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Frightened man awake in bed after a nightmare, representing trauma-related nightmares, PTSD sleep problems, and EMDR treatment

Can EMDR Help Reduce Nightmares?

EMDR, EMDR Therapy, Insomnia, PTSD, Sleep Psychology, Treatment for Sleep Disorders / admin

Can EMDR help reduce nightmares? Yes, EMDR may help reduce nightmares when the nightmares are connected to trauma, PTSD, anxiety, or disturbing memories that the nervous system has not fully processed. EMDR does not work by trying to force the dream to stop. It works by helping the brain process the emotional material that may be driving the nightmares in the first place.

EMDR stands for Eye Movement Desensitization and Reprocessing. It is a trauma-focused therapy that helps the brain reprocess distressing memories so they are less emotionally charged. When nightmares are connected to trauma, the dream may be one way the nervous system keeps replaying unresolved threat. In that situation, reducing the charge of the trauma memory can sometimes reduce the frequency, intensity, or emotional impact of nightmares.

Nightmares are not “just dreams” when they repeatedly disrupt sleep, create dread before bedtime, or leave a person feeling unsafe in their own body. They can become part of a larger insomnia pattern. A person may start avoiding sleep, staying up too late, relying on medication or alcohol, or waking in panic and then being unable to return to sleep.

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Healthy bedtime foods including oatmeal, cherries, kiwi, nuts, and yogurt that may support better sleep

Foods That Help You Sleep: What to Eat Before Bed

Insomnia, nutrition and sleep, Sleep Psychology, Treatment for Sleep Disorders / admin

