Do I Have Insomnia? Three Ways to Evaluate How You're Sleeping
By Eleanor McGlinchey, PhD
One of the hardest things about being a sleep specialist is practicing what I preach! I generally keep a steady sleep and wake schedule, try to limit screens and light right before bed, and accept those moments when my thoughts are racing overnight by remembering that I will be ok. However, it is still easy to forget that sleep is a paradoxical thing in life that you simultaneously have great influence and no influence over. There are definitely actions you can take that will support quality sleep. Yet you can be doing all the right things and still struggle to sleep. In the end sleep cannot be forced, it can only be accepted.
You may now be wondering, how do I know if I am doing the “right things”? Or that the things I’m doing are having the effect they’re supposed to? While you have slept nearly every single night of your life, it can actually take work and planning to sleep well! It can also be quite challenging to know what to look for during the day to know whether you’re getting what you need at night sleep-wise. Many of us may assume our bodies will just do its thing if given enough hours of sleep. While that may be the case, it can also be helpful to get curious about our daytime experiences to evaluate our sleep quality. As a psychologist who specializes in sleep, I hope that this can help you discern whether you simply need a few tweaks to your sleep routine or if it may help to seek professional sleep support.
Get curious about your sleep timing
First, evaluate your sleep timing by asking yourself these questions. Do I wake up at the same time (within an hour or so) everyday? Do I feel sleepy around the same time every night? When I get into bed to sleep, do I fall asleep within 30 minutes or so? When I wake in the morning, do I generally feel refreshed (after that initial, normal grogginess)? If you answered no to these questions, try reviewing some common sleep hygiene suggestions to identify what might be getting in the way of your sleep timing. Resetting some common sleep-wake blockers, such as avoiding naps can improve your sleep timing.
Get curious about your bedtime and wake routines
After assessing your sleep timing, check in on your bedtime and wake up routines. For bedtime, what do you generally do in the hour before bed? How do you feel during this time (e.g., anxious, irritated, calm, relaxed)? If your routine does not leave you feeling calm and relaxed, it might be worth rethinking and changing up some of your nightly rituals. In the morning, do you have a wake-up routine? For wake time, do you rely on an alarm to wake you up? If so, do you hit snooze? Does that normal morning grogginess stick with you longer than one hour? If you don’t have a routine, perhaps try to implement the R.I.S.E. U.P. routine.
Get curious about daytime fatigue
Finally, observe your daytime fatigue. Are there times during the day that you find yourself dozing off? Is it a struggle to keep your eyes open in a boring meeting? How often do you rely on caffeine or other substances to help you stay awake? Do you find it difficult to concentrate or engage in work or other activities that you enjoy?
After taking stock of these three general areas, you might find that a return to good sleep hygiene practices in a few key areas is all you needed to get back on track to better sleep. However, if you have been trying to reset but are struggling, it might be a good time to reach out to a sleep specialist.
When should I seek sleep treatment?
Generally speaking, insomnia is when you have difficulty falling asleep or staying asleep to the point that it is directly affecting your daytime functioning. While we all may have some difficult nights or even weeks of sleep - for example, due to a work-related project or life transition - more often than not sleep disruptions can resolve on their own as your life returns to what is familiar or adjusts. That being said, it’s important to know that if you have been struggling more evenings than not during a week, and it’s been the case for consecutive weeks, even months - seeing a sleep specialist is likely a good idea. If you have been struggling with insomnia for a while, you may also prefer to try and reestablish new patterns with the direct support of a professional. Sleep therapy for insomnia is typically short-term, lasting between 4-8 sessions. Even if there are multiple targets of intervention beyond changing your sleep schedule, sleep treatment remains focused and time-limited in most cases. Most interventions do not require medications or other sleep props (e.g., special pillows, weighted blankets). Instead, they focus on changing specific behaviors and thought patterns interfering with sleep - which is why working with a trained mental health professional can be particularly beneficial when it comes to sleep. A sleep specialist can also help you better understand the overwhelming internet information on sleep and boil it down to what is truly relevant for your specific sleep difficulties. Furthermore, having a comprehensive evaluation can also differentiate if there are more complex or underlying medical reasons for disrupted sleep that warrant additional specialty attention that an application of sleep hygiene practices may not fully address.
At the end of the day, we must all remember that nights of poor sleep are unfortunately inevitable. It might sneak up unexpectedly or come up regularly during times of stress. It might be helpful to remember that difficulties with sleep are normal from time to time. In this case, being a bit gentler with yourself will actually help you to stop forcing it and accept when sleep comes your way.
About the Author: Dr. McGlinchey is a sleep specialist, psychologist, and researcher who is passionate about helping others accept sleep and rest. She is also planning for a short term experiment with sleep deprivation and irregular sleep-wake routines – in other words, she will be on maternity leave for a few months and adjusting to the new rhythms of infant sleep.