Psychophysiological Insomnia (si ko fiz ee ol e jee)   [Greek psykhe = breath, life, soul, plus physis = nature, origin] a disorder of learned sleep-preventing associations. People with this insomnia learn to associate sleep with anxiety. A vicious cycle of worrying about Insomnia then not sleeping because of it pursues until the individual changes their perception of sleep and their sleep habits.


Psychophysiological Insomnia may develop over the course of many years, as the result of bad sleep habits. Very often, it begins as innocently as the occasional bout of insomnia following an event. Anxiety at night shifts from grieving the death of a loved one, a job loss, or other life stress to worrying about not sleeping.
       People with this disorder obsess over whether or not they will sleep. As each night passes, their concern about past sleep loss convinces them that they will not sleep that night. Anxiety and agitation builds as evening approaches, making it even harder to sleep. Eventually, they associate bedtime, the bedroom, and related rituals with tension.
    Bad sleep behaviors such as taking sleeping pills, drinking alcohol, or even staying in bed despite being wide awake may further undermine sleep. Those bad behaviors sometimes continue during the day, as tiredness from sleep deprivation sets in. Some individuals cope by drinking large quantities of caffeine thoughout the day without realizing that it will remain in their system for many hours after consumption.


         If healthy sleep hygiene or a visit to your doctor to identify additional problems are not enough, then a consultation with a sleep specialist is the next step. The sleep specialist will examine a Sleep Diary of your nighttime and daytime sleep habits. He or she will also ask about medical or psychiatric problems, as well medications, alcohol or caffeine use. Sleep studies are rarely needed to indentify Psychophysiological Insomnia, unless another sleep disorder is suspected.


Treating Psychophysiological Insomnia involves some combination of the following:
Good Sleep Hygiene: habits that are conducive to good sleep. Avoiding caffeine after noon and alcohol within four hours of bedtime are examples of good sleep hygiene.
Cognitive Behavioral Therapy (CBT): often approached with the aid of a Sleep Specialist or Psychotherapist, aims to redirect actions or thoughts that impair the ability to sleep. Some examples of CBT include Sleep Restriction, Stimulus Control, Relaxation Training, and Biofeedback.
Sleeping Medications: prescription and over-the-counter drugs called Hypnotics, some of which are used to treat depression, but which also promote sleep.

Psychophysiological Insomnia Mechanics

There is a physical component to this "learned" insomnia. The relationship between  emotional stress and enough physiological arousal to disturb sleep is called Somatized Tension, or stress that is expressed as bodily dysfunction. Anxiety of any kind awakens the body. When we feel threatened or extremely worried, our bodies release a hormone called adrenalin, which among other factors arouses us. The greater our stress about not sleeping, the less likely we are able to fall asleep, no matter how much we demand it of ourselves. We become too "pumped up" to sleep.

Suggested Downlaods

SleepIssues:Can’t Sleep
SleepCaptions:Psychophysiological Insomnia