The night’s worst enemy: insomnia


Tick-tock… tick-tock… tick-tock.
The clock keeps on ticking. Your eyes are closed yet you are totally awake. A thousand thoughts bounce around in your head and you wonder, what shall I do tomorrow? What time does the meeting start? Will they like my project? Why did my colleague use that tone of voice with me? Did I do something wrong…? What then?

Tick-tock... tick-tock.
Did I call mum yesterday? No… I've got to keep it in mind… do it tomorrow morning, remember… I’ve been tossing and turning in bed for ages… I will wake up Fred. Mmmm, I’d better try to sleep.


Still awake. 
Tick-tock… tick-tock… tick-tock.
Did the kids finish their homework? What time is it? 4am. Alright so… if I fall asleep right now perhaps I’ll be able to get three hours of sleep. Oh my god, it certainly is not enough! Oh gosh, tomorrow I’ll be so tired at the meeting… I won’t perform as good as I ought to… what if I lose the client? I have to fall asleep! 

This is what usually happens when psychophysiological insomnia pays us an unpleasant visit.

You may experience problems falling asleep (initial insomnia), maintaining your sleep (middle insomnia) or waking up too early in the morning (terminal insomnia).

The main feature of psychophysiological insomnia is the intense sense of worry and anxiety related to getting to sleep. As described above, very often, the foregone day’s worries or the ones of the day about to begin and preoccupation with our own condition dominate our mental world as we try to fall asleep. Many times, our worry is the very cause of imaginary catastrophic scenarios related to the consequences of not getting enough sleeping.

As you can well imagine, being trapped by worry in our bed is totally counterproductive to sleep. Worry and anxiety activate and prepare our body for the “fight-or-flight” response (release of cortisol and adrenaline, increased heart beat and breath, muscle tension, etc…) that is completely incompatible with the sleep inducing state of relaxation. 

Psychophysiological insomnia is the most common type of insomnia and is caused by stress and not by medical conditions, substance abuse or any other kind of mental disorders.

As a matter of fact insomnia can be a consequence of other sleep disorders (such as Periodic Sleep Movements), psychiatric disorders (anxiety, depressive and bipolar disorders can have a strong impact on our sleep), medical conditions causing intense body pain or it could be a side effect of some medications. 

The first thing to do if you persistently suffer from insomnia is to find out and identify its root cause with the help of a specialist.

If the cause of insomnia is psychological, cognitive behavioural psychotherapy can help.
Psychotherapy indeed can help you recognise the vicious cycles created by worry and will help you work on them and manage anxiety, by gradually improving the negative association with sleep and fostering positive behavioural habits.

If you need some interesting behavioural tips and tricks to getting good sleep, you can also read the following article:

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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London, WC1A 1LH
Written by Ilaria Tedeschi
London, WC1A 1LH

Ilaria Tedeschi is a cognitive behavioural psychotherapist in Marylebone, London, with several years' experience working with depressive, anxiety, sleep and relational problems.

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