Breaking "The Switch" in Insomnia

by Brian Curtis, PhD, DBSM

People with difficulty falling asleep and staying asleep don’t usually associate the bed and bedroom as reliable cues for sleep.

Instead, due to frequently pairing the bed and bedroom with heightened states of alertness (e.g., anxiety, fear, tossing and turning, frustration), the bed and bedroom become reliable cues for physiological and psychological activation, vigilance, and readiness for action (i.e., arousal).

When the bed and bedroom become reliable learned (i.e., conditioned) cues for arousal, thereby interfering with the automatic process of sleep, this is known as “conditioned arousal.”

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Conditioned arousal can also result from past stressful or traumatic experiences that occurred while in bed or during sleep.

Examples include physical or sexual abuse, or a sleep environment felt to be unsafe and requiring hypervigilance (e.g., an unstable home environment, a combat zone).

Any intrusive thought, memory, or image of a prior trauma, including nightmares, can strengthen the learned connection between the bed and arousal.

Accordingly, conditioned arousal can occasionally form even after a single significantly stressful event.

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“It’s like a switch flips and I’m wide awake.”

If you’ve experienced a pattern of struggling to stay awake and possibly dozing off while reading or watching TV outside your bedroom, only to suddenly feel wide awake as you approach your bedroom or get into bed, you’ve likely experienced conditioned arousal.

It’s like a switch suddenly flips from being sleepy outside our bedroom to feeling wide awake as we approach our bedroom or get into bed, often resulting in trouble falling asleep and staying asleep.

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Consistently pairing your bed and bedroom with states of rest and relaxation rather than stress and hyperarousal can effectively break the cycle of conditioned arousal.

Learn how at https://www.honestsleep.com/insomnia-disorder