I can always tell when my friend has had a sleepless night with her toddlers. Beyond the obvious yawning there’s a general droopiness and lack of sparkle. She has good reason to be sleep-deprived and she reminds me that, eventually, this experience will pass. (Not soon enough perhaps, but it will pass).
Insomnia is a related cousin and may not pass as easily. Defined as “prolonged and usually abnormal inability to get enough sleep especially due to trouble falling asleep or staying asleep.” Whatever the source (many and complex), I think of it as a particular kind of torture. There are far worse kinds of course, but sleep deprivation is a nightmare (no pun intended).
Around a third of adults in the UK report regular insomnia, and it rarely occurs in isolation. For years it was called “secondary insomnia” when paired with anxiety, depression, chronic pain, or physical conditions like diabetes or heart issues. The assumption was this: treat the main problem, sleep would follow. Now we know differently.
In the early 2000s research showed insomnia can arrive first, outlast other difficulties, and even amplify them. Treating sleep doesn’t just help getting through the night – it supports the possibility for better mood, less pain, even supporting recovery from a variety of concerns. Women, older adults, and those facing socio-economic pressures remain most vulnerable to insomnia, navigating multiple layers of biological concerns (think perimenopause and menopause especially) and social stressors.
Amidst the general umbrella term of insomnia is the nightmare 3am wake-up. However unsettling, it’s normal. Sleep unfolds in 90-minute cycles – light, deep, REM – and naturally lightens towards morning. Brief arousals from sleep happen to everyone around that time (although we may not remember them). What turns the 3am wake-up into trouble is when stress or rumination turn a natural sleep pause into overthinking and over-worrying. In my experience, what are actually solvable problems take on barbaric and catastrophic proportions at 3am and beyond.
The good news is that the brain learns quickly. Lie awake worrying, and bed becomes an environment predicting alert frustration rather than rest. Get up if sleep won’t come. Don’t check email or turn on bright lights. Find somewhere else cosy, maybe listen to some soothing music, maybe read fiction or poetry, allow your thoughts to disperse like dandelion seeds in the wind. Easier said than done I know, but worth trying to shift an engrained pattern. (The Sleep Foundation has useful suggestions for sleep hygiene).
The experts regard insomnia as territory with hope. It isn’t trivial or inevitable; it’s treatable. We’ve made strides in understanding it as a standalone challenge deserving real attention. The invitation now is to take that knowledge to heart—because better sleep doesn’t just change your nights. It quietly transforms the rest of your life.
With thanks to The Conversation for two articles which sparked this post, one on insomnia and the other on the 3am-wake-up-and-worry phenomenon.
[My private practice is usually full and you’re welcome to reach out to see if that’s changed]