Insomnia: why does the mind stay awake when the body is tired?

Lying awake at night as the hours pass is one of the most common complaints people bring to a psychologist. Sometimes it starts after a stressful period and never quite settles; sometimes it creeps in gradually, and every evening begins with the question: “Will tonight be different?”

Insomnia usually means difficulty falling asleep, waking during the night or waking too early; it happens at least a few nights a week and comes with tiredness, restlessness or difficulty concentrating the next day.

How does a sleep problem become a habit?

A few bad nights are normal. What turns them into a lasting problem is often the response: going to bed early to make up the deficit, staying in bed for hours trying to sleep, napping during the day or checking the clock again and again. Over time the bed stops being a place of rest and becomes a place of effort and frustration.

Worry about sleep itself plays a large part. The more important sleep feels, the harder it is to let go; the mind stays on alert exactly when it should be settling.

Sleep, mood and anxiety

Poor sleep and emotional difficulties often go hand in hand. Anxiety and low mood make sleep lighter and more broken; insomnia in turn makes it harder to cope with stress the next day. Looking at only one side of this cycle rarely solves the problem.

Some sleep problems have medical causes, such as sleep apnoea or circadian rhythm disorders. In these cases psychological work does not replace medical follow-up; it runs alongside it.

How psychological work proceeds

Approaches to insomnia based on Cognitive Behavioural Therapy look at sleep habits, the timing of sleep and the thoughts that occupy the mind at night. A sleep diary is often kept for a week or two to see the real pattern rather than the remembered one.

Changes are made gradually: a regular wake-up time, a wind-down period before bed, getting out of bed when sleep does not come and ways of handling night-time worry. The aim is to rebuild trust in the body’s own ability to sleep.

When to seek support

If sleep has been difficult for several weeks, if it affects your work, mood or relationships, or if you are relying on sleeping pills without a clear plan, a consultation can help clarify what is going on. Loud snoring or pauses in breathing during sleep should also be assessed medically.

For the first session it helps to bring any previous sleep tests and reports, along with a short note describing your usual bed and wake times and your daytime routine.