Dear Dr Gray,
I have a sleep problem. I can usually get to sleep without too much trouble but I then wake up a couple of hours later and find it almost impossible to get back to sleep.  Some nights I get as little as 2 hours sleep. I had some counselling sessions a few months ago and was taught some practical strategies, like not reading in bed, getting up instead of lying in bed when I can’t sleep but they didn’t make much difference. I have always been a bit of a worrier and my sleep problem is definitely worse if I am stressed. I am exhausted, please help.
Jessica (Richmond, London)

Dr Gray Replies……..

Dear Jessica,
Sleep problems are nearly always a symptom of another problem, usually an emotional/psychological one. You mention that you are a worrier so I will use this as an example. When we are anxious, one or all of our basic functions (i.e. appetite, sleep and sex drive) are disrupted; anxiety is our body’s response to perceived danger, when we are in danger our chances of survival greatly improve if we don’t take time out for a nap. The advice that you received in your previous counselling sessions is a necessary part of any therapy programme for a sleep problem (as you are probably aware the strategies you were taught are called ‘sleep hygiene’) but on their own they are not sufficient to resolve a sleep problem. Without identifying the problem that underlies your sleep problem i.e. what has lead to the perception that you are in danger and the subsequent increase in anxiety levels that are disrupting your sleep, all the practical techniques in the world won’t help you to sleep because your mind believes you are at risk (and the ‘risk’ is most likely to be an emotional/psychological unless you are living in a war zone) and so keeps your body on high alert.
I suggest that you seek the help of a psychologist trained in Cognitive Behavioural Therapy (CBT) who will be able to identify the issue that underlies your sleep problem and help you to resolve this as well as supporting you to implement the sleep hygiene techniques.


If you are suffering with any of the issues discussed in this article and would like to seek professional help then you may find our page about Sleep problems useful.

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