Understanding Insomnia: When Sleepless Nights Persist

In today’s fast-paced world, stress seems to be a constant companion. As our human needs increasingly clash with society’s demands, many people find themselves struggling with sleep. Whether it’s lying awake for hours, waking up repeatedly, or rising too early and being unable to fall back asleep, difficulty sleeping is a common experience, especially during stressful times.

Sleep and stress are natural opposites. When we are stressed, our bodies release hormones like cortisol and adrenaline that keep us alert and vigilant, which is a state incompatible with rest. Sleep, on the other hand, requires vulnerability and relaxation. If our nervous system senses “threat,” even unconsciously, it can be hard to let go enough to drift into restorative rest.

Occasional sleepless nights are normal, and our bodies often compensate the next night. But what happens when sleep troubles become a lasting pattern?

What is Insomnia?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), insomnia becomes clinically significant when sleep difficulties occur at least three nights per week for a month or longer and cause distress or interfere with daily life.

Common Symptoms Include:

• Difficulty falling asleep

• Difficulty staying asleep or waking frequently

• Waking up too early and being unable to return to sleep

• Poor sleep quality and dissatisfaction despite enough time in bed

  Other Signs of Insomnia:

• Daytime fatigue or sleepiness

• Irritability or mood changes

• Trouble concentrating or “mental fog”

• Worry or distress about sleep itself

In short, insomnia isn’t just about not sleeping. It’s about how that lack of sleep affects your days, your mood, and your functioning.

How Sleep Works

Getting good sleep depends on two main systems in our body: our circadian rhythm, also known as our internal body clock, and our sleep drive.

Circadian Rhythm

Our circadian rhythm is like an internal clock that helps our body know when it’s time to be awake and when it’s time to rest. It influences when we feel most alert, when we start to feel sleepy, and when our body gets its best quality sleep.

Everyone’s clock runs a little differently. Some people are morning types (“larks”) who naturally feel their best earlier in the day, while others are night owls who feel more awake later and prefer sleeping in. Most of us fall somewhere in between and, overall it does not cause significant concern unless your schedule is completely incompatible with your internal body clock. Sometimes, life and work schedules don’t line up well with our natural rhythm. Shift work or early morning jobs can make it harder to follow the body’s natural sleep patterns.

Our circadian rhythm also changes as we age — for example, teens often stay up later and sleep in, while older adults tend to go to bed and wake up earlier.

Sleep Drive

The other key part of sleep is our sleep drive, also known as our sleep-wake balance. This system builds pressure for sleep the longer we’re awake.

You can think of it like a balloon filling up throughout the day. The more time you spend awake and active, the more “air” fills the balloon. By bedtime, when it’s full, your body is ready for deep, restful sleep.

When we nap or spend a lot of time lying in bed during the day, it’s like letting some of that air out. This can make it harder to fall asleep later because your sleep drive isn’t as strong.

Why Does Insomnia Happen?

To understand insomnia, it helps to look at three types of contributing factors:

Predisposing Factors

These are risk factors largely beyond our control. Some people are naturally more prone to sleep difficulties due to genetics, age, or personality traits. For example, anxious or highly sensitive individuals may have a lower threshold for sleep disruption.

Precipitating Factors

These are events or stressors that trigger the initial bout of insomnia. Common examples include illness, job stress, loss, or major life changes. These stressors can cause short-term sleep difficulties that may resolve when the stress passes.

Perpetuating Factors

These are behaviours and thought patterns that keep insomnia going long after the initial trigger. For example, spending more time in bed trying to “catch up” on sleep, worrying excessively about not sleeping, or relying too heavily on caffeine can all make insomnia worse.

While we can’t change our predisposition, we can address the precipitating and perpetuating factors that turn occasional sleeplessness into a chronic problem.

Getting Help: Where to Start

You don’t need a formal diagnosis to recognize that sleep is a problem worth addressing. Many people first turn to over-the-counter sleep aids or supplements such as melatonin. While these can provide short-term relief, they don’t address the root cause of insomnia.

Before starting any treatment, it’s wise to rule out other causes:

• Sleep disorders such as sleep apnea, restless leg syndrome, or parasomnias may need a professional sleep study.

• Hormonal changes and aging naturally affect sleep. As we age, we produce less melatonin and growth hormone, leading to lighter, more fragmented sleep. Older adults may also need less sleep overall and may find themselves going to bed earlier and waking earlier

• Medication or supplements can interfere with sleep. Consult with your doctor or pharmacist to review potential side effects

  Reviewing Your Sleep Routine and Lifestyle

  Take an honest look at your daily habits and beliefs about sleep:

  • Do you have a consistent bedtime and wake-up time?

  • What activities do you do before bed?

  • Are you using electronics late into the night?

  • What are your current life stressors, and how are you coping?

  • Do you hold beliefs like “I must get 8 hours” that create anxiety when you can’t?
    
