All of us experience disturbed sleep from time to time, often caused by stress. As our body has learned to cope with short-term stress, we usually recover fast once the stressful event is over. Our sleep pattern returns to normal, and we quickly forget the sleepless nights.
Things are getting complicated when your sleeplessness continues even after the stress has passed. When your difficulties falling or staying asleep at night outlast the stressful period, your insomnia has become chronic. And along with your continuous sleep struggle, you may develop a whole range of negative and destructive beliefs, which have a powerful impact on your everyday life.
While this condition is painful and frustrating, it also reveals a lot about how you developed insomnia, and, even more crucial, why you got stuck so that your insomnia persists, although the initial stressor is long gone.
The habit of pitying yourself
Over the years I was suffering from insomnia, I wasn’t really interested in finding out how insomnia develops. I think the reason was that I was just too preoccupied with my worries and thoughts. After a while, I started to believe that my sleep problems are unique, that my insomnia is worse than other’s, and that there is no way to cure it.
Let’s face it: if life gets complicated, it often is more comfortable to get stuck in the habit of being miserable with yourself. That’s exactly the state I was in; instead of acknowledging and accepting what was happening while I was lying wide awake in bed, I was pitying myself. Due to my intense focus on myself, insomnia became this highly subjective, unique experience which paralyzed me from moving on.
While it is true that your experiences with insomnia might be different from mine, we both need to stop to believe that there is something unique about our sleep problem. Also, unless we acknowledge and accept our current situation, the things we are resisting and avoiding persist and change for the better can not occur.
It took me far too long to make a conscious choice to turn away from my negative beliefs. Today I know that I could have escaped the vicious cycle of worry, fear, and frustration much earlier if – instead of feeling sorry for myself – I would have taken a step back to gain objectivity and to look at some facts how insomnia develops. Fortunately, with the help of others, I was eventually able to do so. The distance then allowed me to view my problems through a lens of objectivity, which was a necessary first step in overcoming insomnia.
How insomnia develops: The 3P model of insomnia
The 3P model of insomnia from Spielman and Glovinsky offers you a structured explanation of how insomnia starts and how people get stuck. When I came across this model, it wasn’t just that I suddenly understood that my sleep problem wasn’t unique; more important was the realization that while insomnia was the cause of my pain, the way insomnia worked and impacted my life also showed me how to cure it. I know this sounds a bit simplistic but let’s dive in a bit deeper and you will see what I mean.
According to the 3P model, there are three primary factors why you develop insomnia and why it is not easily going away: predisposing factors, or risk factors; precipitating factors, or triggers; and perpetuating factors, which refer to your practices or coping strategies reinforcing your sleeplessness. Let’s have a closer look at each one of them.
Predisposing factors: Your risk to develop insomnia
Every human being is different, and some of us are born with or acquire over time psychological or biological characteristics, which increase the risk, or predisposition, to develop sleep difficulties. Important to note is that while you may have one or several of these factors, it does not necessarily mean that you become an insomniac. Therefore, predisposing characteristics are not a direct cause of insomnia, but they increase the probability that you will struggle to sleep. Think of it like being overweight; it increases the risk for diabetes but doesn’t guarantee that you get diabetes.
These are some of the main predisposing of risk factors for insomnia:
- general high arousal levels
- being female (menstrual cycle, menopause, pregnancy)
- genetic predisposition and family history
Precipitating factors: the trigger events for your insomnia
Precipitating factors are the events that can trigger insomnia; they are almost always linked to stress and mental overstimulation. They can occur unexpectedly, like the sudden death of a loved one or losing your job, or they develop over time, like growing pressure at work or relationship problems.
Interestingly a trigger event can also be something you are looking forward to, like organizing your wedding or your mother’s birthday party. You may end up being so overwhelmed that you have difficulties to calm your overstimulated mind. The ongoing high level of stress hormones make you feel irritated and kick off further worrying, frustration, and anger. Other examples of precipitating events are illness, hormonal changes, divorce, or becoming a parent.
The interaction between precipitating events and predisposing characteristics
It is often the interaction between the precipitating events and your predisposing characteristics, which then leads up to sleep problems.
Here is an example: You always have been a night owl, meaning you functioned better late in the evening. This is your predisposing factor based on your genes. However, you adapted your life accordingly by getting up later in the morning.
Suddenly you get into a situation where you have to get up early because let’s say you start a new job which requires early morning presence. This is now the trigger for you developing sleep problems. In other words, being a night owl puts you at risk for developing insomnia, changing your sleep schedule then triggered insomnia.
