Insomnia: Causes and Cures

Good sleep is as vital to good mental health as good nutrition is to physical health. Good sleep supports effective coping with daily challenges.

When we are stressed by daily demands on our minds and bodies, getting and maintain good sleep can be difficult. When we feel that we are constantly fighting the clock, we often regard sleep as one more task to be done by somehow forcing ourselves.  Hard-driving people view sleep as one more job to worry about accomplishing.  Worrying about getting to sleep has complications, and can induce reliance on self-medication and counterproductive behavior.

Removing the pressure of sleep problems may require renegotiating how we share responsibilities with people in our personal and professional lives. It may require instituting brief breaks during the day in order to re-focus and re-gain perspective.  Even the shortest break allows us to coax physical tension out of our muscles.  A two minute break – something as simple as focusing on a photo of a child or pet or vacation spot – allows us to re-set our outlook. 

To gain a better chance at solid, natural sleep, we may need to heighten our awareness of our need for modest but vital rewards before, during and after our work day.  These rewards renew body, mind and spirit.  In the morning, allow yourself three minutes to plan these simple breaks for the day, and enforce these little breaks.  In the long term, these breaks are investments that will pay off.

Everyone needs to experience some reward each day in order to slumber easily and solidly.  Try to create small rewards throughout the day.  These rewards can be physical and they can be mental.  A physical reward might be a walk around the office to relieve the tightness of sitting in front of a computer.  It might be a walk around the block.  It might be going out to lunch.  It might be standing next to one’s desk on tippy-toes.  It might be a warm shower before bed. It might be a bottle of cold spring water. A mental reward might be a one minute look at your child’s artwork, or a glance at a photo of a  hoped-for vacation spot. It might be a look at the newspaper.  It might be fifteen minutes with a book, or some gentle music. 

The cues to yourself for small rewards can be slight, but they must be regular.  A routine before bed helps most people.  Make your bedroom a stress-free zone.  Handle your problems elsewhere.  Don’t leave reminders of your work and your problems in your bedroom. Throughout the day and especially in the half-hour before we try to sleep, we need to lose physical tension and gain perspective.  In doing so, we have a chance at easy sleep.

For some, late night eating or alcohol or drugs are their only rewards after a stressful day.  But these may impede easy and natural sleep in the long run.  They may create more anxiety, more stress, and stomach upset.   Better rewards are immersion in the senses…things like music, movement, touch, nature and pleasant aroma.

No matter how much we are inclined to push ourselves, pushing for sleep is counterproductive.  One simply cannot will it.  We need to create routines for regular re-setting of mind and body throughout the day.  Without these consistent, though minor, physical and mental rewards, getting quality and well timed sleep will often be a struggle. Once we have taken control of our re-focusing and reward issues, sleep medicines are no longer our only tools for sleep.  Better tools can be created.


In genuine, acute mental health crisis, stopping insomnia becomes an urgent issue. Although all of the behavioral ideas mentioned above remain important, using medication safely under a physician’s care to ensure sleep may be appropriate for some because insomnia itself rapidly can instigate or aggravate mental health crisis.  Medication is not for every patient, and self-medication can be dangerous.

Insomnia causes fatigue that undercuts daytime confidence in facing the crisis at hand.  It promotes a false but disturbing sense of helplessness and defeat, aggravating a depressed or even paranoid mood. Insomnia can expose us to negative repetitive thinking, agitation and exaggerated fears while lying helplessly in bed, aggravating anxiety and escalating apprehension into damaging personal over generalizations.

Good sleep is vital to good health and to restorative good mental health.

I hope this is of help.

Jerrold Bonn, M.D.
Psychiatrist & Talk Therapist
Greater Philadelphia

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