Foods That Help You Sleep: What to Eat Before Bed for Better Sleep By Dr. Charles R. Freeman, Ph.D. If you are struggling with insomnia, you may wonder whether certain foods can help you sleep better. The short answer is yes. Some foods appear to support healthy sleep, while others can interfere with it. However, nutrition is rarely the entire answer. While the right foods may help you fall asleep more easily and improve sleep quality, chronic insomnia is often driven by deeper factors such as anxiety, trauma, PTSD, chronic stress, grief, depression, pain, or learned sleep habits. As a psychologist specializing in insomnia and sleep disorders, I often see people searching for the perfect supplement, medication, or bedtime snack that will finally solve their sleep problems. Nutrition matters, but it is only one piece of a much larger puzzle. The most sustainable improvements in sleep usually come from combining healthy lifestyle habits with evidence-based treatment that addresses the underlying causes of insomnia. That being said, what you eat throughout the day—and especially in the evening—can absolutely influence how well you sleep at night. Why Nutrition Matters for Sleep When discussing health and emotional well-being, I often refer to four major foundations: exercise, nutrition, sound sleep, and meaning or purpose. These foundations work together much like the legs of a table. When one becomes unstable, the others are often affected as well. Many people focus exclusively on sleep when they are tired. Others focus on anxiety, stress, or mood. However, nutrition frequently gets overlooked. Poor dietary choices can contribute to fluctuations in energy, mood, inflammation, and blood sugar regulation, all of which can affect sleep quality. Nutrition also influences the body’s ability to regulate hormones and neurotransmitters involved in sleep. While no food can guarantee a perfect night’s sleep, a consistent pattern of healthy eating can create conditions that support healthy sleep over time. Can Certain Foods Really Help You Sleep? Modern research suggests that some foods may modestly improve sleep quality by supporting healthy melatonin production, promoting stable blood sugar levels, reducing inflammation, or helping the body relax before bedtime. One important point is that there is no magical sleep food. Unfortunately, many online articles oversimplify the science and suggest that eating one specific food will cure insomnia. If that were true, chronic insomnia would be easy to solve. Instead, think of nutrition as a way of creating a sleep-friendly environment within your body. The goal is to reduce factors that interfere with sleep while supporting the body’s natural sleep processes. What Foods Help You Sleep? Tart cherries are among the most researched foods associated with sleep. They contain naturally occurring melatonin and antioxidants that may support healthy sleep patterns. Some studies suggest that tart cherry juice may improve both sleep duration and sleep quality in certain individuals. Kiwi fruit has also attracted attention from researchers. Some studies have found that people who eat kiwi regularly before bedtime may fall asleep faster and experience better overall sleep quality. Kiwi contains antioxidants and other compounds that may support sleep regulation. Oatmeal is another useful option because it provides complex carbohydrates and fiber. Unlike sugary snacks that can create dramatic blood sugar fluctuations, oatmeal tends to provide a more gradual release of energy. Stable blood sugar levels are often beneficial for both sleep quality and emotional well-being. Nuts such as almonds and walnuts may also support sleep. They contain magnesium, healthy fats, and other nutrients associated with relaxation and overall health. While they are not sleep medications, they can be part of a healthy evening snack. Greek yogurt and other protein-rich dairy products may be beneficial as well. They provide protein, calcium, and sustained nutrition without causing rapid spikes and crashes in blood sugar. Many people find that a small serving of yogurt satisfies evening hunger without feeling overly heavy before bed. Whole grains, legumes, and other minimally processed foods can also support sleep by helping maintain more stable energy levels throughout the evening. In contrast, highly processed foods often contribute to blood sugar instability and may leave people feeling restless or uncomfortable during the night. What Foods Can Make Sleep Worse? Just as some foods may support sleep, others can interfere with it. Caffeine remains one of the most common sleep disruptors. Many people assume that if they can fall asleep after drinking coffee, caffeine is not affecting them. However, caffeine can reduce sleep quality even when a person appears to fall asleep without difficulty. Depending on the individual, caffeine consumed in the afternoon or evening may continue affecting sleep many hours later. Alcohol is another common culprit. Many people use alcohol because it initially makes them feel sleepy. Unfortunately, alcohol often disrupts sleep architecture later in the night. People may fall asleep quickly but experience fragmented sleep, increased awakenings, vivid dreams, and poor sleep quality. Large meals close to bedtime can also interfere with sleep. Heavy meals may increase digestive discomfort, reflux symptoms, or feelings of fullness that make it difficult to relax and fall asleep. Sugary foods and desserts deserve special attention. While they may provide temporary comfort, they can contribute to significant blood sugar fluctuations. These swings can increase physiological arousal and sometimes contribute to nighttime awakenings. Individuals with anxiety, depression, or insomnia may be particularly sensitive to these effects. Why Blood Sugar Stability Matters One of the most overlooked aspects of sleep nutrition is blood sugar regulation. Many people go through a daily cycle of consuming highly processed foods, sugary snacks, energy drinks, and caffeine. These foods can create periods of temporary energy followed by crashes in mood, concentration, and physical energy. When blood sugar fluctuates dramatically, the body often responds by releasing stress hormones. Those same stress hormones can make it harder to relax and initiate sleep. This is one reason why stable, balanced meals often support better sleep than restrictive dieting followed by evening overeating. For individuals struggling with insomnia, anxiety, or irritability, reducing blood sugar volatility may be one small but meaningful step toward

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Adult participating in an online sleep coaching session to improve sleep habits and overall well-being

What Is Sleep Coaching and Can It Help You Sleep Better?

Cognitive Behavioral Therapy (CBT), Insomnia, Sleep coach, Sleep Psychology, Treatment for Sleep Disorders / admin

