Psychophysiological Insomnia: Causes, Symptoms, and Diagnosis

Problems falling asleep or staying asleep are hallmarks of insomnia, a sleep condition. Typically, we divide it into two types: acute and chronic.

Acute insomnia though short-term, may have damaging consequences on your emotional and physical well-being. Many people suffer from episodes of acute insomnia when they are under extreme emotional or mental stress. People who are experiencing acute insomnia often have trouble concentrating and report feeling more stressed than usual.

Higher incidences of heart disease, type 2 diabetes, cancer, and obesity have all been linked to the chronic sleep disorder known as insomnia.

Insomnia is tough to treat; however, several alternatives may help you sleep better and longer.

Insomnia can have serious consequences. So if you think you could be experiencing its effects, discussing your worries with a medical professional is important. From an expert, you will receive a proper diagnosis, learn about how your lifestyle might affect your sleep, and discuss short-term and long-term therapy options.

Insomnia of the psychophysiological variety is associated with stress over getting to sleep at night. Below, we will discuss the signs and symptoms, as well as the diagnosis and treatment choices available for this condition.

Psychophysiological Insomnia

Psychophysiological Insomnia

A sleep disorder that prevents adequate nighttime sleep is psychophysiological insomnia. Most of the time, this is because of the stress associated with going to bed and remaining asleep due to worries about not getting enough sleep. For this condition to qualify as a sleep disorder, it must occur frequently enough to affect sleep routines.

It occurs when there are no other reasons for insomnia, but chronic cases can lead to issues like depression. To battle daytime sleepiness, many people consume excessive amounts of caffeine while either taking sedatives or drinking alcohol at night. Anxiety and the subsequent attempts to self-medicate only make things worse.

If you’ve ever had trouble sleeping, you may have had psychophysiological insomnia, which is characterized by a state of heightened arousal and a learned sleep-preventing association that keeps you up at night and hinders your performance during the day. The duration of insomnia must be at least 30 days.

Cognitive hypervigilance may be reflected in physiological arousal coupled with feelings and actions that do not fit the diagnostic criteria for any other disease. ‘Racing thoughts’ is a common symptom of this form of insomnia.

The longer the patient tries to sleep, the more anxious and agitated they become, and the less likely they are to fall asleep on their own.

As a consequence of this recurrent pattern, the quality of the sleep environment itself deteriorates to the point where it no longer effectively promotes rest. Reports from patients that they sleep better away from their usual bedroom or sleep surroundings could be an indication of this phenomenon.

Prior to developing real psychophysiological insomnia, patients may have described themselves as light sleepers or occasional poor sleeper. Many people say they had problems sleeping as kids or young adults.

It’s possible that the sleep-preventing connections might be originally formed during an episode of insomnia brought on by a specific cause; nevertheless, insomnia would persist even after the cause was removed.

Some people struggle with getting a decent night’s sleep for months or even years, to the point that it becomes their primary worry.

Reduced ‘well-being’ is a common contributor to low spirits and a lack of motivation. Attention, attentiveness, energy, and concentration may all suffer, and symptoms like weariness and malaise may worsen.

Patients may also report having trouble initiating a daily nap; therefore, daytime sleepiness is not improved. Those who suffer from chronic issues are more likely to say that they first had insomnia symptoms as children. In contrast, the onset of psychophysiological insomnia can be either sudden or gradual.

When left untreated, insomnia can last for years, if not decades. If you have psychophysiological insomnia and don’t get it addressed, you greatly up your odds of developing serious depression or having an existing episode return.

Causes of Psychophysiological Insomnia

Causes of Psychophysiological Insomnia

Stress and the accompanying worrisome thoughts that keep the patient awake are typically the root cause of psychophysiological insomnia. Insomnia is a cause for growing anxiety after multiple sleepless nights. The subsequent stress over the incapacity to sleep therefore prevents the sufferer from getting any sleep.

As insomnia worsens, even mundane pre-bedtime rituals like setting the alarm clock or brushing one’s teeth can become conditioned to bring on a wakeful state of mind. One of the hallmarks of this condition is an obsession with the inability to sleep that takes precedence over concerns for one’s physical or social well.

Insomnia can have a variety of underlying physiological causes. Major ones include:

  • Stress
  • Worry and anxiety
  • Depression and grief
  • Recent experience with mental or physical distress
  • Disrupted sleep patterns
  • Lack of quality sleep 
  • The effects of crossing time zones

Symptoms of Psychophysiological Insomnia

Symptoms of Psychophysiological Insomnia

People with psychophysiological insomnia are less likely to have the classic symptoms of insomnia, such as daytime tiredness, but they still may have trouble waking up and staying awake.

Symptoms of neurasthenia, such as a throbbing head or numb extremities, may also be present. While you’re not trying to sleep, as when you’re reading or watching TV, you fall asleep.

