Psychophysiologic insomnia is a common sleep disorder whose sufferers include would-be sleepers from across all demographics. We spoke to Subin Jain, M.D., a physician at the Sleep Disorders Center, Baptist Hospital East, in Louisville, Kentucky, for one approach to the medical problems you or your loved one may suffer from when trying to sleep.
If you think you might have psychophysiologic insomnia, use this as a reference point before getting personalized medical advice from your doctor or other accredited sleep expert. --Tracie Handley
Dr. Jain defines psychophysiologic insomnia as "an excessive focus and increased anxiety about sleep, which slowly progresses to a difficulty in falling asleep at the desired time or problems staying asleep." He explains, "Usually, it is precipitated by some stress, but the stressful event then goes away, yet the insomnia stays because you have taught yourself not to fall asleep when you go to bed." Dr. Jain also says the disorder is recognizable because the symptoms usually manifest themselves only in the home environment.
Get A Professional AssessmentDr. Jain recommends a professional assessment to accurately identify this disorder and begin the proper treatment of it. "Most of the interventions to treat psychophysiologic insomnia," he says, "have to do with relearning the process of associating your bed and your bedroom with sleep."
Optimize Your Sleep EnvironmentAccording to Dr. Jain, one of the first steps a patient should take is to "practice good sleep hygiene." In order to do that, the patient must "make sure the sleep environment is optimal, such as a comfortable bed, quiet room, dark room. Making the environment conducive to sleep is the first step."
Maintain A Regular Sleep ScheduleDr. Jain recommends that patients go to sleep and wake up at fixed times, rather than having a variable sleep schedule. "Consistency in the sleep schedule is very important in patients with psychophysiologic insomnia," he emphasizes.
Practice Sleep RestrictionDr. Jain instructs patients "to go to bed at 12 and wake up at 5; if they are unable to sleep, they should get out of bed, do something that is not very strenuous and does not involve any bright lights, and then come back." Patients can repeat the process, but Dr. Jain advises that they "get up and get out of the room at 5 a.m., regardless." By avoiding naps and caffeine, the sleep drive is heightened, sleep is achieved, and doctors can slowly increase the sleep time until the desired amount and times are reached.
Utilize Behavioral TherapyDr. Jain recommends behavioral therapy, saying, "The patient sees a behavioral therapist who will talk him through some of the sleep techniques, as well as discuss the event which may have precipitated the insomnia, the anxieties he may have while falling asleep, and how to combat that anxiety." He notes the effectiveness of some of the newer sleep agents, such as Lunesta and Ambien, in helping patients to sleep when used in conjunction with these other techniques.
Subin Jain, M.D., is a specialist in pulmonary medicine, sleep medicine, internal medicine and critical care medicine, and is a physician at the Sleep Disorders Center, Baptist Hospital East, in Louisville, Kentucky, as well as with Louisville Pulmonary Care, LLC. A graduate of Maulana Azad Medical College at the University of Delhi, Dr. Jain completed residency and fellowships at the Long Island Jewish Medical Center, the University of Connecticut, and Baylor College of Medicine. He is also board certified in internal medicine, pulmonary medicine, critical care medicine and sleep medicine.
Have you ever suffered from a sleep disorder? What worked for you?