What Is Sleep Coaching and Can It Help You Sleep Better? By Dr. Charles R. Freeman, Ph.D. You might be wondering, what is sleep coaching and can it help you sleep better? You may have come across the term “sleep coach,” but what exactly is sleep coaching, and can it actually help you sleep better? For many people, sleep problems are not caused by a single issue. Difficulty falling asleep, frequent awakenings, daytime fatigue, and restless nights are often influenced by stress, habits, lifestyle choices, health conditions, or anxiety. This approach helps people identify and address these factors while developing practical skills that support healthier sleep. What Is Sleep Coaching? Sleep coaching is a personalized process designed to help people improve sleep through education, behavioral strategies, accountability, and support. Unlike quick fixes that focus only on symptoms, sleep coaching looks at the bigger picture. A sleep coach helps individuals examine sleep habits, daily routines, stress levels, exercise patterns, nutrition, sleep environment, and thoughts and beliefs about sleep. The goal is to create sustainable changes that improve sleep over time. Who Benefits Most From Professional Sleep Guidance? Sleep coaching may help people who have difficulty falling asleep, wake up frequently during the night, feel tired despite spending enough time in bed, experience stress-related sleep problems, want to improve sleep without relying entirely on medication, or need accountability and guidance while making lifestyle changes. Sleep coaching can also be valuable for people who want to optimize their sleep, energy, and overall well-being. Why Sleep Problems Are Often More Complex Than They Seem One of the most important things I’ve learned throughout my career is that insomnia is often the symptom rather than the root cause. People frequently focus on what happens at bedtime, but sleep is influenced by what happens throughout the day. Stress, anxiety, trauma, health habits, excessive worry, and even nutrition can all affect sleep quality. This is why simply trying a new supplement or changing a bedtime routine does not always solve the problem. When the underlying causes are identified and addressed, sleep often improves naturally. What Does the Process Look Like? Every person’s sleep challenges are unique, so sleep coaching is tailored to individual needs and goals. The process typically begins with identifying factors that may contribute to poor sleep, followed by a review of current sleep habits, routines, and lifestyle patterns. Together, the client and coach establish realistic goals and develop a plan based on evidence-based sleep strategies. As new habits are introduced, progress is monitored and adjustments are made as needed. The goal is to create practical, sustainable changes that support healthy sleep and continue to benefit the client long after coaching has ended. CBT-I and Other Evidence-Based Sleep Strategies Many people are surprised to learn that Cognitive Behavioral Therapy for Insomnia (CBT-I) is considered the gold standard treatment for chronic insomnia. CBT-I helps people change the thoughts and behaviors that interfere with healthy sleep. Many sleep coaches incorporate CBT-I principles or related behavioral strategies when helping people improve sleep. Research consistently shows that skill-based approaches often provide longer-lasting benefits than relying solely on medication. What I Often See in Practice Many people come to me believing they have a sleep problem. As we work together, they often discover that sleep is connected to stress, anxiety, lifestyle habits, trauma, or other challenges that have been affecting them for years. One of the most rewarding aspects of this work is seeing people gain confidence in their ability to improve sleep naturally. When people learn the skills that support healthy sleep, they often experience improvements not only in sleep quality but also in mood, energy, focus, and overall well-being. Key Takeaways Sleep coaching helps people improve sleep through education, guidance, and behavioral strategies. Sleep problems are often influenced by factors beyond the bedroom. Insomnia is frequently the symptom rather than the root cause. This approach can help people build long-term skills for better sleep. CBT-I is considered the gold standard treatment for chronic insomnia. Better sleep often leads to improvements in mood, energy, and resilience. Frequently Asked Questions What is sleep coaching? Sleep coaching is a personalized process that helps people improve sleep through education, behavior change, accountability, and practical strategies. Can this approach help insomnia? Yes. Sleep coaching can help many people identify and address habits, stressors, and behaviors that contribute to insomnia. Is sleep coaching the same as therapy? No. Therapy focuses on diagnosing and treating mental health conditions, while sleep coaching focuses on guidance, education, and behavior change related to sleep and well-being. How long does this coaching take? The length of sleep coaching varies depending on the individual’s goals, sleep challenges, and progress. Conclusion Better sleep rarely comes from a single trick, supplement, or device. More often, it comes from understanding the factors that interfere with healthy sleep and developing practical strategies to address them. Sleep coaching provides guidance, accountability, and evidence-based tools that can help people create lasting improvements in sleep and overall quality of life. About the Author Dr. Charles R. Freeman, Ph.D., is a psychologist specializing in insomnia, sleep disorders, PTSD, anxiety, trauma, and Cognitive Behavioral Therapy for Insomnia (CBT-I). He has more than 25 years of experience helping individuals improve sleep, emotional well-being, and overall quality of life through evidence-based treatment approaches. If you would like to learn more about treatment options or schedule a consultation, please contact Dr. Freeman. The information in this article is provided for educational purposes only and is not intended to replace professional medical or psychological advice. Individual circumstances vary, and readers should consult a qualified healthcare professional regarding their specific concerns.

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Why Can’t I Sleep When It’s Hot?

