Sleep is essential to our well-being. It’s when our bodies rest, repair, and rejuvenate. For many, a good night’s sleep is the cornerstone of feeling healthy, productive, and emotionally balanced. However, if you’re one of the millions of people who struggle with sleep difficulties, you may already know that insomnia can have a significant impact on your daily life, mental health, and overall quality of life.

In this blog post, we’ll explore what insomnia is, the different types of sleep difficulties, why insomnia happens, and how therapy, particularly Cognitive Behavioural Therapy for Insomnia (CBT-I),  can help improve your sleep and mental health.

What Is Insomnia?

Insomnia refers to difficulty falling asleep, staying asleep, or waking up too early and not being able to fall back asleep. It can be either short-term (acute) or long-term (chronic). Insomnia can leave you feeling tired, frustrated, and stressed, which in turn can affect your mood, cognitive function, and overall well-being. The causes of insomnia can vary greatly, but they are often linked to stress, anxiety, depression, lifestyle factors, and medical conditions.

Types of Insomnia

Insomnia can manifest in various ways, and it’s important to understand the different types to effectively address the issue. It can be categorised into primary and secondary types. Primary insomnia is not linked to any other health condition, while secondary insomnia arises due to another health issue, such as asthma, depression, or medication use. Additionally, insomnia can be classified based on the specific sleep difficulties experienced:

  • Sleep-onset insomnia: Difficulty falling asleep.
  • Sleep-maintenance insomnia: Difficulty staying asleep.
  • Mixed insomnia: Difficulty both falling and staying asleep.
  • Paradoxical insomnia: Underestimating the amount of sleep actually obtained.

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Australian Sleep Stats

Insomnia is a widespread issue in Australia, affecting a significant portion of the population across various demographics. Here’s a breakdown of the statistics and the groups most impacted:

  • General Population: Over 60% of Australian adults report experiencing at least one sleep symptom (e.g., trouble falling or staying asleep) three or more times a week. Of these, 14.8% have symptoms severe enough to potentially warrant a diagnosis of clinical insomnia.
  • Chronic Insomnia: Approximately 12.2% of Australian adults suffer from chronic insomnia, which is often under-diagnosed, with only 7.5% reporting a formal diagnosis by a medical professional.
  • Younger Adults (18-24 years): This group is more likely to experience difficulty falling asleep (32%) compared to older adults. They also report higher rates of sleep disturbances and daytime tiredness.
  • Older Adults (≥65 years): Older individuals are more prone to waking up during the night or early in the morning (47%). They also report higher rates of insomnia symptoms compared to younger adults, with 65% of older adults experiencing insomnia symptoms versus 43% of younger adults.
  • Women: Women are more likely to report insomnia symptoms across all age groups. They also report higher rates of worrying about sleep (31% vs. 21% in men) and being overwhelmed by thoughts when trying to sleep (35% vs. 25% in men). Women are more likely to experience daytime impairments such as fatigue, irritability, and inability to concentrate due to lack of sleep.
  • Men: While men also experience insomnia, they report fewer symptoms compared to women. The youngest male age group (18-39 years) reports more sleep disturbances than those over 80 years.

Why Can’t I Sleep? Common Causes of Insomnia

There are many potential reasons why you may struggle with sleep. Understanding the underlying cause is the first step toward finding an effective solution. Some of the most common reasons for insomnia include:

  1. Stress and Anxiety: One of the most common causes of insomnia is stress. When we are stressed or anxious, our body enters a state of heightened alertness, which makes it difficult to relax enough to sleep. Overactive thoughts, worrying about work, relationships, or other challenges can keep the mind racing long after we’ve gone to bed.
  1. Depression: People with depression often experience changes in their sleep patterns. Some may sleep too much (hypersomnia), while others experience insomnia. Insomnia is often a symptom of depression, and it can worsen the condition, creating a feedback loop where poor sleep contributes to feelings of hopelessness or fatigue.
  1. Poor Sleep Hygiene: Sleep hygiene refers to the habits and practices that promote good sleep. Poor sleep hygiene, such as using electronic devices in bed, consuming caffeine or alcohol close to bedtime, or having an irregular sleep schedule, can disrupt your circadian rhythm and lead to difficulty sleeping.
  1. Medical Conditions: Certain medical conditions, such as chronic pain, asthma, arthritis, and gastroesophageal reflux disease (GERD), can interfere with sleep. These conditions can cause discomfort or symptoms that make it difficult to sleep through the night.
  1. Medications: Some medications, such as stimulants, antidepressants, and high blood pressure medications, can interfere with sleep. If you suspect that your medication may be contributing to your sleep difficulties, it’s important to talk to your healthcare provider.
  2. Caffeine, Nicotine, and Alcohol: Substances like caffeine, nicotine, and alcohol are stimulants or disruptors of the sleep-wake cycle. Caffeine and nicotine can keep you awake, while alcohol, though it may make you feel sleepy initially, can lead to fragmented sleep and more frequent wakefulness during the night.

