What is the Cause of Insomnia?

It seems everyone is talking about sleep these days. Take magnesium, drink banana skin tea, do 4-7-8 breathing, what about lavender? Have you tried Epsom salt baths? And on and on and on.

With this plethora of advice, you would think we would all be sleeping machines! So why then is sleep getting worse with 1 in 5 American adults struggling to sleep every single night and half of US adults experiencing insomnia once a month or more?

Why is Sleep Getting Worse?

There are many theories and one of the most common things I come across with my clients is advice overload.

Say the average person has trouble sleeping. They might start off by asking Dr Google or talking to people they know, and they will likely get a wide variety of advice, some of it conflicting. Use a sleep tracker, don’t use a sleep tracker. Get out of bed if you can’t sleep. No stay in bed and rest. The sheer volume of sleep advice out there can be completely overwhelming.

The Importance of Questions

The problem is that we are all so busy giving advice that we forget to ask questions. Questions are important. There is a reason that any time you see a healthcare worker (traditional or holistic) we ask you a buttload of questions.

Anyone trained in health is taught something called differential diagnosis. This is a process of asking questions to learn about the problem our client is experiencing and narrow down the likely cause. Using this information, we then give targeted advice that is applicable to that specific client.

Without differential diagnosis it is not possible to give relevant advice and the treatment is not as likely to work.

It’s like the story of the blind men trying to describe an elephant. One man is touching the trunk, so he thinks an elephant is like a snake. Another is touching its side and thinks it’s like a wall, another grasps the elephant’s ear and thinks it is like a fan. Etc. None of the men can see the whole picture and they don’t take the time to fully explore so they are all partially right and at the same time completely wrong.

Let's Get Practical

Imagine if you had a big blister on your heel and someone saw you limping. The person doesn’t ask what is wrong. They just think “oh I remember I had trouble walking when strained my knee. I was limping just like that” so they offer you their old knee brace because “it was so helpful to them!”

While this is a very kind gesture, a knee brace does nothing to help your blister. There are many reasons to walk with a limp (knee injury, blisters, plantar fasciitis etc) you need to take time to uncover the CAUSE of the limp for your advice to be impactful and relevant. The same principle applies to sleep.

Now we are all guilty of this and I am no better. The internet, and social media in particular, love sound bites. Fix my problem in 30 seconds or less! Unfortunately, effective advice is a bit more nuanced than that and can be more difficult to explain. This is why we find so much generalized advice floating around without context.

3 Main Categories of Sleep Advice

In general, sleep advice can be broken down into 3 main categories- sleep hygiene, sleep behavior and nervous system regulation.

Sleep hygiene is all the general advice about sleep environment and healthy lifestyle. Things like get morning sun, sleep in a cool dark room, balance your blood sugar levels, take a warm bath before bed, etc.

This advice is essentially the low hanging fruit of the sleep world in that it is obvious and easy to change. There is nothing wrong with sleep hygiene. It is good solid advice about how to live a generally healthy life and it sets the stage for sleep to occur.

The problem is, this general health advice is thrown around as if it were a guaranteed insomnia cure with no thought given to the underlying cause of insomnia, which changes person to person.

Sleep Coaching Should Be Specific to You

Just like a knee brace won’t help heal a blister, magnesium will not help insomnia unless that insomnia is the result of a magnesium deficiency. The treatment does not match the causal factor and is therefore not very effective in that instance.

Because this is not well understood by the general public, the average person experiencing insomnia ends up trying many sleep hygiene practices to “cure” their insomnia and every time one of these cures fails, the person is left feeling broken and hopeless.

What is Sleep Behavior?

Enter sleep behavior. Sleep behavior looks at a person’s emotional response to insomnia. Is the person stressed at bedtime? Is difficulty sleeping causing sleep related anxiety? Etc.  Because sleep is a passive parasympathetic process, building up a fear or anger stress response around bedtime can often perpetuate the problem and make insomnia more likely to occur.

 CBTi and ACT are two psychotherapy modalities commonly used to help with sleep anxiety. There are differences between them but both work on the client’s perception of and thoughts around their experience of insomnia.

Sleep and Anxiety

Insomnia often goes hand in hand with anxiety and people who experience frequent stress and anxiety are more likely to also struggle with insomnia. As previously mentioned, there are strong ties between the ability to sleep and the state of our nervous system. If someone is stressed or angry about sleep, work, money (add life event here) then they are less likely to be able to sleep.

If you stay in a state of chronic stress for long periods of time (days, months, or years) this can dysregulate the nervous system and eventually “stressed” just becomes your body’s new set point.

Breathwork, meditation, exercise, somatic exercises, and time in nature are all excellent for relaxing and resetting the nervous system over time. Ideally, they should be practiced daily, as part of a healthy routine, and not specifically to sleep.

Healthy Sleep Takes Time

Just as training your muscles in the gym takes time and dedication so does releasing stored stress and rebalancing the nervous system. It involves learning new behaviors and building new neural pathways, which takes time, so don’t be surprised if 1 round of 4-7-8 breathing doesn’t magically change your life. You did not become chronically stressed overnight so you aren’t going to become permanently unstressed in 30 minutes or less!

The next time you experience sleep problems, I suggest you sit down and ask yourself “am I living a healthy lifestyle in an environment that promotes sleep (cool dark room etc.). If the answer is yes, then honestly evaluate the stress in your life. Are you feeling anxious about anything (including sleep) or have there been any significant changes in your life recently? Is anxiety something you commonly feel, or would your lifestyle be considered stressful by others? If so, then you likely need more than sleep hygiene to reset sleep and I would recommend exploring sleep behavior coupled with relaxation techniques.

Whatever the cause, please be assured that there IS an answer. Insomnia is a symptom, not a disease, which means that there is always a solution. Sometimes it just takes a bit of digging coupled with time and patience to find the best answer for YOU, in your unique body, with your individual thoughts and life experiences. 

If you would like to learn more or book an individual session, please visit the Memberships page. 

In the meantime, I would like to leave you with this important message. You are not broken! You are whole, perfect, and healthy exactly as you are, and you CAN sleep!