It starts off in the usual fashion.
You're chugging along and some kind of stressor enters you life. It keeps rolling around your head for a few days, keeping you up at night. And then it keeps rolling.
All of a sudden, you're looking ahead at a string of sleepless nights in the face of an, at times, debilitating condition. You try to problem solve your sleeplessness away -- which only makes it worse.
Insomnia becomes a self-fulfilling prophecy.
The cycle of insomnia is complex, and one which sleep psychologist Rosemary Clancy from the Sydney Sleep Centre explains can be overcome using an application of reverse psychology.
What is it?
Among a string of sleep-related disorders, clinical insomnia is a form of habitual sleeplessness.
"The main thing that strikes insomnia apart is continued dissatisfaction with sleep quality and quantity. This involves difficulty initiating sleep, maintaining sleep or early morning waking with an inability to resume sleep," Clancy told The Huffington Post Australia.
"It involves clinically significant distress and impairment related to social, occupational, educational and other areas of functioning."
To be diagnosed as an insomniac, such symptoms much occur for at least three nights each week and be present for at least three months.
According to Clancy, the condition moves beyond sleep deprivation.
Your physiology starts working against you to keep you awake.
"We tend to talk about having enough time and adequate opportunity to sleep, but that is not the full picture," Clancy said. "One of the safety-seeking behaviours that we see in those with insomnia is stretching out their time in bed. They don't necessarily spend any more time asleep, but they spend more time awake in bed."
This creates an enduring cycle of hypervigilance or increased anxiety.
"Insomnia becomes a process of attention, worry, rumination and safety behaviours that create this struggle with hypervigilance. The worry itself leads you into sleep deprivation," Clancy said.
"Your physiology starts working against you to keep you awake."
How can you treat it?
When it comes to managing insomnia, Clancy treats the condition as a form of performance anxiety.
"I set out a model of how a person's thoughts, feelings, emotional responses and behaviours interact to perpetuate the problem and create hypervigilance," Clancy said.
From there, treatment strategies such as attention training, central nervous system training or cognitive behavioural therapy are put in place.
What happens if you stay awake?
Remember how we told you insomnia was a form of performance anxiety? This may sound familiar:
I am doing everything right. It should be working. But it's not.
"Very often, people with insomnia actively try to problem solve and they have adequate sleep hygiene," Clancy said. "There's good science behind these strategies and they work well -- until you cling to them.
"Amplified sleep hygiene can in turn create more threat and higher expectations that your sleep should work...this can often be too much for your sleep to bear."
Rather than relying on this, experts have proven the benefits of staying awake. In a 2013 study coming out of the University of Glasgow, a group of insomniacs were divided into two groups: one was told to do what they normally did, the other instructed to try to stay awake.
This is known as paradoxical intention.
"The group that was asked to try to stay awake had a significant reduction in sleep efforts and sleep performance anxiety, with improved sleep," Clancy said.
"When they tried to stay awake, they felt sleepier. That's what normal sleepers do."
How can we actually use this?
Essentially, the message of this study is simple: "Try less hard".
"When we are under threat, we actively want to problem solve. This is a hard message to get across," Clancy said.
She recommends applying cognitive behavioural therapy (CBT) to retrain your thought processes, calm your central nervous system and overwrite old expectations.
"With time, this approach has proven to work -- you just need to apply yourself."
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