Most people who suffer from insomnia do exactly what seems logical — and that is precisely what keeps the problem going.
Going to bed earlier, staying in bed trying to fall asleep, catching up on sleep during the day — all of these weaken the sleep mechanism. Cognitive behavioural therapy for insomnia is considered the most recommended treatment, and it is usually short and structured.
What is insomnia?
Sleep relies on two mechanisms: sleep pressure, which builds up the longer we are awake, and a biological clock that determines when the body expects to sleep. Spending long periods awake in bed weakens the first, and irregular sleeping hours disrupt the second. At the same time a learned link forms between the bed and alertness and frustration. Treatment strengthens both mechanisms again and restores the link between bed and sleep.
When to seek help
Recognising the signs and knowing when help can make a difference
If it takes more than half an hour to fall asleep, if you wake in the middle of the night and struggle to get back to sleep, or if you wake too early — three times a week or more for three months — this is chronic insomnia. Reaching out early prevents dependence on sleeping pills, whose long-term effectiveness is limited and whose discontinuation requires medical supervision.
Types of sleep disorders
Chronic insomnia
Chronic insomnia lasts more than three months and is accompanied by fatigue, irritability and difficulty concentrating during the day. It often began because of a stressful event that has already passed, but the pattern remained. Structured treatment — limiting time in bed, restoring the link between bed and sleep and working on the thoughts around it — brings improvement for most people.
Sleep and anxiety
Worrying about another sleepless night itself becomes a trigger. The thought “If I don’t fall asleep now, tomorrow will be terrible” increases alertness and pushes sleep further away. Working on this cycle of thoughts is a central part of treatment, alongside the behavioural components.
Sleep apnoea
Loud snoring, pauses in breathing noticed by a partner, and extreme daytime sleepiness — even after a full night — raise suspicion of sleep apnoea. This is a medical condition that requires a sleep study and is not treated with psychotherapy. It’s important to diagnose it, because it also affects mood and general health.
Circadian rhythm disorders
Some people’s internal clock is shifted: they fall asleep and wake up very late, or the reverse. The difficulty is sharper in adolescence and among shift workers. Treatment includes gradually shifting sleep times and making sensible use of exposure to light at the right hours.
Nightmares and recurring dreams
Recurring nightmares often appear after a traumatic event, and lead to avoiding sleep itself. There are focused methods for working with the content of the dream that significantly reduce its frequency and intensity, alongside treatment of the trauma itself.
Dependence on sleeping pills
Prolonged use of sleeping pills sometimes leads to dependence and reduced effectiveness, so that a higher dose is needed for the same result. They should not be stopped suddenly. Combining gradual reduction under a doctor’s supervision with cognitive behavioural therapy is the effective and safe way.