Making the Most of Your Therapy: Insomnia: Why Can’t I Sleep and What Can I Do About It?

Insomnia can be a short-term (< 3 months) or long-term (> 6 months) sleep condition. It is characterized by both nighttime and daytime symptoms occurring at least three times per week.

Nighttime Symptoms:

  • Difficulty falling asleep
  • Difficulty staying asleep
  • Early morning awakening

Daytime Symptoms:

  • Reduced physical energy, mood, memory, and concentration
  • Decreased daytime productivity

How Common Is Insomnia?

A 2021 online survey conducted by Philips Global Sleep Study with 1,000 participants in Singapore found that 35% had difficulty falling asleep, while 25% struggled to stay asleep.
Transient sleep difficulties are a normal part of life. However, when these issues persist and cause significant impairments—such as daytime symptoms—it is essential to assess one’s sleep health.

How Does Long-Term Insomnia Develop?

Insomnia does not have a single cause; rather, it results from a combination of current stressors and other contributing factors. These include:
  • Pre-existing risk factors – Genetics, an anxious personality, and environmental conditions can increase the likelihood of insomnia.
  • Poor sleep habits – Irregular bedtime routines, excessive caffeine intake, and daytime naps can contribute to sleep difficulties.
  • Conditioning response – Over time, spending extended periods awake in bed can create an association between the bed and wakefulness, making it even harder to sleep.

What Helps (or Hurts) Insomnia Management?

A common instinct when struggling with sleep deprivation is to go to bed earlier, hoping that more time in bed will lead to better rest. However, this can worsen insomnia due to a misalignment with the body’s internal sleep-wake cycle (circadian rhythm), leading to more time spent awake in bed.

Tips for Good Sleep Hygiene:

  • Maintain a consistent sleep-wake schedule – Try to sleep and wake up at the same time daily.
  • Establish a bedtime routine – Engage in relaxing activities before bed, such as a warm bath or reading.
  • Use your bed only for sleep and intimacy – Avoid activities like watching TV or using your phone in bed.
  • Avoid caffeine after 2 PM – Coffee, tea, chocolate, energy drinks, and some soft drinks contain caffeine that can interfere with sleep.
  • Limit daytime naps – Napping can make it harder to fall asleep at night.
If these strategies do not improve your insomnia symptoms, a comprehensive assessment by a clinical psychologist or psychiatrist is recommended. Long-term insomnia can lead to both physical and mental health issues, so early identification and treatment can significantly improve quality of life.

How Is Insomnia Treated?

The first-line treatment for insomnia is Cognitive Behavioural Therapy for Insomnia (CBT-I), an evidence-based approach that typically involves 5-8 weekly sessions aimed at improving sleep over time. The effectiveness of CBT-I depends on an individual’s motivation, practice, and commitment to the process.

References

Take the Next Step Toward Better Sleep

Struggling with persistent sleep issues? Our experienced psychiatrists and psychologists at Private Space Medical can help you regain restful sleep with expert-guided strategies tailored to your needs. Reach out today
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Dr Beron Tan
Senior Psychologist