Around 10 percent of the population suffers from chronic insomnia, according to the Sleep Management Institute, and for many of those people, insomnia is a psychological issue. In fact, cognitive behavioral therapy is usually the first line of treatment for insomnia, not pills. A recent review of the scientific literature on insomnia in the journal Behaviour Research and Therapy (spotted by BPS Research Digest) identifies yet another piece of the psychological puzzle that could help people with insomnia. According to findings from University of Alabama psychologist Kenneth Lichstein, just identifying as an insomniac can make you feel worse than the lack of sleep does.
Not everyone who sleeps poorly during the night feels equally foggy the next day. The less satisfied you feel with your night's sleep, the worse you probably feel after you wake up. If you get three hours of sleep but aren't worried about it, you're less likely to complain of fatigue and impairment the next day than someone who lies awake beating themselves up over those hours without sleep. Whether or not you think of yourself as an insomniac is surprisingly idiosyncratic, and isn't always tied to your actual sleep quality.
Lichstein calls this "insomnia identity," suggesting that no matter what the quality of your sleep at night, if you think of yourself as an insomniac, you'll probably feel worse. For one thing, if you're primed to think you'll have trouble falling asleep, you'll be far more sensitive to even the mildest of insomnia symptoms. All that stress, in turn, will make it harder to fall asleep, starting the process over again. You'll be primed for disappointment, and probably won't acknowledge any small gains you make, because you'll have a rather fatalistic attitude toward the whole endeavor of sleep. This insomnia identity is tied to all the same negative effects of the not-sleeping itself, including hypertension, fatigue, depression, and anxiety, according to the study.
If identifying as an insomniac really does have such a major impact, therapies designed to improve symptoms of insomnia should be tackling the self-stigma first, helping people get over their conviction that they are irreformable insomniacs so that they can keep an open mind during their treatment. In the process, they'll start to feel better, even if they don't begin to sleep all that much more.
[h/t BPS Research Digest]