Why Can’t I Sleep?

If you’re reading this blog post you’ve probably been asking yourself for a while, “Why can’t I sleep?”. You’ve consulted the internet for answers and found advice about sleep habits or “sleep hygiene”. You’ve tried to relax before or in bed. You may have tried over-the-counter or prescription sleep medications. You might think your insomnia can’t be solved. What you may not realize is that you haven’t yet tried the most effective insomnia treatment: cognitive behavioral therapy for insomnia (CBT-I).

I’m not going to attempt to describe that entire insomnia treatment here, but I’m going to give you three likely answers to your question, “Why can’t I sleep?”:

1.  You are sabotaging your internal clock or “circadian rhythm”. This mechanism in your brain signals the rest of your brain when it’s time to wake up and when it’s time to fall asleep. You set your internal clock by following a regular sleep schedule. If your sleep and wake time vary by more than a half-hour, you’re probably sabotaging your internal clock. If you buy into the myth that you can “catch up” on sleep by sleeping in or taking long naps, you may be making your insomnia more persistent and severe.
2.  You are disrespecting your sleep environment. The main message you can take from your insomnia is that good sleep is important. Good sleep depends on creating a strong association between your bed and bedroom and sleep. Unfortunately, many people disrespect their sleep environment by using it for activities that stimulate the brain, such as watching television, discussing emotional topics, worrying, reading, looking at electronic devices, or doing work in bed. This can maintain or worsen insomnia, creating an association between brain stimulation and the sleep environment, the opposite of what you need to sleep well. Even if you’re simply awake for more than 15 minutes it is best to get out of bed.
3.  You’re impatient to improve your sleep. This is an understandable feeling, but one that it is important to learn to manage so it doesn’t translate into insomnia-inducing behavior. Sleep is an involuntary behavior. We influence it over time; we don’t control it. Trying to control it in the short run stimulates the brain and can feed into “sleep performance anxiety” (worry about whether you’ll sleep) which worsens or maintains insomnia. You have probably already learned some ways to cope after a bad night of sleep. Building on those can reduce anxiety. Improving sleep requires at least 2-3 weeks of consistently following good sleep habits. Too often people maintain these habits for a few days and give up. Additional techniques overseen by a CBT-I therapist may be necessary.

I don’t want any of the above to suggest that overcoming insomnia is easy. It’s not. It is a significant challenge in managing your own habits. Insomnia-inducing habits may be quite engrained. This is where a well-trained specialist in cognitive behavioral therapy for insomnia can help.