Insomnia, Sleep Psychology, Treatment for Sleep Disorders / admin

Why Can’t I Sleep When It’s Hot? By Dr. Charles R. Freeman, Ph.D. You may have trouble sleeping when it’s hot because your body needs to cool down in order to fall asleep and stay asleep. You may be asking yourself, “Why can’t I sleep when it’s hot?” When your sleeping environment is too warm, your brain and body have to work harder to regulate temperature. As a result, you may have difficulty falling asleep, wake up more often during the night, experience lighter sleep, and wake up feeling less rested. For people who already struggle with insomnia, anxiety, PTSD, or chronic stress, hot weather can make existing sleep problems even worse. Introduction Many patients ask, “Why can’t I sleep when it’s hot?” The answer involves both biology and environment. Your body depends on a gradual drop in core temperature to initiate sleep. When the room remains too warm, that process becomes more difficult, making it harder to fall asleep and stay asleep. Every summer, I hear the same complaint from patients. “I was finally sleeping better, and then the heat wave arrived.” They describe lying in bed feeling exhausted but unable to get comfortable. They toss and turn. They throw off the covers and then pull them back on. They wake up repeatedly during the night and feel frustrated that sleep seems impossible. Many people assume this is simply an inconvenience. In reality, temperature plays a significant role in sleep quality. Sleep is not something the brain does in isolation. It is a whole-body process. Your nervous system, hormones, metabolism, and body temperature all work together to create healthy sleep. When one of those systems is disrupted, sleep often suffers. Why Can’t I Sleep When It’s Hot? Your Body Needs to Cool Down for Sleep One of the normal biological changes that occurs before sleep is a gradual drop in core body temperature. Think of it as the body’s natural signal that it is time to rest. When your bedroom is excessively warm, that cooling process becomes more difficult. Your body continues trying to release heat while also attempting to fall asleep. The result can feel like your body and brain are working against each other. You may notice that you feel sleepy but not sleepy enough to actually drift off. Or you may fall asleep initially but wake up several times throughout the night because your body never fully settles into deeper, more restorative sleep. This is one reason many people report feeling like they slept all night but still wake up tired after a hot evening. Why Can’t I Sleep When It’s Hot? Heat Creates Lighter Sleep When temperatures rise, sleep often becomes more fragmented. Instead of moving smoothly through the normal stages of sleep, people may experience more interruptions and lighter sleep. Many patients describe this as feeling like they were “half awake” all night. They remember every noise. They become aware of every position change. They wake up feeling as though they were sleeping on the surface rather than getting deep, restorative rest. Research has found that higher temperatures can reduce overall sleep quality, shorten sleep duration, and increase lighter stages of sleep. People also report more difficulty falling asleep and less satisfaction with their sleep when temperatures become excessively warm. These effects become more noticeable as temperatures continue to rise. Why Can’t I Sleep When It’s Hot If I Already Have Insomnia? For someone who sleeps well most of the year, a few hot nights may simply be annoying. For someone with chronic insomnia, the impact can be much larger. One of the central themes of my clinical work is that insomnia is often the symptom rather than the root cause. Sleep difficulties may be connected to anxiety, trauma, PTSD, grief, depression, chronic pain, medical conditions, or stress. When sleep is already fragile, heat can become one more factor that pushes the nervous system toward wakefulness rather than rest. The person who already worries about sleep may become increasingly frustrated. They start checking the clock. They worry about tomorrow. They become anxious about not sleeping. Soon the heat is no longer the only problem. The anxiety about sleep has become part of the problem as well. This is how temporary sleep disruption can sometimes evolve into chronic insomnia. Why Can’t I Sleep When It’s Hot If I Have PTSD or Anxiety? People with PTSD or trauma histories often have a nervous system that remains more alert than average. Many already struggle with hypervigilance, nightmares, nighttime anxiety, or difficulty feeling safe enough to fully relax. Heat can increase physical discomfort and make it harder for the body to settle into a calm state. If someone is already waking from nightmares or experiencing heightened nighttime alertness, the additional stress of a hot environment may amplify those sleep disruptions. This is one reason I encourage patients to look beyond sleep itself and examine the entire picture. The temperature in the room matters, but so do stress levels, emotional health, trauma history, and overall nervous system regulation. How to Sleep Better When It’s Hot When patients tell me they cannot sleep because of the heat, they are often expecting a simple environmental solution. Sometimes that is enough. A cooler bedroom, lighter bedding, improved airflow, or adjustments to evening routines can make a meaningful difference. However, I frequently find that the heat is exposing a sleep system that was already vulnerable. A person may have been coping with anxiety for years. Another may have unresolved trauma. Someone else may have become conditioned to associate bedtime with frustration and wakefulness. The heat becomes the final straw rather than the entire cause. That is why I often combine practical sleep strategies with treatments that address the underlying causes of insomnia. Cognitive Behavioral Therapy for Insomnia (CBT-I) remains the gold standard treatment for chronic insomnia. When trauma, PTSD, anxiety, or grief are involved, treatments such as CBT and EMDR can also play an important role. The goal is not simply surviving the next heat wave. The goal is creating a sleep system that remains resilient even when conditions are not perfect. If you are wondering how to sleep when it’s hot, several practical changes can help. Use lightweight

