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

PSYCHOLOGICAL CAUSES OF INSOMNIA: VICTIMS’ OF INSOMNIA SIMILAR PATTERNS OF BEHAVIOR


As a rule, victims of insomnia reveal similar patterns of behavior. At bedtime, for example, the tensions of the day have accumulated to a fever pitch. Thoughts of work, health, personal problems, even death, predominate. They awaken feeling even worse: sleepy, groggy, tired physically as well as mentally. They slog through the day worried, tense, anxious, and irritable. They may describe themselves as nervous, lonely, or lacking in self-confidence. In extreme cases they may be depressed and report that they fear they will lose control of themselves. Many feel that their situation is "hopeless."

I'd like to expand briefly on the association between insomnia and thoughts of death. Some experts feel that fear of death may underlie all forms of insomnia. I remember the little bedtime prayer I used to say as a child: "Now I lay me down to sleep, I pray the Lord my soul to keep. If I die before I wake, I pray the Lord my soul to take." How strange that so strong a connection between death and sleep should be forged in the prayers of children. For some the negative associations of sleep are extended to everything connected with the bedroom: darkness, pillows, even a toothbrush. One insomniac patient of mine noticed that his heart began to race as soon as he started to put on his pajamas. A small but significant element of his therapy was to encourage him to sleep in the nude.

*19\226\8*