Being concerned when you can’t sleep – it can contribute to insomnia in the long term. (Photo: Colourbox)

Worrying about sleep will keep you awake

If you are afraid of not being able to sleep, insomnia may become more severe.

You look at the clock, counting out the number of hours of sleep you can get if you fall asleep NOW. But it does not happen.

The next time you peek over at the watch, the number has fallen again. You’re worried about what the lack of sleep can do to you.

“Worrying over lack of sleep can lead to prolonged insomnia,” says psychologist Annika Norell-Clarke at Örebro University in Sweden.

She has studied the sleep habits of about 1,800 Swedes over a period of eighteen months. A little under half of the 5,000 randomly selected people responded to the survey; a further 500 dropped out along the way.

“It is important to take the concerns for lack of sleep seriously at an early stage,” says researcher Annika Norell-Clarke. (Photo: Malin Brand)

Among those who slept poorly at the beginning of the study, worrying about lack of sleep was linked to long-term problems with insomnia. In other words, the worrying is not just a symptom: it can be a contributing factor.

Vicious circle

The concerns can come at night when lying in bed wide awake and in the daytime when you are tired and not feeling well. It becomes a vicious circle.

“Worrying constituted a larger risk of prolonged insomnia than habits like taking a nap at noon,” says Norell-Clarke.

Those who thought differently often resolved their problems.

“They gave their problems less attention. They spent less time looking at the clock at night, were less concerned about being tired the next day,” says the researcher.

“This is not surprising,” says Bjørn Bjorvatn, Professor of Family Medicine at the University of Bergen and the leader of the National Expertise Service for Sleep Disorders.

“The fear of not getting enough sleep has a negative effect. Other studies show the same thing, but it’s great that the development over time has been documented,” says Bjorvatn.

Don’t worry

There is much research to suggest that sleep deprivation may be harmful.

This does not apply to those who have an occasional sleepless night. Treatment is only necessary when the problem lasts for months.

“Everybody sleeps badly sometimes, especially when there is a lot of stress. That is not dangerous. However, if these problems last, one must seek help,” says Norell-Clarke.

She has defined insomnia as problems falling asleep more than three nights a week for at least three months.

Patients often have to wait more than half an hour to fall asleep. They wake up during the night or very early in the morning without falling back to sleep.

There are many causes of insomnia, such as genetic disposition, anxiety, depression, side effects of medications, heart problems, and pain or metabolic disorders. Drinking coffee, watching television and other habits can contribute. Affected groups are women, the elderly and people with little education.

Patterns of thinking are important, Bjorvatn suggests.

“It is important to avoid worrying, although I can understand that this can be difficult,” he says.

More depression

Bjorvatn believes that people who tend to worry about things are more concerned when it comes to sleep.

Similar patterns of thinking lead to insomnia and depression.

“Both groups think negatively about the future, that there is no hope of recovery,” says Norell-Clarke.

Depressed patients are often sleepless. People with sleep problems have a higher risk of developing depression.

Early intervention

Thought patterns can be changed: Psychological therapy has been proven to be useful.

In a small study of 64 people suffering from both insomnia and depression, Norell-Clarke found that changing thoughts about sleep through cognitive behavioural therapy relieved both problems.

Norell-Clarke believes that concerns about lack of sleep must be taken seriously at an early stage in order to prevent problems from becoming entrenched.

“We ask patients if they feel worried,” says Bjorvatn.

“But our patients already have a definite sleep problem. It will be hard to capture all those people who are worried about sleep deprivation. But it is important to be aware of this when they first come to therapy.”


Clarke, A. N.: Cogito ergo insomnis; I think, therefore I am sleepless. Doctoral thesis at Örebro University.

Translated by: Lars Nygaard

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