Insomnia is a subjective feeling and is influenced by many factors. The main component of insomnia is the distress felt as a result of not being able to sleep. People who say they are suffering from insomnia may in fact be getting enough sleep. But why do these people say they are not sleeping? It is because of the distress they feel when they are not able to fall asleep when they want to. These people who get enough sleep biologically and yet complain of insomnia, we call 'pseudo-insomniacs'. 'Pseudo' means imposter.
(I) Feeling of distress. The difference between short sleepers and insomniacs is that the former sleep only a few hours at night, but feel well and function well the next day, whereas insomniacs invariably are miserable, feel distressed, became impatient of not sleeping, feel frustrated, and have little confidence in their innate ability to fall asleep even when they feel very sleepy. There are some people who can play cards all night without much sleep or attend wild parties well into the morning and yet feel no distress at all. However, these same people, when they are in bed and if they want to sleep and yet fail, will be so distressed and worried that they keep turning in bed and try all sorts of ways to make themselves sleep. Of course, the more they try to sleep, the more they cannot, which is the law of reverse effect. Hence they lose confidence in their innate ability to sleep and take sleeping pills.
(2) The expectation of more and better sleep. People are trained to sleep a certain number of hours a day when they are very young, and this magic number of hours stays in their subconscious, which has led them to think that a good sleep means sleeping eight hours or more. If they ever fall short of this, they become dissatisfied and distressed. They call themselves insomniacs.
(3) The facts of NREM sleep. During NREM sleep there are no thoughts and no memory. The only way to convince ourselves that we have in fact been sleeping is either to remember our dreams or to look at the clock before and after sleep. NREM sleep is like general anaesthesia—there is a blank in our continual awareness. These pseudo-insomniacs do not remember their dreams. They are not aware that they have slept as no one can 'feel' NREM sleep. It is difficult to convince them that they have had a normal sleep, as they expect to feel something when asleep.
(4) Frequent awakenings in the night. In the sleep laboratory it has been shown that we normally wake up many times in the night Most of the awakenings last only a few seconds and we fall back to sleep, not remembering them in the morning. If these awakenings last longer we feel distressed and, if they are all added up in the morning and remembered, we tell ourselves that we have had a bad night of broken sleep. The distress of lying awake in bed even for a few minutes will be remembered and exaggerated in the morning, even if there was actually many hours of sleep. This is the power of exaggeration when we are stressed.
(5) Natural insomnia sets in with age. As we grow older we need less sleep. Ian Oswald in Edinburgh reported an interview of 2500 people of different ages. Over 20 per cent of the elderly who were interviewed said they slept less than five hours each night As we grow older we need less and less sleep. However, even if we need less sleep, we are not contented, as the distress of lying in bed and not sleeping is unbearable to a lot of us. In contrast, there are a lot of older people who are completely satisfied with only three to four hours sleep at night They do not complain of insomnia and they do not take sleeping pills.
Hence a large proportion of people who think they have insomnia are in fact experiencing pseudo-insomnia. In fact these people are healthy, and if they are tested in the sleep laboratory they are found to have a normal sleep profile. They are imposters.