Why Can’t I Sleep?
If you’ve ever spent the night tossing and turning or staring at the ceiling while your brain does it’s best impression of a hamster running on a wheel, you are not alone. Studies estimate that 33% to 50% of adults have trouble sleeping and 7% to 18% meet the diagnostic criteria for insomnia. That is, they have trouble falling asleep, staying asleep or waking too early at least 3 nights per week for at least 3 months. This difficulty with sleep can lead to irritability, depression, anxiety, brain fog, trouble concentrating or poor memory. It can also lead to you cancelling appointments or social activities or calling in sick to work because of poor sleep the previous night. It gets even worse. The lack of sleep starts to affect your body in ways that aren’t immediately obvious. People with insomnia are more likely to have high blood pressure, diabetes, immune problems, headaches, and obesity. Addressing insomnia is crucial for maintaining overall health and well-being.
How does insomnia start?
Before we talk about how to fix insomnia, it helps to understand how it develops in the first place. Dr. Arthur Spielman explained the development of insomnia using the 3Ps: Predisposing factors, Precipitating factors, and Perpetuating factors. He suggested that some people may have risk factors for insomnia. These might be biological, genetic, or personality traits that make it possible for you to develop problems sleeping. These predisposing factors are always there in the background, not necessarily affecting sleep, until they are triggered by a precipitating factor. This is usually a stressful life event, like a new job, retirement, a big project, or an illness. This stress makes it hard to sleep. So, you do whatever you have to do to get through the day. You start napping in the afternoon, try to catch up on sleep on the weekends, or drink a ton of caffeine. You also might start worrying about sleep, dreading going to bed, and spend the night watching the clock and doing mental math about how much (or how little) sleep you can get if you fall asleep right now. These things feel right in the moment and may even help us live our lives during the stressful times. However, they become bad habits that perpetuate your sleep difficulties. So, if you already have risk factors for insomnia and are faced with a stressor (or stressors) that impact your sleep, you start to do things that feel good, but actually make your sleep worse.
How can you overcome insomnia to sleep better?
The good news is that you can reteach your mind and body good habits to improve your sleep, just like you inadvertently taught yourself bad habits to mess up your sleep. Cognitive Behavioral Therapy for Insomnia (CBT-I) tackles the behaviors and thoughts (the perpetuating factors) that are getting in the way of good sleep. It uses what we know about how sleep works to create habits that work with your body to get you the best sleep possible. When you participate in CBT-I, you will be asked to track your sleep so that your therapist can make personalized recommendations based on what your body needs. You will change your sleep schedule, the things you do around sleep, and the way you think about sleep, so that you get great quality sleep. Then you work on expanding the good quality sleep to the amount of sleep that you need to function at your best. CBT-I fixes the problem by addressing what is causing the insomnia (those perpetuating factors). Research shows that CBT-I helps people to fall asleep faster, spend less time awake overnight, and sleep longer overall.
Why not just take medication to help me sleep?
If you take a sleep medication, it will probably help you sleep the night you take it. But you have to keep taking it to keep getting good sleep. Overtime, you might find that you need more of the medication to help you sleep. You aren’t really fixing the sleep problem, you are just putting a band-aid on the symptoms. The best thing about CBT-I is that it works over a long period of time because it is actually fixing the problem. CBT-I also doesn’t have the side-effects that are associated with sleep medications. CBT-I requires a little more time and effort than taking a pill. However, once you figure out what your perpetuating factors are and learn new ways to support sleep, you will continue to get quality sleep long into the future.
How can I get started with CBT-I?
If you are tired of sleepless nights and ready to invest in your health by improving your sleep, let’s find a time to talk. Click here to schedule a free 15-minute call to talk about whether CBT-I is right for you. Most people start experiencing better quality sleep in just a couple of weeks, why wait to feel better?
References:
Morin, C. M., & Jarrin, D. C. (2013). Epidemiology of insomnia: Prevalence, course, risk factors, and public health burden. Sleep Medicine Clinics, 8(3), 281–297. https://doi.org/10.1016/j.jsmc.2013.05.002
Rossman, J. (2019). Cognitive-behavioral therapy for insomnia: An effective and underutilized treatment for insomnia. American Journal of Lifestyle Medicine, 13(6), 544–547. https://doi.org/10.1177/1559827619867677
Spielman, A. J., Caruso, L. S., & Glovinsky, P. B. (1987). A behavioral perspective on insomnia treatment. Psychiatric Clinics of North America, 10(4), 541–553.
