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Psychophysiological Insomnia

Psychophysiological insomnia is a chronic sleep disorder characterized by difficulty falling asleep, staying asleep, and/or waking up too early. It is caused by a combination of psychological and physiological factors, such as stress, anxiety, and depression. Treatment usually involves cognitive behavioral therapy, stress reduction techniques, and relaxation techniques in order to alleviate symptoms.

Symptoms Of Psychophysiological Insomnia

There are symptoms that are peculiar to psychophysiological insomnia. Apart from helping to further identify psychophysiological insomnia, they also help to differentiate it from other types of sleep disorders. They include:

Difficulties in Sleeping

Psychophysiological insomnia is often characterized by difficulty falling asleep, staying asleep, or both. It is often accompanied by worrying thoughts, anxiety, and fear, which can make it even more difficult to sleep. Treatment for this condition may include lifestyle changes and/or medication.

Early Morning Rising

Early morning awakening (EMA) is a common symptom of psychophysiological insomnia, involving difficulty falling back asleep after waking up in the middle of the night or very early in the morning. People experiencing EMA may be overly sensitive to noise, light, and other environmental factors, making it hard to return to sleep. These symptoms may be indicative of underlying psychological or physiological issues and should be addressed by a qualified health professional.

Decreased Quality of Sleep

People with psychophysiological insomnia often have difficulty achieving a full night’s sleep, and even when they do manage to fall asleep, they tend to wake up feeling fatigued and unrested. This can lead to a cycle of poor-quality sleep, further impacting overall health and well-being.

Poor Concentration

This symptom is often associated with difficulty concentrating, difficulty thinking clearly, difficulty remembering information, feeling tired and irritable during the day, and more. Treatment options for this condition include lifestyle changes, such as relaxation techniques, as well as cognitive-behavioral therapy to address underlying psychological issues.


Individuals with psychophysiological insomnia often report having difficulty falling asleep and staying asleep, accompanied by a sense of low mood and lack of motivation. This is known as a state of depression,” and it is one of the most common symptoms of psychophysiological insomnia. Depression can present itself in a variety of ways, including with feelings of sadness, hopelessness, and worthlessness. Treating the underlying cause of insomnia is the best way to reduce the symptoms of depression associated with this condition.


Anxiety is one of the most common symptoms associated with psychophysiological insomnia. This type of insomnia is characterized by an inability to fall asleep or stay asleep due to excessive mental or physical arousal. Anxiety can manifest itself in a variety of ways, such as feeling overwhelmed, having racing thoughts, worrying excessively, or feeling helpless. People with psychophysiological insomnia may also experience physical signs of anxiety, such as an increased heart rate, sweating, and difficulty breathing. It is important to recognize and manage the anxiety associated with psychophysiological insomnia in order to improve sleep.

Poor Sleep Hygiene

Psychophysiological insomnia can lead to poor sleep habits such as staying up late, napping during the day, and engaging in stimulating activities before bed. It can also lead to a decrease in one’s quality of sleep, which can increase the risk of developing other health problems.


One of the most common physical symptoms of psychophysiological insomnia is headache. They can vary in severity and duration. In some cases, there can be a mild, constant pressure behind the eyes or forehead, while in more severe cases, there can be intense throbbing or pulsing sensations lasting for hours. Headaches can be caused by a number of factors, including insomnia itself, stress, anxiety, fatigue, and certain medications. Treatments, such as relaxation techniques, meditation, and cognitive behavioral therapy, can also help reduce the frequency and intensity of the headaches.

Muscle Tension 

In cases of muscle tension, the body remains in a state of alertness and heightened awareness, resulting in tense muscles. Tight muscles can cause pain, headaches, and other physical issues. To help reduce muscle tension associated with psychophysiological insomnia, relaxation techniques such as progressive muscle relaxation, deep breathing, and mindfulness can be used. Additionally, creating a soothing sleep environment and avoiding caffeine and alcohol, especially before bedtime, can help promote better sleep.

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How Do Therapists Diagnose Psychophysiological Insomnia?

Therapists diagnose psychophysiological insomnia by obtaining a detailed medical, psychological, and sleep history. The therapist may also need to ask the patient to keep a sleep diary to track sleeping patterns over a certain period of time. The therapist will also assess the patient’s current lifestyle and sleeping environment.

The therapist will then ask the patient questions to assess the severity of the insomnia. The therapist may ask the patient questions about the frequency and duration of symptoms, the impact of the insomnia on the patient’s daily life, and the patient’s ability to cope with the symptoms.

To identify the cause of the insomnia, the therapist will ask the patient about his or her sleep habits, including bedtime and wake-up times, use of sleep aids, and any environmental disturbances that may affect sleep. The therapist may also ask the patient about any medications or substances that could be affecting sleep.

The therapist may also attempt to identify any underlying psychological or medical issues that may be contributing to the insomnia. This can include asking the patient about any recent life changes, relationship issues, or stressors. The therapist may also assess the patient’s mental health, including any anxiety, depression, or other mental health conditions.

The therapist may also conduct a physical exam to rule out any medical conditions that could be causing the insomnia. This may include testing for thyroid disorders, heart problems, or other medical conditions. The therapist may also order laboratory tests or other diagnostic tests to rule out any underlying medical issues.

Once the therapist has gathered all the necessary information, he or she can make an accurate diagnosis. The therapist may then recommend a treatment plan to address the underlying cause of the insomnia. This may include lifestyle changes, cognitive behavioral therapy, medications, or other treatments.

