[KatBLilly]

I have a history of health anxiety, which I’ve had my whole life. I’ve managed it well with the help of psychologists & have had periods of insomnia before but it has eventually passed. Recently I had a hysterectomy as a preventative measure as I had breast cancer 11 years ago. It was a big decision to make as there was no immediate threat. I also kept my ovaries. Around week 3 post surgery I began to have trouble falling asleep & staying asleep. This immediately sparked worry as I had experienced insomnia before & didn’t want to go back to daily exhaustion as well as try to recover from surgery. It’s been 4 weeks now of sleeplessness. I have already begun bedtime restriction but cheated a bit on the timing as I felt tired earlier than my allotted sleep window time, which resulted in me getting into bed & feeling wide awake! I’m guessing it’s best to trust in & not rush the process or it backfires on you. One problem I find, is that when I do fall asleep sometimes, I wake shortly after in a state of panic which sends my heart racing & makes calmly falling back to sleep difficult. Does anyone else experience this?? I am someone who naturally has a tendency to worry but I’ve been like this my whole life, so I hope retraining myself for sleep won’t be impeded by my already anxious nature. After all, I’ve had 44 years of life with only small chunks of time with insomnia. Physically, I have recovered from surgery, so it’s not pain that keeps me from sleeping. I’m not big on taking pills either, so I have avoided all analgesics & sleeping tabs. Hopefully someone can relate to this or give me some hope xx

[Martin Reed]

Thanks for sharing your story, KatBLilly!

I hope you find it reassuring when I tell you that nothing in what you’ve shared sounds unusual in any way — it sounds like a typical case of insomnia.

We actually have a model for describing how insomnia develops, called the 3P model.

The first “P” is predisposing factors — put simply, some of us are more predisposed to sleep disruption. For example, we may be more reactive to stress, tend to worry a lot, maybe have a stressful job, or be a light sleeper. This puts us more at risk for temporary sleep disruption.

The second “P” is precipitating factors. This is the event or issue that triggers actual sleep disruption. There are as many triggers for sleep disruption as there are people in the world! These could be things like health issues, an injury, receiving bad news, having a tight deadline at work, losing our job, getting a new job, arguing with our spouse, etc.

Usually, sleep recovers by itself after the precipitating issue has been “processed” or is no longer an issue. However, sometimes sleep issues remain — and this is usually down to the third “P”, which are the perpetuating factors.

These perpetuating factors are the things we do in response to the bad nights and things we might do to try to get our sleep back on track but have the opposite effect — they make it harder for our sleep to get back on track. Examples include spending a lot of time researching sleep, thinking about sleep, worrying about sleep, spending more time in bed, trying to conserve energy during the day, and modifying our lives in response to poor sleep.

These perpetuating factors make it hard to get sleep back on track because they lead to one (or all) of the following problems:

1. Sleep drive disruption (in other words, we might go to bed when we are not sufficiently sleepy for sleep, nap during the day, or stay in bed longer than usual)
2. Body clock disruption (usually caused by an inappropriate or irregular sleep schedule, and daytime inactivity)
3. High levels of arousal (this includes cognitive arousal, physiological arousal, and conditioned arousal)

Cognitive arousal describes the worries that keep us awake or fill our daytime thoughts, hyperarousal/physiological arousal describes our body’s response to arousal (such as a racing heart), and conditioned arousal describes the sense of fear, worry, anxiety or even dread that many people with insomnia have learned to associate with their own beds.

The good news is, cognitive and behavioral techniques help address all these perpetuating factors so they are really effective at helping people who struggle with insomnia make long term improvements to their sleep.

This model is put into a bit of context in this YouTube video: Watch me use my mystical powers to reveal how your sleep issues began and why you now have insomnia.

I hope this helps!

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If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.

The content of this post is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.

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