Another example: You are a successful manager with a lot of energy (predisposing characteristic). You and your wife have a newborn baby, and both of you spend the first month getting up during the night soothing the baby (trigger event). After a few months – although the baby sleeps through most of the nights – you still have trouble sleeping. But now it is your racing mind about work issues which leaves you lying wide awake in bed.
Why do we get stuck in insomnia?
The above examples show that we often cannot or are not willing to change our risk factors or our triggers. And that’s totally ok. Our sleep patterns shouldn’t dictate the most critical decisions in our life. There is no reason why you should decide not having children or give up a good job just because these things might increase your risk of developing a sleep problem.
It might also be possible that you don’t know what it was that initially caused your insomnia. While this might be confusing and frustrating, it’s not the end of the world. The good news is that in order to successfully treat your insomnia, you don’t really need to know what it was that ruined your sleep in the first place.
What is more important is this: Why did you get stuck so that your sleep problem persists? That is the real question that leads us to the third element of the model, the perpetuating factors.
Perpetuating factors: Your doings while you can’t sleep
Perpetuating means to preserve or to maintain and refers to your ongoing practices and coping strategies, your current doing while you can’t sleep. In other words, these are the factors which determine how you respond to your current struggle with sleep, and more importantly, why your sleeplessness persists.
I don’t know what your exact coping strategies are to try to improve your sleep. When I think of my insomnia journey and the many discussion I had with other insomniacs, desperate to sleep combination of two things: the way we behave and the way we think while we can’t sleep. Let’s dive deeper into each of them.
Mental and behavioral aspects of insomnia
First, it is important to understand that chronic insomnia is almost always based on both mental and behavioral aspects, meaning the interaction between your thoughts, feelings, and behavior. While a stressful life event can contribute to triggering insomnia, it is often the excess worrying coupled with wrong coping strategies that make the problem worse.
Paradoxically, although our intrusive thinking about our situation digs deep into our psyche, we often focus purely on external ways such as prop, pills, and potions in trying to get rid of our pain. We end up spending a lot of money for all sorts of sleep remedies and cures; we rearrange our bedrooms, try different relaxation techniques, take hot baths, change our diet and avoid social activities which might interfere with our meticulously planned sleep rituals. And, yet we still find ourselves lying wide awake in bed at night.
On top of this unhelpful behavior, many of us turn to the internet and start reading about other insomniac’s experiences by joining one of the many online insomnia communities. I did that too – one of my biggest mistakes. Instead of trying to find a way out of the vicious cycle of worries, frustration and anger, I was either identifying myself with other people’s suffering, or I was torn between panic and relief when I learned that there are people whose sleep problems were even worse than mine. Will I end up like him or her or is my situation not that bad after all?
The root cause of your struggle to sleep is faulty thinking
Worrying about sleep makes your sleep problem worse – it is as simple as that. Of course, you should also keep an eye on your sleep habits and routines. But chronic insomnia is primarily a mental problem, and that’s why it is necessary to seek for psychological solutions.
The root cause of your struggle to sleep is faulty thinking and negative beliefs, so that’s where you need to put your focus on to improve your situation – and not on implementing new sleep rituals or taking sleeping pills. These coping strategies may give you some relief in the short term, if at all. But in the long run, they won’t help you at all and will keep you even more awake.
The way chronic insomnia works also reveals its cure
What I found so fascinating about the 3P model of insomnia is this: the way chronic insomnia works also reveals its cure. By looking at this model, you gain objectivity and valuable insights why your sleeplessness started, but more importantly, why it doesn’t go away.
As every person is to some degree vulnerable to develop insomnia, there is no uniqueness or magic about this condition. Even if you are not predisposed to develop insomnia, it still could be kicked off by a trigger event.
If your sleep problem persists, the model indicates the way to solve it. You may not be able to change the predisposing/risk (P1) or precipitating/trigger (P2) factors, but what you can influence are the perpetuating factors (P3), the way you respond to your insomnia. Here lies the real secret of curing insomnia. It is your doing, your focus on trying to get rid of insomnia which is the main contributor to your sleep struggle; by testing different experiments and remedies and by blocking out unpleasant thoughts you spend your time and energy on resistance rather than changing the situation.
How to cure chronic insomnia?
If you want to cure insomnia effectively, you must target your unhelpful coping strategies and learn to accept how things are right now. Without the awareness and acceptance of your current condition, the things you are resisting and avoiding persist and change can not occur.
Start by taking a step back to gain more objectivity. Then, instead of trying to get rid of your troublesome thoughts while lying awake at night, acknowledge and accept what is happening in that very moment. It won’t be easy to feel the pain, the tension, the anger, or whatever else comes up. But acceptance is the most crucial ingredient for stopping your insomnia battle. If done wholeheartedly – it can provide instant relief and enable you to take the next smalls steps that are required to return to restful sleep.