Chronic sleeplessness and significant worry about falling asleep are hallmarks of psychophysiological insomnia. Moreover, a lack of restful sleep also contributes to daytime fatigue.

 Two other signs resulting are alcoholism and excessive coffee consumption.

Diagnosis of Psychophysiological Insomnia

Diagnosis of Psychophysiological Insomnia

See a doctor if you have trouble sleeping and worry about it being anxiety related. Those who meet the following criteria may be diagnosed with psychophysiological insomnia:

  • Your bouts of sleeplessness have lasted for at least a month.
  • You have ruled out the possibility that your insomnia is due to an underlying medical or psychological issue or to a drug you’re now taking.
  • If you want to go to sleep, you may have trouble doing so, but if you’re watching TV or reading a book, you might nod off unexpectedly.
  • You have trouble sleeping despite you give yourself many chances to do so.
  • You never seem to get a good night’s rest.
  • You wake up feeling refreshed when you attempt to sleep at predetermined times.

In addition to asking about your sleep history and conducting a physical exam, your doctor may ask you to keep a sleep diary for a few days or weeks. A sleep study is something your doctor may do to track things like brain activity, eye movement, and breathing while you sleep.

Treatment Options For Psychophysiological Insomnia

Though psychophysiological insomnia lacks a defined framework for therapy, it may benefit from the same approaches used to combat more common forms of insomnia.

Standard treatments for insomnia include:

1. Treatment of Insomnia With Cognitive Behavioral Therapy (CBT-I)

Treatment of Insomnia With Cognitive Behavioral Therapy (CBT-I)

Insomnia treatment plans frequently include cognitive-behavioral therapy as a first step. Insomnia medicine is often the first line of treatment; however, cognitive behavioral therapy for insomnia (CBT-I) can be just as effective, and in some circumstances more effective, than medication.

Exploring how your own internal processes, emotions, and actions may contribute to the issue at hand is at the heart of this treatment. In addition to relieving sleeplessness, it has a wide range of medical applications.

The primary objective of CBT-I is to help you make self-aware of damaging thought patterns connected to your sleep that impede your ability to get to sleep and remain asleep during the night.

If you’re having trouble at your job, school, or home because of your lack of sleep, talking to a therapist can help alleviate some of the stress you’re under. Sleeping better may be as simple as implementing the suggestions made by your cognitive behavioral therapist or counselor.

In addition to teaching techniques like going to bed and waking up at the same time each day, CBT-I instructs patients on managing external stimuli.

Sleep restriction therapy, in which you are encouraged to spend less time in bed each night to accumulate the time you do spend sleeping, may also be used. There is a correlation between increasing the amount of time spent in bed and improving sleep quality.

2. Sleep Meds

Sleep Meds

There are medications that are only taken when needed, and there are others that are more beneficial when used regularly. Sleeping pills might help you nod off sooner or stay asleep for longer, or do both.

The following are examples of long-term sleep aids:

  • Zolpidem
  • Zaleplon
  • Ramelteon
  • Eszopiclone

Some people find that they become dependent on these drugs. And they have undesirable side effects such as daily sleepiness. Please take these drugs exactly as directed and report any side effects to your doctor or pharmacist.

3. Prescription-Free Sleep Aids

Prescription-Free Sleep Aids

To get to sleep more quickly at night, you can try some of the following over-the-counter sleep aids:

  • Melatonin
  • Diphenhydramine
  • Doxylamine
  • Valerian

These sleep aids might assist occasionally, but it’s simple to build up a tolerance for them. There are risks associated with them, and they shouldn’t be combined with alcohol.

Before trying an OTC sleep aid, make sure there won’t be any bad interactions with any prescription drugs you’re currently taking by consulting with your doctor.

Since it is challenging to overcome excessive concern and establish healthy sleep routines, treatment is time-consuming. Patients can keep a log of their sleep habits and schedule follow-up appointments with their doctors to assess the efficacy of their medications. In light of this information, doctors revise their suggestions.

Closing Thoughts

Learning about psychophysiological insomnia is the first step in treating it. People who suffer from psychophysiological insomnia often report feeling anxious before bed.

You should consult a medical professional if you have persistent problems falling asleep or staying asleep. Your doctor will likely present you with other therapy alternatives.

Also, they may be able to refer you to a professional who can educate you on the topic of nighttime anxiety and equip you with techniques to get to sleep more quickly and remain asleep for longer.

Insomnia, in any form, can be challenging to manage, despite the importance of sleep to overall health. The right combination of experimentation and close collaboration with an experienced medical expert can yield excellent results.


Sarah Wagner

I'm Sarah Wagner, and I founded Sweet Island Dreams in 2022. It's a blog dedicated to helping people mental vacation virtually anytime they want. By providing information about the best sleep of your life, I help people drift away to paradise without ever having to leave their bed!