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Insomnia and the Good Fortune of Knowing Its Causes

February 15, 2014

Saint Augustine was fond of quoting a line from Virgil’s poem Georgics, “Fortunate (felix) is the one who has learned the causes of things” (The City of God, Book 7, chapter 9, PL 41.204). He once expanded on that verse elsewhere as follows: “we ought to know the causes of good and evil as far as a person in this life may know them in order to avoid the mistakes and troubles that so fill this life. Our aim must always be to reach that fortunate state in which no trouble shall distress us and no error shall mislead us. If we must know the causes of physical convulsions, there are none that concerns us more than knowing the causes that affect our own health” (The Enchyridion, Chapter 16, PL 40.239). Having discussed the “physical convulsions” and debilitating consequences of insomnia, it is time to review the various causes of this misfortune in order to chart a path towards that fortunate state of a good night’s sleep. Contemporary researchers generally categorize the causes of insomnia in terms of physiological, cognitive, and emotional factors.

In terms of physiological causes, the body needs to be ready for sleep, meaning to be in a state physiologically conducive to sleep. Saint Gregory of Nyssa once wrote, “sleep relaxes the strain of waking, and, again, awakening tenses up what had become slack: and neither of these abides continually, but both give way, each at the other’s coming” (On the Making of Man, 13, PG 44.165). In modern terms, Saint Gregory was referring to cycle of the autonomic nervous system. Alfonso Marino notes in his dissertation, “Autonomic activity must be reduced in order to initiate sleep.  A rapid heart rate or muscle tension are examples of factors that can manifest physiological arousal in an individual.  When these factors are present, onset of sleep is difficult (Freedman & Sattler, 1982). The aim is to lower the physiological arousal.  This can be done by using relaxation techniques (Morin, 1993).” Physiological arousal can also be influenced by alcohol or caffeine intake as well as by eating just prior to going to bed, all of which can make it harder to fall asleep.

In terms of cognitive causes, having a peaceful or an agitated mind at bedtime can make all the difference in the world. In the ancient Clementine homilies, the author recounts, “O friends, I confess that through much anxiety about the discussion that was to take place with Appion I was not able to get any sleep” (Homily 4).  And this is precisely what modern researchers have found: anxiety-producing thoughts are known to affect one’s ability to fall asleep and maintain a restful sleep pattern. Alfonso Marino notes that “cognitive activity may be manifested in terms of worry, racing mind, rumination, intrusive thoughts, planning, analyzing or difficulty in controlling exciting thoughts” (Morin et al., 1999). And that cognitive activity prevents a person from falling asleep as Lynn Petras Gould makes clear in her dissertation entitled, “A Comparison of Three Cognitive Behavioral Treatments for Insomnia:  Paradoxical Intention, Coping Imagery, and Sleep Information.” Thus, she observes that “highly-demanding cognitive activities (such as studying and planning) and emotional stress have been associated with longer sleep onset latencies.”

Emotional factors play a similar role in disturbing sleep patterns and frustrating the onset of sleep. According to A. Harvey in her article, “Beliefs About the Utility of Presleep Worry,” “patients with insomnia are more emotionally reactive to and take longer to recover from stressors during the day. Further, there is evidence that people with insomnia inhibit or internalize their emotions throughout the day compared to good sleepers.” In other words, having a hot temper or being oversensitive to slights and easily hurt all bode ill for a good night’s sleep.

Obviously, these three sets of causes are intertwined in complex ways and not always completely separable. People often need help in all three areas. Marino writes, “The psychological profile of individuals with insomnia, indicates that these are individuals with higher levels of anxiety, dysphoria, worry, or somatized tension”  (Freedman & Sattler, 1982). A tense body, emotional distress, and cognitive worries, all seem to combine forces to prevent someone from falling asleep.

To return to Augustine’s quote from Virgil, we are indeed fortunate to know the causes of things and insomnia in particular, for that knowledge may contain the key to a solution. If the problem is with the thoughts, the emotions, and bodily responses, then part of the solution will involve their change. Saint Gregory of Nyssa once wrote, “if wise thought assumes sway over such movements of the soul, each of them can be transformed into a form of virtue, so that anger becomes courage, terror caution, fear obedience, hatred aversion to vice, the power of love the desire for what is truly beautiful; high spirit in our character raises our thought above the passions, and keeps it from bondage to what is base; indeed, the great Apostle, even, praises such a form of mental elevation when he bids us constantly to “think those things that are above,” and so we find that every such movement, when elevated by loftiness of mind, is conformed to the beauty of the Divine image”  (On the Making of Man, chapter 18, PG 44.193).

Virtue can brings harmony to one’s thoughts, emotions, and actions, so that they reflect the beauty of God. In that reflection, there is peace, there is calm, there is rest. Perhaps, virtue can transform a portion of one’s experience of insomnia into an experience of vigil, waiting on God, waiting for God, and waiting in God. And as we wait and trust, thanking God for His mercies and for giving us strength, time, even sleepless time, passes with a sense of purpose. In the arms of our loving God, we can relax in His warmth, we can feel secure in His care, and we can let go of our worries knowing that He cares for us and provides us, whether we sleep or remain awake. Then as His children, we can make the words of the psalmist our own: “I will both lay me down in peace, and sleep: for Thou, Lord, only makest me dwell in safety” (Psalm 4:8).

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