Psychophysiologic insomnia is an objectively verifiable insomnia that develops as a consequence of two mutually reinforcing factors:
- somatic tension and
- learned sleep-preventing associations.
Individuals who have psychophysiologic insomnia typically react to stress with somatic tension and agitation. The meaning of stressful events (other than insomnia) is typically denied and repressed but manifests itself as increased physiologic arousal.
Definition of Psychophysiologic Insomnia Disorder
Conditioned external factors causing insomnia often develop from the continued association of sleeplessness with situations and behaviors that are related to sleep.
People who trying too hard to sleep find out that this is a driving force for insomnia and often find that they fall asleep easily when not trying to do so like while watching television, reading, or driving.
What psychophysiologic insomnia causes
As in all insomnias, chronically poor sleepers tend to note decreased feelings of well-being during the day.
Psychophysiologic insomnia causes deterioration of mood and motivation; decreased attention, vigilance, energy, and concentration; and an increase in fatigue and malaise but no objective sleepiness.
Some psychophysiologic insomnia information
Although patients with psychopathologic insomnia have little overt psychopathology, they tend to be guarded, with denial and repression often being their main defenses.
They typically are sensation avoiders, claiming that they do not want to aggravate their insomnia by deviating from their daily routine. They do show an increased incidence of stress-related psychophysiologic problems, such as tension headaches or cold hands and feet.
Psychophysiologic insomnia may last for years or decades. In some cases, it may gradually worsen over time because a vicious cycle of insomnia develops.
In sleep disorders centers, about 15% of all insomniacs are diagnosed with psychophysiologic insomnia.
The true incidence in the general population is unknown. Learned sleep-preventing associations, while paramount in psychophysiologic insomnia, also tend to play an important role in most other forms of chronic insomnia.
Psychophysiologic insomnia typically starts in young adulthood (20s or 30s) and gradually exacerbates until help is sought typically in middle adulthood.
Complications that are frequently found are the excessive use of hypnotics or alcohol, plus either administration of tranquilizers during the day to combat the somatized tension, or excessive use of caffeine or abuse of stimulants to combat excessive fatigue. The chronic pattern of failure to attain good sleep may occasionally generalize to other areas of psychologic functions, leading to a passive, defeatist attitude.
There are obviously many causes for this. Hectic work and family life, stress, anxiety and all kinds of medical conditions can mean that you are not getting the recommended 8 to 10 hours of sleep every night.