What Has Goes Wrong With Insomnia?

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This model is one way that we commonly think about the question, why on earth does someone ultimately develop insomnia to begin with? And then what aret things that they're doing that keeps them locked in this terrible prison of insomnia each and every night. But it's no difference here in terms of insomnia. What i mean is that this three part model does not tell you anything about the underlying physiological changes that ultimately cause insomnia. So to put that another way, what has biologically gone wrong in insomnia? Now that is a critical question, and we have to answer it,. If we don't understand that question, then we can't develop medical treatments for insomnia without knowing the underlying biological mechanism. Well

Today’s episode takes two questions as its subject: first, why does someone develop insomnia, and second, what adds gasoline to the sleep-disorder fire of insomnia and only makes it rage more powerfully? These are two very complex questions, but through lots of great science and wonderful scientists, we now have a conceptual model explaining how you may find yourself falling into the pit of insomnia. This is called the “3-Ps” model, and it consists of a three-step knock-on cascade of factors that lead to insomnia: predisposing, precipitating, and perpetuating factors.

Predisposing factors are those that make a person more vulnerable to insomnia, a good example being certain types of genes that play a non-trivial role in your risk of developing insomnia. It’s been discovered that insomnia shows a genetic heritability of between 28%-45%, so if one or both of your parents had insomnia, there is a predisposing risk of developing it. This is not, however, an absolute guarantee that you will develop the condition; these genes simply make you statistically more predisposed. Instead, something else has to come along to flick the first domino that causes the chain reaction development of insomnia.

This inciting flick is what the second P—precipitating factors—refers to. The word “precipitate” comes from the Latin root praecipitat, meaning “thrown headlong into something,” which is a good description of what a precipitating factor is—it’s a trigger that pushes you headlong into this thing called an insomnia disorder. Examples of these factors include bereavement, bad breakups, and stress at work, all of which can push someone over the threshold of developing insomnia.

The third P—perpetuating factors—can also be understood through its Latin root, perpetuus, meaning “to continue or make permanent.” Perpetuating factors are those which continue the condition and make it even more permanent. They include examples of poor sleep hygiene like drinking too much caffeine during the day or using alcohol or THC (which is involved in cannabis) as a sedative in the evening. Of course, it’s completely understandable that someone suffering from insomnia would reach for the crutch of alcohol or THC, but they are now understood to be perpetuating factors that only make matters worse.

Please note that Matt is not a medical doctor, and none of the content in this podcast should be considered medical advice in any way, shape, or form, nor prescriptive in any way.

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