Environmental Factors
In some cases, despite stress subsiding and medical conditions receiving treatment, insomnia can persist. Patients will find that they have trouble either falling asleep or staying asleep – and occasionally, both. Here are a few of common reasons people experience persistent insomnia.
Conditioned arousal: The bed and the bedroom become linked with wakefulness, arousal or negative emotions. The bed and the bedroom become unconscious cues for arousal rather than sleep. For example, many people with insomnia report that they doze off while watching TV or reading in the living room, but become fully awake when they go to bed. For these people, past experience with tossing and turning while trying to sleep has made the bed a cue for wakefulness rather than sleep.
Trying too hard: Some people react to poor sleep by trying harder. They extend the time they spend in bed, avoid evening activities that they used to enjoy, toss and turn in bed, and even try a "night cap." Rather than solve the problem, these strategies often make it worse. Prolonged time in bed actually promotes wakefulness. The very act of "trying" produces frustration, increases arousal and can actually cause stress. The process is like trying to get out of a Chinese finger cuff. The harder you try to pull your fingers away, the more stuck they become. When you let go, you can ease your fingers out.
Worrying: Worry about sleep is another common reaction to having difficulty sleeping. After a period of not sleeping well, you may find that you start worrying about whether you'll struggle to sleep in the coming night. Then you can begin to worry about how insufficient sleep will negatively affect you the next day. Such worries, though understandable, are counterproductive and end up making even more difficult to fall asleep.
