will. All we need to do is create the best conditions for the body to be able to sleep and then let go of control.