    What you do during the day also influences how you sleep at night. Ask yourself:

  • Am I getting regular physical activity?

  • Do I engage in hobbies or activities that bring joy?

  • Is my diet balanced and nutritious?

  • Am I maintaining meaningful social connections?

  These daytime habits form the foundation for better sleep.
  

Cognitive Behavioural Therapy for Insomnia (CBT-I)

One of the most effective long-term treatments for insomnia is Cognitive Behavioural Therapy for Insomnia (CBT-I). Unlike medication, CBT-I addresses the thoughts and behaviors that sustain sleep difficulties. While working with a professional is recommended, some strategies can be practiced independently. And, resources like Sleepwell website and workbooks like Quiet your Mind & Get to Sleep can help you along.

Keep a Sleep Diary

Track your sleep for at least two weeks. Record when you go to bed, how long it takes to fall asleep, how often you wake, and when you get up. This helps you identify patterns and problem areas.

During this period, don’t change your routine. Once you have enough data, you’ll create a sleep prescription based on your average total sleep time.

A sleep prescription dictates how much time you will be in bed sleeping.

Sleep Efficiency Training

When you’re living with insomnia, it’s natural to start spending more and more time in bed, hoping that extra time will lead to more rest. Unfortunately, the opposite often happens. The more time we spend awake in bed, the more our brains start to associate our bed with wakefulness and frustration instead of rest.

Sleep Efficiency Training helps retrain your brain and body to reconnect the bed with sleep. It focuses on building healthy sleep patterns through structure, consistency, and gentle habit changes.

Create a Consistent Sleep Schedule

Start by choosing a regular bedtime and wake-up time that you can keep, including weekends.

Your schedule should match your current sleep ability (also called a “sleep prescription”). You can create your own sleep prescription by using a sleep calculator using the information you logged in your sleep diary. For example, if you typically sleep for about 6 hours and need to wake up at 7:00 a.m., your bedtime would be 1:00 a.m.

This may feel short at first, but it helps your body learn to sleep more soundly during the time you’re in bed.

Don’t Stay in Bed Awake
If you find yourself awake for about 15–20 minutes, it’s best to get out of bed. Move to another quiet, comfortable space with dim lighting and do something calming. reading a light book, stretching gently, or listening to soft music are all great options.

When you start feeling sleepy again, return to bed. This teaches your brain that the bed is for sleeping, not for thinking, worrying, or waiting for sleep to come.

Rebuild your Sleep Connection
Think of this process as reconditioning your mind and body to see your bed as a cue for rest and safety. Over time, the frustration and alertness that often come with insomnia begin to fade, and your body starts to respond naturally to bedtime again.

Reframe Your Beliefs Around Sleep
It's easy to develop rigid ideas about sleep. such as believing we must get eight hours of sleep or that we'll be unable to function without it. While these thoughts come from a good place, they often add pressure and make sleep feel even harder. The truth is, everyone's sleep needs are different, and our bodies are more resilient than we often give them credit for. Think back to the times you managed a full day on less rest than expected to remind yourself of your bodies capacity to adapt.

As you work through CBT-I strategies, remind yourself that this process takes time but leads to lasting change. Try using realistic coping statements like "my body knows how to rest; I'm giving it time to relearn", or if you struggle getting out of bed if you're unable to sleep tell yourself" I'm going to do something enjoyable tonight so it's fine if I wake up". These reminders can help you stay grounded and patient while rebuilding trust in your natural sleep rhythm.

Track and Adjust Gradually
As you work through this process, continue tracking your sleep.
Once you’re sleeping through most of the night for at least a week, you can gently increase your sleep window by about 15 minutes. Keep doing this until you reach the number of hours that feel restorative for you.

Be Flexible with Yourself
If sleep becomes difficult again and you’re finding yourself lying awake for long periods, waking up often, or rising too early, it’s okay to return to your previous schedule for a while. Small adjustments and patience are key.

Remember: improving sleep takes practice, not perfection. These changes help your body rebuild confidence in its natural ability to rest.

Schedule “Worry Time”

If your mind races at night, schedule worry time earlier in the evening at least two hours before bed. Write down your concerns in one column, and in the next, outline small steps you can take to address them. This practice signals to your brain that you’ve “handled” those worries, freeing your mind to rest later. If you find your mind wandering back to your worries while trying to fall asleep, remind yourself you’ve already written it down and you will tend to it tomorrow. At first it may take a bit of time to get adjusted to but over time your mind will get accustomed to it.

Takeaways

Sleep is the foundation of our overall health and well-being. Without it, even the simplest daily tasks can start to feel overwhelming.
Sleep difficulties are not a sign of weakness or something to push through by “toughing it out.”

With the right tools, consistent habits, and approaches like CBT-I, it’s absolutely possible to retrain your body and mind to rest again.

And if you’d like support along the way, I’m here to help.