“I need to sleep. I have to be functional tomorrow.”
You look at the clock. It is 2:15 a.m. You try to relax, but you start thinking about how little time is left before your alarm goes off.
The harder you try to fall asleep, the further away sleep seems to become.
Insomnia is often described simply as difficulty sleeping. From a psychological perspective, however, the problem can become much more complex: worry about sleep can itself contribute to maintaining sleep difficulties.
Insomnia is not simply a matter of “not being tired enough.” It is a complex phenomenon involving biological, cognitive, emotional and behavioural processes.
When sleep becomes a task
Sleep is a particular process: we cannot simply decide to fall asleep in the same way that we decide to start an activity.
Yet when sleep difficulties begin, we may unintentionally turn sleep into a goal that needs to be achieved.
“I need to fall asleep.”
“I need to get at least seven hours.”
“If I don’t sleep now, I won’t be able to function tomorrow.”
These thoughts can increase mental activation precisely when the body needs to reduce it.
The result can be a paradox: the more we try to control sleep, the more we may increase the activation that interferes with it.
Hyperarousal: when the mind does not “switch off”
One of the central concepts in contemporary insomnia research is hyperarousal, a state of increased activation that can involve cognitive, emotional, physiological and neurobiological processes.
Psychologically, it may involve persistent thoughts, worry, negative anticipation, tension and difficulty interrupting the flow of mental activity.
Recent research continues to identify associations between insomnia and forms of cognitive hyperarousal, while neurophysiological research suggests that increased activation may not only be present at night but may extend across the 24 hour period.
This can help explain why someone may feel physically exhausted while simultaneously feeling mentally “switched on.”
“If I don’t sleep, tomorrow will be a disaster”
One factor that may maintain insomnia is the meaning we give to a poor night’s sleep.
A person may begin anticipating extremely negative consequences:
- “I won’t be able to concentrate tomorrow.”
- “I will definitely make mistakes.”
- “I won’t be able to work properly.”
- “I will be completely exhausted.”
These concerns are not necessarily irrational. Poor sleep can indeed affect attention, energy, mood and everyday functioning.
The difficulty can arise when anticipating these consequences becomes a source of anticipatory anxiety, further increasing activation before sleep.
A cycle can develop:
insomnia → worry → increased activation → greater difficulty falling asleep → further worry.
Can constantly checking the clock make things worse?
For someone struggling to sleep, checking the time may seem like a useful strategy.
“How long until my alarm?”
“I have only slept for four hours.”
“It will be five o’clock soon.”
However, continuous monitoring can turn time spent in bed into a series of checks on whether we are failing to sleep.
Attention shifts away from the natural process of falling asleep and towards the question: “Am I getting enough sleep?”
This increased attention can further heighten awareness of every moment of wakefulness.
When being tired does not necessarily mean being sleepy
A person may feel exhausted during the day and yet experience strong mental activation once they get into bed.
Physical tiredness and sleepiness are not exactly the same thing.
We may feel tired because we have had a demanding day, because we are emotionally overwhelmed or because we have slept poorly. This does not necessarily mean that our system is ready to fall asleep immediately.
When someone interprets this discrepancy as a problem, they may become increasingly concerned:
“I am exhausted, so why can’t I sleep?”
This question itself can become part of the hyperarousal cycle.
Emotional regulation and sleep
The relationship between sleep and emotions is bidirectional.
Stress and intense emotions can make sleep more difficult, while persistent sleep difficulties can make emotional regulation more challenging during the day.
A 2025 meta analysis integrating 57 studies found a significant association between insomnia symptoms and difficulties with emotion regulation.
This does not mean that every person with insomnia has difficulties regulating emotions. Rather, it suggests that sleep and emotional wellbeing can influence one another.
For some people, therefore, working on how they manage stress, worry and emotional activation may be an important part of their overall psychological wellbeing.
“I barely slept”: how accurate is our perception?
