PSYCHOLOGICAL CAUSES OF INSOMNIA

By far the most frequent source of insomnia is some form of mental or emotional disquiet. Since one primary biological reason for sleep is to provide the brain with a chance to rest, it is perhaps not surprising that one consequence of a troubled mind should be troubled sleep.

I must hasten to point out that in using such terms as "mental disquiet" or "psychological disturbance" I am not suggesting, by any stretch of the imagination, that people with insomnia are thereby crazy, or that their sleep troubles are "all in their minds." Quite the contrary. Insomnia is a very real, and very widely experienced, phenomenon. Insomniacs really do sleep less than other people, as measured not just by their own perceptions but clinically and scientifically in sleep laboratories. Nor do victims of insomnia have unrealistic expectations or beliefs about what constitutes a good night's sleep; studies have shown that insomniacs desire only the same amount of sleep as other people.

While it is true that insomnia is a feature of a number of severe mental disorders, including clinical depression, it may also appear when a psychologically healthy person's life is unusually stressful or tension-filled. Often people with sleep disorders have endured troubling situations over which they had no control—an unhappy home life during childhood, for example/ And the increasing pressure and pace of today's society adds to everyone's mental load. The primary purpose of labeling insomnia as largely psychiatric in origin is not to suggest that the disorder is illusory or that its victims are mentally disturbed but to call attention to the types of therapy that have the greatest chance of succeeding.

With that in mind, then, let me proceed to describe some of the behavioral patterns and mental attitudes that are frequently associated with insomnia. Perhaps you will recognize one or more of these traits in yourself or in a loved one who suffers from sleepless nights. If so, you will be better able to focus on the cause of the problem—the first step toward resolving it.

*16\226\8*
Portuguese Italian Spanish English French German

SLEEP DISTURBANCES — CAUSES AND CONSEQUENCES: EXOGENOUS DISTURBANCES IN FALLING ASLEEP


This kind of problem in sleeping is caused by a disturbing, external stimulus or by a change in sleep rhythms or sleep habits.

Changes in rhythm occur, for example, in plane travel as a result of time changes. They also occur at work as a result of switching from the day to the night shift, on vacation due to the absence of the usual work schedule, or upon retirement. Paradoxically enough, difficulty in falling asleep as a result of unaccustomed exhaustion that upsets the organism's familiar rhythm also belongs in this category. A change of climate, an unfamiliar bedroom, new sensory impressions, acoustic stimuli such as strange sounds, or optical stimuli resulting from a room that cannot be darkened can become exogenous disturbing factors.

Difficulties in falling asleep resulting from such factors are considered to be physiological in origin if they again disappear soon among sleepers not usually troubled by

difficulty in sleeping—i.e., as soon as the body has become accustomed to the new set of environmental stimuli and has adjusted to the new rhythm or if the environmental situation has changed. If normal sleep is not resumed, however, and if the difficulty in sleeping continues even after a longer period for adjustment, then a real sleep disturbance is involved. This is termed a psychically conditioned (psychoreactive) sleep disturbance, since the psychic reaction to the disturbance stimulus is the predominant factor.

*16\340\2*