Disclaimer: This article is not intended to diagnose or treat any insomnia disorder. Only an American Academy of Sleep Medicine doctor should diagnose and provide insomnia treatment.
Do you wake up in the middle of the night, unable to fall back asleep? Do you feel like no matter how much sleep you get, it's never enough? Psychophysiological Insomnia is a subset of chronic Insomnia that can be hard to diagnose and even harder to treat. In this article, we'll go over what Psychophysiological Insomnia is and how different treatments work.
What is Insomnia?
Insomnia is a sleep disorder that makes it difficult to fall asleep, stay asleep, and get the amount of sleep you need. There are different types of Insomnia.
Getting sleep is critical for our health. It's when our body repairs itself, builds our immune system and balances the hormones in our body. It's when we consolidate memories, learn new things, solve problems in creative ways - you get the idea!
Insomnia symptoms include :
- Difficulty falling asleep
- Waking up too early in the morning
- Feeling tired throughout the day, even if you've slept enough hours.
Chronic Insomnia is when these symptoms persist for over three months. Insomnia can be caused by stress or anxiety, medical conditions, medications that interfere with sleep, changes to lifestyle, and poor sleep hygiene.
What is Healthy Sleep
To fully grasp what Insomnia is, you have to contrast it to what healthy sleep is like. Good sleepers' time in bed ranges from six to eight hours. They fall asleep within minutes, sleep straight through the night, and wake up refreshed in the morning with little or no effort.
Good sleep hygiene starts with a schedule of consistent bed and wakes time. It would help if you looked for a total sleep time of seven to nine hours each night, including naps, maintaining sleep through the night.
The average sleep cycle lasts 90 minutes and repeats four to six times in a single night. Each cycle consists of five stages: four non-rapid eye movement (REM) stages and one REM sleep stage. The first three are the lightest or non-delta sleep. REM is when your dreams occur and is one of the most critical sleep cycles.
Additional Sleep Conditions
Insomnia is not the only condition related to sleep. One of the most common non-insomnia sleep disorders is sleep apnea. It's a condition in which breathing is interrupted during sleep, sometimes dozens of times an hour. This can cause the sufferer to wake up feeling unrested and unrefreshed.
Sleep apnea has many symptoms, including chronic fatigue throughout the day, snoring loudly enough to disturb your bed partner's sleep, loud gasps for air while sleeping, or choking sounds.
The condition can lead to many more dangerous conditions like high blood pressure, heart disease, and diabetes.
Sleep apnea is often treated with a CPAP machine at night that helps keep the airway open. There are also surgical options for more severe cases of sleep apnea.
Types of Insomnia
The International Classification of Sleep Disorders lists five main types of Insomnia. They range from mental to physical impairments to falling asleep. These insomnia types are primary Insomnia due to the effects not being brought on by other medical conditions.
The most common type of Insomnia is acute Insomnia. It's when you have temporary sleep issues due to a specific cause, like jet lag or stress at work. Acute Insomnia typically goes away after the root causes are treated.
Chronic Insomnia is longer lasting and doesn't have a root cause. Things like chronic pain can cause it, stress at work, or anxiety disorders - to name a few.
The main difference between chronic and acute is that chronic Insomnia can last for months or years while acute is typically a few days to a week.
Onset insomnia is when someone has trouble falling asleep. It can be caused by things like irregular sleep patterns, shift work, or alcohol abuse.
Any time you wake up in the middle of the night or before your alarm, and you cannot fall back asleep is considered maintenance insomnia.
Specific to children, behavioral Insomnia is when children have trouble falling asleep. The leading causes of this type are bedtime fears and nightmares.
What is Psychophysiological Insomnia
Psychophysiological Insomnia is a subtype of chronic Insomnia where the sufferer worries about getting enough sleep, causing anxiety that causes them to struggle to fall asleep initially or wake up in the middle of the night.
This is not a physical condition and results from a negative mental feedback loop.
It's most commonly found in adult women and is not common in children.
Treating Psychophysiological Insomnia
The most common way to treat psychophysiological Insomnia is cognitive behavioral therapy. Other methods involve relaxation exercises, sleep aids and sleep medicine.
Cognitive Behavioral Therapy
Cognitive behavioral therapy treats psychophysiological Insomnia by targeting the mental feedback loop.
It is helpful because it gets to the root of why someone cannot sleep instead of just treating their symptoms. Treatment can take anywhere from a few weeks to months, depending on how long they've had Insomnia and how entrenched their negative sleeping habits are.
Cognitive Behavioral Therapy targets your thoughts about sleep, stressors that affect your sleep and help create a healthy sleep onset.
A therapist or physician performs behavioral therapy for Insomnia.
The first step is usually developing a sleep plan, which includes keeping track of your sleeping patterns in a sleep diary and the time you go to bed each night for one week. This gives them an idea of what works best for their patient's schedules. Then they will create personalized suggestions based on that information, such as staying away from technology before bed and a consistent sleep schedule.
With anxiety being the main culprit of psychophysiological Insomnia, relaxation exercises can help.
This includes breathing exercises and mindfulness meditation. These practices allow you to deal with stress more effectively through deep, even breaths, which also help relax the body for sleep.
In addition to relaxation exercises and cognitive behavioral therapy for Insomnia, sleep aids can help you fall and stay asleep. They range from vitamins and herbs to prescription medicines.
Some common sleep aids are melatonin, lavender oil, and valerian root.
For the harder to treat insomnia disorder, common prescription drugs include Lunesta, Sonata, and Ambien.
Psychophysiological Insomnia is brought on by sleep related anxiety. CBD is a new way some people are treating their anxiety. The studies are still ongoing to prove these anecdotal claims, but initial releases are looking promising.
While it's not a sure thing, using CBD to try and tone down your anxiety related to a sleep disorder may be worth a try as it is readily available and cost-effective.
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Psychophysiological Insomnia is a tougher primary insomnia disorder to treat. It requires consistent action to improve sleep hygiene and habits from insomnia patients. The most common way to treat psychophysiological Insomnia is cognitive behavioral therapy. Other actions like sleep exercises and taking sleep aids can help supplement the therapy as well.
It is critical to get your Insomnia under control as it can lead to many other health conditions. We wish you luck in conquering Insomnia.