The Effects of Insomnia on Your Health

Chronic insomnia doesn’t just make you feel tired; it can have a profound impact on your mental and physical health. When you don’t get enough quality sleep, you are at greater risk for developing a range of health problems, including:

  • Increased risk of depression and anxiety: Chronic sleep deprivation is a major contributor to mood disorders and can exacerbate existing mental health issues.
  • Cognitive difficulties: Sleep is crucial for cognitive functions like memory, concentration, and decision-making. Poor sleep can impair your ability to think clearly and remember information.
  • Physical health problems: Lack of sleep is linked to a variety of health issues, including heart disease, high blood pressure, diabetes, and a weakened immune system.
  • Reduced quality of life: Ongoing sleep difficulties can interfere with daily functioning, reducing productivity at work, limiting social interactions, and affecting overall happiness and life satisfaction.

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How Therapy Can Help with Insomnia: CBT-I

While many people turn to sleep aids to help them fall asleep, therapy can offer a more sustainable and healthier solution. Cognitive Behavioural Therapy for Insomnia (CBT-I) is a well-researched and effective form of therapy that helps individuals address the root causes of insomnia.

CBT-I is considered the gold standard in the treatment of insomnia. It involves a structured, evidence-based approach that helps individuals change negative thought patterns and behaviours that contribute to sleep difficulties. CBT-I typically includes the following components:

Behavioural Interventions

  1. Sleep Restriction
    This technique involves limiting the time spent in bed to match the actual amount of sleep a person gets. The goal is to increase sleep efficiency (the percentage of time spent asleep while in bed) by reducing the time spent awake in bed. For example, if someone typically sleeps for 6 hours but stays in bed for 8 hours, they might be advised to limit their time in bed to 6 hours initially. Over time, as sleep efficiency improves, the time in bed is gradually increased.
  2. Stimulus Control
    Stimulus control aims to re-associate the bed and bedroom with sleep rather than wakefulness. This involves:

    • Using the bed only for sleep and intimacy.
    • Getting out of bed if unable to sleep within 15-20 minutes and returning only when sleepy.
    • Avoiding activities like reading, watching TV, or working in bed.
  3. Relaxation Training
    Relaxation techniques help reduce physical and mental arousal that can interfere with sleep. Common methods include:
    • Mindful breathing: Focusing on slow, deep breaths to calm the mind.
    • Progressive muscle relaxation: Tensing and then relaxing different muscle groups to release tension.
    • Visual imagery: Imagining calming scenes to distract from stressful thoughts.
    • Cognitive Interventions
  1. Cognitive Restructuring
    This component focuses on identifying and challenging unhelpful thoughts and beliefs about sleep. Common examples include:

    • “I must get 8 hours of sleep to function.”
    • “If I don’t sleep tonight, tomorrow will be a disaster.”
    • “I’ll never sleep well again.”
      By replacing these thoughts with more realistic and balanced ones, cognitive restructuring reduces anxiety and promotes healthier sleep patterns.
  2. Third-Wave Components
    These include mindfulness and acceptance-based strategies that help individuals manage stress and reduce sleep-related anxiety. Techniques like mindfulness meditation encourage present-moment awareness and acceptance of sleep difficulties without judgment.

Educational Components

  1. Sleep Hygiene Education
    Sleep hygiene involves adopting habits that promote better sleep, such as:

    • Maintaining a consistent sleep schedule.
    • Avoiding caffeine, alcohol, and heavy meals close to bedtime.
    • Creating a sleep-friendly environment (e.g., cool, dark, and quiet).
  2. Sleep Diary Tracking
    Keeping a sleep diary helps individuals and therapists monitor sleep patterns, identify triggers for poor sleep, and track progress over time. It typically includes details like bedtime, wake time, total sleep duration, and nighttime awakenings.

CBT-I is highly effective, with research showing improvements in sleep quality, sleep efficiency, and reduced wake time after sleep onset. It is particularly beneficial because it addresses the root causes of insomnia rather than just the symptoms, offering long-term relief without the side effects associated with sleep medications.

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Sleep Medications

While medications like sleeping pills may offer short-term relief, they don’t address the underlying causes of insomnia. Medications may even lead to dependency or tolerance, where higher doses are needed over time to achieve the same effect. In contrast, therapy helps individuals develop healthier sleep habits, reduce anxiety around sleep, and overcome the root causes of their insomnia.

CBT-I is widely regarded as a long-term solution to sleep problems. Studies have shown that people who undergo CBT-I not only experience better sleep but also report improvements in mood, daytime functioning, and overall quality of life.

Resources

For those seeking further assistance, several resources are available:

  • Sleep Ninja: A free, evidence-based app for young people with sleep problems.
  • THIS WAY UP: A free online program based on CBT-I principles.

Conclusion

Sleep is vital for your overall well-being, and chronic insomnia can affect both your mental and physical health. Understanding the causes of your sleep difficulties and seeking therapy can help break the cycle of poor sleep and improve your quality of life. Cognitive Behavioural Therapy for Insomnia (CBT-I) has been proven to be one of the most effective treatments, offering long-term benefits without the need for medication.

If you’re struggling with sleep difficulties and want to explore how therapy can help, reach out to our team at MyLife Psychologists for a consultation. With the right support, you can regain control over your sleep and, ultimately, your health.

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