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Adult reviewing a sleep journal with a therapist while seeking help for insomnia and chronic sleep problems

When Should You Seek Help for Insomnia?

Insomnia and Sleep Problems, Sleep Psychology / admin

When Should You Seek Help for Insomnia? By Dr. Charles R. Freeman, Ph.D. You should seek help for insomnia when sleep problems last more than a few weeks, affect your daytime functioning, increase anxiety about bedtime, or lead you to rely more heavily on medication, alcohol, or other sleep aids. Occasional poor sleep is normal. Chronic insomnia is different because it can become a self-reinforcing pattern that affects your health, mood, work, relationships, and confidence in your ability to sleep. Many people wait too long before getting help. They tell themselves, “I just need to relax,” “I should be able to fix this myself,” or “Maybe tonight will be better.” Sometimes it is. But when insomnia keeps returning, the problem usually needs more than willpower or another sleep hygiene checklist. In my practice, insomnia is often the symptom, not the root cause. The visible problem may be lying awake, waking at 3 A.M., or feeling exhausted after enough hours in bed. Underneath may be anxiety, trauma, PTSD, grief, depression, chronic pain, conditioned arousal, medication concerns, or a nervous system that has forgotten how to stand down. How Long Should You Wait Before You Seek Help for Insomnia? You do not need to wait until insomnia has taken over your life. A few rough nights after stress, travel, illness, or a major life event may resolve on their own. But when poor sleep continues for several weeks, becomes predictable, or starts changing how you live during the day, it is time to take it seriously. One warning sign is when you begin organizing your life around sleep fear. You may cancel plans, avoid travel, dread bedtime, watch the clock, or spend the evening calculating how many hours you might get. At that point, the insomnia is no longer only about sleep. It has become a pattern of anticipation, monitoring, and fear. What Are Signs That Insomnia Needs Professional Treatment? Insomnia deserves professional attention when it begins affecting your daytime life. Sleep is one of the foundations of health. I often describe exercise, nutrition, sound sleep, and meaning or purpose as four legs of the table. When sleep becomes unstable, the whole table starts to wobble. Common signs that you may need help include: You regularly lie awake for long periods despite feeling exhausted. You wake during the night and cannot return to sleep. You dread bedtime or feel anxious as evening approaches. You rely more on sleep medication, alcohol, supplements, or over-the-counter sleep aids. You feel irritable, foggy, depressed, anxious, or less able to function during the day. These symptoms do not mean you are broken. They mean your sleep system may be stuck in a learned pattern that needs retraining. When Does Insomnia Become a Habit? Insomnia can become a habit when the brain learns to associate the bed with wakefulness instead of sleep. If you spend night after night lying in bed worried, frustrated, or afraid, the bed can become a cue for alertness. You may feel sleepy on the couch but wide awake the moment you get into bed. This is called conditioned arousal. The nervous system begins preparing for another bad night before anything has actually happened. The clock, darkness, silence, bedroom, or even the thought of bedtime may start triggering the body’s alarm system. That is one reason early treatment matters. The longer the pattern continues, the more automatic it can feel. The goal is not to force sleep harder. The goal is to retrain the association between bed, safety, and sleep. Should You Seek Help If You Wake Up at 3 A.M.? Yes, especially if it happens repeatedly and you cannot return to sleep easily. Waking during the night is common. The clinical problem often begins with what happens next. If you wake up and immediately check the clock, calculate tomorrow’s damage, or panic about being awake, the nervous system becomes more activated. Many patients say, “I can fall asleep, but I wake up in the middle of the night and my mind turns on.” This pattern can be connected to stress, trauma, alcohol, medication rebound, pain, depression, blood sugar changes, or conditioned arousal. Treatment should look at the whole picture, not just the hour on the clock. Should You Seek Help If Sleep Medication Is No Longer Working? If you are needing higher doses, combining substances, drinking alcohol to sleep, or feeling afraid that you cannot sleep without medication, it is time to get help. Medication changes should always be coordinated with the prescribing physician, especially with benzodiazepines, sedative hypnotics, or long-term use. Medication may provide short-term symptom relief, but it may not retrain the nervous system. Some people sleep but do not feel restored. Others develop tolerance, rebound insomnia, dependence, or fear that natural sleep is no longer possible. A major goal of treatment is to help patients build skills so sleep does not depend entirely on an external substance. How Can CBT-I Help When You Seek Help for Insomnia? CBT-I, or Cognitive Behavioral Therapy for Insomnia, is the gold-standard behavioral treatment for chronic insomnia. It helps change the thoughts, behaviors, schedules, and conditioned patterns that keep insomnia going. CBT-I is different from general sleep advice. Sleep hygiene may tell you to keep the room dark or avoid caffeine. CBT-I looks deeper. How much time are you spending awake in bed? What happens when you wake up? Do you fear wakefulness? Do you check the clock? Has the bed become associated with effort instead of rest? In my practice, treatment is directive, collaborative, practical, and solution-focused. We identify what is maintaining the insomnia, create a plan, assign homework, review what happened, and fine-tune the tools. You are driving the car with your therapeutic goals, and I am the passenger helping guide the route. What I Often See in Practice I often meet patients who are very capable during the day and deeply discouraged at night. They work, parent, lead, care for others, and keep functioning. But functioning is not the same as