Causes of Psychophysiological Insomnia

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Psychophysiological insomnia can be caused by a variety of physical and mental factors. Some of them include:


The loss of a loved one or experiencing a traumatic event can have a significant impact on our sleep. Grief can be a major cause of psychophysiological insomnia, a disorder characterized by abnormal sleeping patterns. To help combat this, it is important to create a regular bedtime routine and practice good sleep hygiene habits.

Stress and Anxiety

Excessive stress and anxiety can contribute to psychophysiological insomnia, a condition where the body is in a state of hyperarousal, making it difficult to relax and fall asleep. Additionally, racing thoughts caused by stress and anxiety can further prevent restful sleep.

Medications and Substances

Certain substances, including caffeine, nicotine, and alcohol, as well as certain medications like decongestants and antidepressants, can lead to psychophysiological insomnia. These substances can disrupt the body’s natural sleep cycle, making it hard to fall asleep and stay asleep.


Depression is a serious mental illness that can have a significant impact on a person’s life, causing a persistent feeling of sadness and a loss of interest in activities they once found enjoyable. It can also lead to changes in sleep patterns, potentially reducing the quality of sleep.

Poor Sleeping Habits 

Developing poor sleeping habits, like staying up late, using electronic devices before bed, or sleeping in an uncomfortable environment, can increase the risk of psychophysiological insomnia.

Is the Cause of Insomnia Genetically Related?

Insomnia is a condition that can significantly impact the quality of life of those affected by it. Recent research has suggested that insomnia may be genetically related, although the exact cause of the condition is not yet known. Studies have shown that people with a family history of insomnia are more likely to suffer from it themselves, indicating that there may be a genetic component to the disorder. It is also possible that certain genetic predispositions could make some people more vulnerable to insomnia than others.

Further research is needed to determine the exact role that genetics plays in insomnia, but the current evidence suggests that there may be a genetic link. However, insomnia can also be caused by other factors, such as stress, certain medications, and changes in the environment. Therefore, the exact cause of insomnia cannot be fully understood at first glance, and most times further research is needed to determine the exact role of genetics in the development of insomnia.


Treatments for Psychophysiological Insomnia

There are various treatments that have been designed for psychophysiological insomnia. Some of these treatments include:

Cognitive Behavioral Therapy (CBT)

This is a form of psychotherapy that helps people recognize and change negative thoughts and behaviors that contribute to insomnia. CBT teaches people to identify and modify thoughts and behaviors that interfere with sleep, such as worrying about not being able to fall asleep or lying in bed for long periods of time.

Stimulus Control Therapy (SCT)

It is a form of cognitive behavioral therapy that helps people associate the bed with sleep by avoiding activities such as watching TV, reading, or working in bed. This therapy also helps people wake up and go to bed at the same time each day.

Relaxation Techniques

Relaxation techniques such as deep breathing, progressive muscle relaxation, and guided imagery can help reduce stress and anxiety that interfere with sleep.

Sleep Restriction Therapy (SRT)

This therapy helps people get more restful sleep by limiting the amount of time spent in bed. This therapy involves setting a regular sleep schedule and gradually increasing the amount of time spent in bed.


Certain medications, such as sedatives and antidepressants, may be prescribed to help people with psychophysiological insomnia get better sleep. However, these medications should be used with caution and only as a last resort.

Cognitive-behavioral Therapy for Psychophysiological Insomnia

Cognitive-behavioral therapy (CBT) for psychophysiological insomnia is a form of psychotherapy that focuses on changing the patient’s thoughts, emotions, and behaviors related to sleep. Unlike other forms of CBT for insomnia, CBT for psychophysiological insomnia is specifically tailored to address the underlying physiological causes of insomnia. This may include techniques to help the patient relax, such as deep breathing or progressive muscle relaxation, as well as cognitive techniques to help the patient manage their thoughts about sleep.

The therapist may also use relaxation techniques, such as progressive muscle relaxation, to help the individual reduce physiological arousal that may be interfering with sleep. Additionally, the therapist may help the individual set realistic sleep goals and provide them with tips for improving sleep hygiene and developing healthy sleep habits. The goal of CBT for psychophysiological insomnia is to help the patient develop healthy sleep habits that will lead to better quality sleep and improved overall health.

Frequently Asked Questions

1. How do I know if I have a sleep problem?

If you are having difficulty falling or staying asleep, or if you are constantly feeling tired throughout the day, then you may have a sleep problem. If you are also having trouble concentrating, feeling irritable or depressed, or experiencing physical symptoms such as headaches, then there is a high chance that you also have a sleep problem.

2. Why is the treatment of insomnia important?

Insomnia can have a significant impact on overall health and quality of life. It can lead to cognitive problems, difficulty concentrating, poor job performance, an increased risk of depression and anxiety, an increased risk of accidents and injury, and even an increased risk of developing chronic health conditions. Treating insomnia can help improve your overall quality of life and reduce the risk of developing associated health conditions.

3. I have tried changing my sleep habits before, but it didn't help much. Why should I try CBT?

CBT is an evidence-based approach to treating sleep issues that has been found to be effective in improving insomnia symptoms. It is different from other approaches because it focuses on changing the thought and behavior patterns that are maintaining the sleep problem. CBT can help you identify and modify the thoughts and behaviors that are contributing to your sleep issues, and it can help you learn more effective ways to cope with stress and anxiety that can interfere with sleep. Additionally, CBT teaches you how to create a healthier sleep environment and better sleep hygiene habits that can have lasting effects.