What Does It Mean To Be an Insomniac? What Most People Get Wrong About Insomnia
If you interviewed random people on the street and asked them what they think having insomnia means, most would answer that it has something to do with not sleeping.
However, it’s sometimes a misconception that insomnia sufferers can’t sleep.
Insomnia is not about sleep deprivation or an inability to sleep. It’s often more about feeling unsatisfied with your sleep.
The Boy Who Didn’t Sleep
In 1963, two high schoolers in need of a science fair project decided that they wanted to analyze what sleeplessness did to a person. One of them, Randy Gardner, went on to stay awake for 11 days straight, beating the world record.1
However, many sleep researchers now doubt this story, stating that studies show that parts of his brain were in fact sleeping throughout the experiment, even though it wasn’t obvious at the time.1
If you deprive yourself of sleep, the brain finds small windows of opportunity to catch up. This process, called microsleep, occurs when your brain essentially goes to sleep for a few seconds at a time. You may still appear to be awake and even have your eyes open, but your brain isn’t taking in information like it usually does.2
Microsleep may be driven by the same brain process that triggers normal sleep — the homeostatic sleep drive. Your sleep drive is a sensation of “pressure” that builds up throughout your day. The longer you stay awake, the more pressure you will feel to fall asleep.3 In some cases, your homeostatic sleep drive may force your brain to go to sleep when you really need it. In fact, you may be more likely to experience microsleeps after just a single night of decreased sleep.4
It may be comforting to know that the brain has a “safety mechanism” to protect itself when it doesn’t get enough rest.
Sleep State Misperception
People with insomnia may be experiencing microsleep or even deeper sleep without realizing it. You may feel like you spent all night lying awake, tossing and turning, but you likely unknowingly dozed off a few times, and your body probably got at least some of the sleep it needs.
While this may sound unlikely — it’s easy to feel convinced that you never slept — research backs up this idea. Studies have found that people with insomnia are more likely to believe they stayed awake longer and got less sleep than they actually did.5
Experts call this phenomenon paradoxical insomnia or sleep state misperception. It occurs when you believe that you can’t sleep well, but when you undergo sleep testing, you discover that you are getting enough quality sleep.6 This tells us that insomnia is often rooted in how we feel about our sleep.
A Broader Definition of Insomnia
The DSM-5 — the so-called “bible” of psychology — defines insomnia as trouble falling asleep, staying asleep, or waking up too early. These problems need to exist at least three nights per week for at least three months.7
However, there may be many people who aren’t happy with their sleep quality who don’t exactly fall into this strict definition. For some, the meaning of insomnia may be more related to whether they feel worried or stressed about sleep
The truth is that sleeping problems are often more about fear and worry about not being able to sleep than actual sleep deprivation.8 When you worry about your sleep, you may also consciously or subconsciously adjust your life around these fears. Rather than helping, this often worsens the problem.
The cure is simpler than you might think. If you find a way to change how you think about sleep, you may worry less and start to actually sleep through the night.
This is exactly why experts recommend cognitive behavioral therapy for insomnia (CBT-I) as the primary sleep treatment. CBT-I helps you analyze your beliefs about sleep and, if needed, change them so you can go to bed with less worry.9 This treatment is just as effective as sleep medication, doesn’t come with side effects that sleeping pills can bring, and is more likely to lead to long-lasting results.10
To get started on your own CBT-I journey and finally address the root causes of your insomnia, fill out Dawn Health’s questionnaire. One of our sleep coaches can help you pinpoint some of your sleep problem areas and help you start to confront your negative thoughts related to rest.
Keating, S. (2018, January 18). The boy who stayed awake for 11 days. BBC Future. https://www.bbc.com/future/article/20180118-the-boy-who-stayed-awake-for-11-days
Centers for Disease Control and Prevention. (2020, March 31). Negative impacts on sleep (continued). NIOSH Training for Nurses on Shift Work and Long Work Hours. https://www.cdc.gov/niosh/work-hour-training-for-nurses/longhours/mod3/03.html
Centers for Disease Control and Prevention. (2020, March 31). Sleep pressure: homeostatic sleep drive. NIOSH Training for Nurses on Shift Work and Long Work Hours. https://www.cdc.gov/niosh/work-hour-training-for-nurses/longhours/mod2/11.html
Innes, C. R., Poudel, G. R., & Jones, R. D. (2013). Efficient and regular patterns of nighttime sleep are related to increased vulnerability to microsleeps following a single night of sleep restriction. Chronobiology international, 30(9), 1187–1196. https://doi.org/10.3109/07420528.2013.810222
Harvey, A. G., & Tang, N. K. (2012). (Mis)perception of sleep in insomnia: a puzzle and a resolution. Psychological bulletin, 138(1), 77–101. https://doi.org/10.1037/a0025730
Lai, C., & Qiu, H. (2017). Paradoxical insomnia: misperception of sleep can be a tormenting experience. American Family Physician, 95(12), 770. https://www.aafp.org/pubs/afp/issues/2017/0615/p770.html
Substance Abuse and Mental Health Services Administration. (2016, January). Table 3.36: DSM-IV to DSM-5 insomnia disorder comparison. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health. https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t36/
Cleveland Clinic. (2021, June 13). Sleep anxiety. https://my.clevelandclinic.org/health/diseases/21543-sleep-anxiety
Mayo Clinic. (2016, September 28). Insomnia treatment: cognitive behavioral therapy instead of sleeping pills. https://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/insomnia-treatment/art-20046677
Rossman J. (2019). Cognitive-Behavioral Therapy for Insomnia: An Effective and Underutilized Treatment for Insomnia. American journal of lifestyle medicine, 13(6), 544–547. https://doi.org/10.1177/1559827619867677
Therapist specializing in applying CBT principles for the treatment of insomnia.