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Why Can’t I Put My Phone Down at Night?

Cognitive Behavioral Therapy (CBT), Insomnia, PTSD, Sleep Psychology, Treatment for Sleep Disorders / admin

Why Can’t I Put My Phone Down at Night? By Dr. Charles R. Freeman, Ph.D. If you find yourself scrolling through your phone long after you intended to go to sleep, and keep asking yourself, “Why can’t I put my phone down at night?” the problem is often not a lack of discipline. More often, it is a sign that something important is happening psychologically. Many people use late-night phone time to decompress from stress, reclaim personal time, avoid difficult thoughts, soothe anxiety, or regain a sense of control after a demanding day. The phone becomes less about entertainment and more about meeting emotional needs that were not addressed earlier in the day. The challenge is that while those extra hours may feel rewarding in the moment, they often come at the expense of sleep, leaving people more stressed, exhausted, and emotionally vulnerable the next day. Introduction One of the most common things I hear from patients is: “I know I should go to bed, but I just can’t seem to stop scrolling.” They are not confused about what they should do. They understand they need sleep. They know they will feel worse in the morning. Yet night after night, they stay awake reading articles, checking social media, watching videos, answering emails, or moving from one app to another without really intending to. Many people assume this is simply a technology problem. In my experience, it is usually something deeper. The phone is often just the vehicle. The real question is why someone feels compelled to stay awake in the first place. Why Can’t I Put My Phone Down at Night Even When I’m Tired? For many adults, the day feels like it belongs to everyone except themselves. They wake up early, rush to work, take care of responsibilities, respond to emails, manage family obligations, solve problems, and spend most of the day reacting to other people’s needs. By the time evening arrives, they finally have a moment that feels like their own. That is when the phone comes out. The scrolling itself may not even be particularly enjoyable. What often feels rewarding is the freedom. No one is asking for anything. No deadlines are looming. No responsibilities need immediate attention. For the first time all day, there is a sense of choice. Some researchers have referred to this pattern as “revenge bedtime procrastination.” The phrase sounds dramatic, but the concept is simple. People delay sleep because staying awake feels like a way to reclaim personal time they could not find during the day. I find that many patients immediately recognize themselves in this description. The issue is rarely that they love scrolling. The issue is that they feel deprived. What I Often See in Practice What surprises many people is how often late-night phone use is connected to stress. Someone spends the day feeling pressured, overwhelmed, or emotionally drained. Then they finally sit down at night. As soon as life becomes quiet, their mind starts speeding up. Worries emerge. Anxiety becomes noticeable. Thoughts that were pushed aside throughout the day suddenly demand attention. The phone becomes a convenient escape. Instead of sitting with uncomfortable thoughts or emotions, people keep scrolling. Every new article, video, notification, or post provides another distraction. The phone is not causing the stress. It is helping them avoid feeling it. I also see this pattern in patients struggling with PTSD and trauma. When the