The question Why can’t I just fall asleep? looks simple and clear enough that it should justify a clean, clear, and direct response, correct?
Regrettably, it's not that simple. Let me explain.
It's a tip-of-the-iceberg type of question. It is the type of question a business owner or an athlete would ask himself in terms of: 'Why am I not achieving my targets?'. Or one would ask a doctor: 'Why does something hurt?'. Or asking a car mechanic: 'Why is my car not working?'
You cannot receive a straightforward solution to any of those questions without undergoing a proper diagnosis.
Why? Simply because the answer depends on many factors. Not considering them would most likely only lead to dead ends, wasted resources, and ultimately unsatisfactory if any, results.
But let's not delay on the philosophy of the approach, but focus on finding an answer. In general terms, the inability to fall asleep can originate in:
Sleep being the problem by itself. A situation classified as primary insomnia, or
Insomnia is a consequence of some other, underlying problem. The condition is called secondary or comorbid insomnia.
Before proceeding to address insomnia directly we must first rule out any possibility of secondary insomnia.
If we skip this, we might find ourselves in a situation where we would be treating a symptom, and not a disease. Imagine coming home, and seeing your apartment being flooded. Yet instead of first aiming to find and fix the water source, you would focus on pumping the water. You could pump all you wanted, but with a constant supply of new water, the flooding problem would never really go away. The same is true with treating any problem, including insomnia.
We rule out the possibility of secondary insomnia quite simply by checking if any of the following holds true for you:
Possible Psychiatric Disorders Causing Insomnia:
Depression. A state of overwhelming psychological pessimism and negativity that causes behavioral deactivation, passivity, and isolation. It is accompanied by intense negative, mostly deactivating, sad emotional states that decrease any interest in external stimuli. Although persons suffering from depression more often experience extended sleep periods (hypersomnia), the other extreme on the pendulum (ie. insomnia) is also possible. If this describes you perfectly, or you suspect or even just feel this could be you, commonly finding yourself in such states, I recommend completing one of the standardized questionnaires such as Beck Depression Inventory II for signs of Depression to verify if you qualify for this nowadays very common, yet fully treatable mental disease.
Post-Traumatic Stress Disorder (PTSD). An irregular heightened state of arousal that is a consequence of a traumatic event. This state is triggered by mental re-experiencing of traumatic events, causing avoidance, detachment, loss of interest, negative thoughts and moods, heightened arousal, and intense reactivity on emotional, mental, and behavioral levels. If this describes you perfectly, or you suspect or just feel this could be you, I highly recommend testing one of the questionnaires available online such as the PTSD Checklist to quickly verify if you suffer from this condition.
Medical Conditions:
Chronic Pain. Conditions such as arthritis, fibromyalgia, and back pain can make it difficult to find a comfortable sleeping position, preventing sleep altogether.
Respiratory Disorders. Such as asthma or any other obstructive respiratory disease can cause nighttime symptoms that disturb sleep.
A Consequence of Medication Use
Are you using any medications that can prevent sleep or cause an overstimulation of the body or mind?
If none of the above three areas could be causing your insomnia, then you most likely have primary insomnia.
Cause of Primary Insomnia
We perceive the inability to ‘fall asleep’ as an incapacity to transition to the state of being separated from reality and turning off our consciousness. Physiologically this means that the body does not transition to a specific state. Although there are many more processes and factors at play, we can simplify by saying that one is unable to shift from the sympathetic (‘fight-or-flight’) to the parasympathetic (‘rest-and-digest’) nervous system.
Why?
Two possible reasons:
The first possible source: Overstimulation
From one or several stimuli presented below.
Motoric stimuli are triggers mainly connected with physical surroundings and physiological occurrences on or inside of our bodies. These range from environment (noise, brightness), physical activation (heart rate, movement), discomforts (pain, aches, itches, etc.), and behavior (habits, routines).
Mental stimuli are triggers left by our conscious (over-)thinking & (over-)contemplation. Examples are planning things for the next day, working on a personal or professional challenge (e.g. homework, tasks, emailing), worry, racing mind, appearing thoughts, overanalyzing/overexciting thoughts, etc. Such mental stimuli keep your brain operating in high gear. These stimuli are not necessarily connected with your environment and can happen either when you are doing something or even when you are just thinking about doing something.
The third type of stimuli are Emotions. These are mental ruminations connected with specific feelings, physiological states, and often an urge to act. Affectual love, hate, fear, anxiety, guilt, and anger, are the most intense emotions and most common sources of aroused states that subsequently lead to poor sleep. However, also long-term emotions such as agitation, remorse, contempt, worry, grief, etc. have a durable and activating effect on the state of arousal. Stress also falls into this category. Regardless of emotional orientation (i.e. positive vs negative), all emotions can manifest themselves in various degrees of intensity, consequently affecting the level of our alertness and arousal, effectively preventing us from transitioning to states conducive to falling asleep.
Nonetheless, stimuli by themselves are not the sole variable in the equation. Besides the actual stimuli, we need to take into consideration your tendency for arousal.
Second possible source: individual's (hyper)arousability
Understand this source as a catalyst, a facilitator, or a booster of the introduced stimuli’s effect. An individual's proneness to arousability depends on his traits such as biology (e.g. sex, age), personality traits (e.g. irritability, nervousness, self-criticism, obsessiveness, being worrisome, hypervigilant, anxious, temperamental, etc.), environment (immediate and broader context), and behavior.
The formula that would best describe it would be something in terms of:
To put things in perspective on a simple example – the same stimulus (in this case an event) of being stuck in a traffic jam could induce very different responses and arousal levels. One person might rage, yell, and make himself and his environment miserable for extended periods, whereas the other might be slightly disappointed but not lose much of its energy over the spilled milk, and forget the event completely quite briefly after it occurred. Which one of them do you think would need more time to fall asleep?
One more note to this source – very few people have the aptitude for self-reflection and self-observation to be able to correctly asses their current arousal levels, let alone make long-term self-observations. If you are interested in developing this skill called Emotional Intelligence I highly recommend the resources of D. Goleman.
Third possible source: undeveloped relaxation methods
Sympathetic and parasympathetic nervous systems are autonomous – this means that under normal circumstances they work automatically. There is no need to consciously control, nor learn how to switch between them.
However, there are situations or professions when it is recommended or even required to develop a self-controlled, conscious switching between these two systems into a skill. For example: shift workers, high-intensity sports, highly vigilant activities, etc. In such cases individuals often develop multiple approaches, techniques, and aids to heighten their arousal on ‘a call’, increasing focus, presence, cognitive and physical performance.
In doing this, they often neglect the other side of the coin – they fail to develop their ability to lower their arousal, which often leads to the inability to fall asleep which is usually coped with short-term fixes such as supplements or pills.
In truth, we are all ‘guilty’ of this phenomenon, since the majority of us know how and use stimulants to activate ourselves (ie. increase arousal) via e.g. caffeine (coffee), yet rarely care to invest any effort into investigating, let alone train methods that would relax (deactivate) us properly.
Final Verdict
All three above-mentioned reasons contribute to the inability of the individual to fall asleep.
Sleep coaching follows a systematic approach to inspect these three pillars, providing you insights into yourself, followed by presenting methods on how to practically cope and improve them so that you can fall asleep when you decide.
The goal of sleep coaching is not only to remove insomnia but to ensure you never suffer from it ever again.
Your coach helps you develop a plan of action on what areas to improve and how, considering short- and long-term implications, ensuring you can fall asleep not only now but for a lifetime.
Ready for professional help?
Get in touch and we'll find a way to improve your sleep.
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