Psychophysiological insomnia causes inadequate sleep due to intense anxiety about getting enough rest. Self-medication and anxiety exacerbate the problem. Diagnosis is made by ruling out other causes, and treatment includes improving sleep habits, cognitive behavioral therapy, and medication if necessary. Women are more affected than men.
Psychophysiological insomnia is a sleep disorder that causes inadequate sleep at night. This is mainly due to a person’s intense anxiety to get enough rest, which makes it difficult to fall asleep or stay asleep. For this to be considered a real disturbance, it must occur regularly, so that sleep is often disrupted. The condition occurs in the absence of other causes of insomnia but, over time, can cause further problems such as depression. People often try to solve this problem on their own by using sedatives or alcohol to promote sleep at night and large amounts of caffeine during the day to combat drowsiness. These attempts at self-medication, coupled with constant anxiety, only exacerbate the problem.
The hallmark symptoms of psychophysiological insomnia are chronic poor sleep and severe anxiety about falling asleep. Poor quality sleep tends to lead to feelings of fatigue during the day. Other symptoms such as depression, alcohol use or abuse, and caffeine abuse may also be present. Depression requires some investigation and it is important to establish that it occurred after the onset of the sleep disturbances and not before, or could be considered the primary cause of insomnia rather than secondary to psychophysiological insomnia.
In fact, the diagnosis of this condition is often made by ruling out other psychological or physiological disorders that can cause sleep difficulties. When a patient has symptoms of poor sleep and extreme concern about them, they may still need sleep studies to rule out causes such as sleep apnea, restless legs syndrome, a long history of depressive or anxiety disorders, and other causes. Patients may also be asked to think about when the problem started and when the concern about sleep started to grow. Often, there is an incident or series of nights of poor sleep that created excessive worry, and over time the condition escalated to such an extent that it was difficult to get enough sleep.
There are several potential treatments for psychophysiological insomnia. One of them is to work on sleep habits or sleep health so that night and day behaviors are more conducive to sleep. Among other things, it is recommended to eliminate the use of alcohol and caffeine to improve sleep health. People could also learn some relaxation exercises.
Psychotherapy is often recommended, and the most common type used to treat this problem is cognitive behavioral therapy (CBT). Sometimes drugs are prescribed to promote sleep, but only if the patient is not abusing other substances. If severe depression is present, doctors may also choose to treat it with antidepressants.
Treatment takes time because it is difficult to recover from excessive worry and improve sleep habits. Patients can monitor their sleep levels and meet with doctors regularly to see if treatments are creating improvements. Doctors adjust recommendations accordingly.
Psychophysiological insomnia is uncommon and tends to affect only adolescents and adults. Women seem to suffer from this condition to a greater extent than men. People who think they have this condition should tell doctors that the sleep loss appears to be caused mostly by worry. This is a strong indicator of the condition.
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