Another phenomenon studied in insomnia research is sleep state misperception, referring to a discrepancy between subjective perceptions of sleep and objective measurements.
Some people may perceive that they have been awake for much of the night even when objective measurements indicate longer periods of sleep.
This does not mean that their experience is “imaginary.” The perception of not having slept is real and can influence how a person interprets their night.
Recent research suggests that cognitive and neurophysiological hyperarousal may contribute to this discrepancy, although the mechanisms are not yet fully understood.
When the bed becomes associated with frustration
Imagine someone who, for months, spends a significant amount of time awake in bed, thinking about work, checking the clock or worrying about the following day.
Over time, the bed may stop being associated primarily with rest and instead become a context of waiting, monitoring and frustration.
This is one reason why psychological approaches specifically developed for insomnia do not focus only on relaxation. They also address the behavioural and cognitive associations that may maintain sleep difficulties.
What can help from a psychological perspective?
Psychological interventions specifically designed for insomnia, particularly Cognitive Behavioural Therapy for Insomnia (CBT I), are considered a first line approach by major international guidelines.
CBT I is not simply a matter of receiving advice about how to sleep better. It is a structured intervention addressing several factors that can maintain insomnia, including thoughts and beliefs about sleep, behaviours, associations with the bed and sleep patterns.
A 2025 meta analysis also found that cognitive behavioural interventions for insomnia remain effective when implemented in routine clinical care, while highlighting some methodological limitations in the available research.
From a psychological perspective, it can also be useful to develop greater awareness of the relationship between thoughts, emotions, behaviours and activation.
The goal is not to “force yourself to sleep,” but to gradually reduce the processes that may be maintaining a state of alertness.
When is it important to seek help?
An occasional poor night’s sleep is common and does not necessarily mean that someone has a sleep disorder.
It is important to explore the situation further when sleep difficulties become persistent, interfere with daytime functioning or begin to significantly affect everyday life.
It is also important to consider possible medical, medication related or other sleep related causes. A healthcare professional can help determine what type of assessment may be appropriate.
Psychological support can help you understand the role of stress, worry, recurring thoughts and emotional regulation in sleep difficulties, and develop more effective strategies for managing activation and overall wellbeing.
Sleep is not something we can simply order our brain to produce.
Sometimes, the first step is not to try to control sleep more, but to understand what is keeping the mind active when the body needs to rest.
If sleep difficulties are accompanied by anxiety, stress or recurring thoughts that interfere with your wellbeing, you can contact me for a psychological consultation.
References
- Riemann, D., Espie, C. A., Altena, E., et al. (2023). The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023. Journal of Sleep Research, 32(6), e14035.
- Zhu, K., & Xue, S. (2025). Identifying the association of hyperarousal and insomnia symptoms: A network perspective. Journal of Psychiatric Research.
- Dai, Y., Ma, J., Vgontzas, A. N., et al. (2024). Insomnia disorder is associated with 24-hour cortical hyperarousal. Sleep Medicine, 124, 681–687.
- Scott, A. J., Correa, A. B., Bisby, M. A., et al. (2025). Cognitive Behavioral Therapy for Insomnia in People With Chronic Disease: A Systematic Review and Meta-Analysis. JAMA Internal Medicine, 185(11), 1350–1361.
- Öst, L. G., Brattmyr, M., Enebrink, P., et al. (2025). Cognitive behavioral therapy for adult insomnia disorder in routine clinical care: A systematic review and meta-analysis. Cognitive Behaviour Therapy.
- Baglioni, C., Altena, E., Bassetti, C., et al. (2025). Insomnia and emotion dysregulation: A meta-analytical perspective integrating regulatory strategies and dispositional difficulties. Sleep Medicine Reviews.
- Van Someren, E. J. W., et al. (2025). Neurobiological mechanisms of sleep state misperception in insomnia disorder: A theoretical review. Sleep Medicine Reviews.