nervous system remains on high alert, quiet moments can feel uncomfortable. Distraction becomes easier than stillness. For some people, the phone functions almost like a form of emotional anesthesia. It keeps the mind occupied long enough to avoid difficult feelings. Unfortunately, it also keeps the brain awake. How Late-Night Phone Use Affects Sleep One reason phone use becomes so problematic is that it creates a state of ongoing mental engagement. The brain never gets a chance to slow down. Sleep requires a transition. The nervous system has to move from alertness into rest. Scrolling works against that process. Every new piece of information encourages the brain to remain engaged. Social media triggers emotional reactions. News headlines activate concern. Videos create stimulation. Text messages invite interaction. Instead of preparing for sleep, the brain remains in consumption mode. Over time, this can contribute to insomnia. One of the ways chronic insomnia develops is when the brain becomes conditioned to stay alert at bedtime. Rather than becoming a cue for sleep, the evening becomes a cue for stimulation, distraction, and wakefulness. Eventually, some people discover they can no longer fall asleep easily even when they put the phone away. When the Problem Is Not the Phone This is the part many people miss. Removing the phone does not automatically solve the problem. If the phone has become a coping strategy for stress, anxiety, loneliness, burnout, trauma, or emotional exhaustion, taking it away simply exposes what was already there. That is why I often tell patients that insomnia is frequently the symptom rather than the root cause. The same principle applies here. The late-night scrolling may be a symptom. The underlying issue may be chronic stress. It may be anxiety. It may be a life that feels overly controlled, overly demanding, or emotionally draining. It may be unresolved trauma. It may be a nervous system that never fully relaxes. When we focus only on the phone, we sometimes miss the real problem. How to Break the Cycle The first step is not forcing yourself to be more disciplined. The first step is becoming curious. Ask yourself what the phone is doing for you. What need is it meeting? What feeling are you avoiding? What are you trying to get more of? For many people, the answer is surprisingly simple. They need downtime, enjoyment, emotional recovery, and a sense of control. Once those needs become visible, healthier solutions become possible. Sometimes that means creating intentional personal time earlier in the evening. Sometimes it means addressing chronic stress directly. Sometimes it means treating anxiety or trauma that is keeping the nervous system activated. For people with chronic insomnia, CBT-I for insomnia remains the gold standard treatment because it helps address the habits, thought patterns, and behaviors that keep sleep problems going. When anxiety, PTSD, or trauma are contributing factors, additional treatments such as CBT or EMDR may be appropriate. The goal is not simply spending

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A calm adult in a therapy office learning how CBT-I treats chronic insomnia and sleep anxiety

Why Insomnia Often Becomes a Habit

Cognitive Behavioral Therapy (CBT), Insomnia, Sleep Psychology, Treatment for Sleep Disorders / admin

Why Insomnia Often Becomes a Habit By Dr. Charles R. Freeman, Ph.D. Insomnia often becomes a habit because the brain and body can learn to associate bedtime, the bed, or nighttime waking with alertness instead of sleep. After enough nights of frustration, clock watching, worry, or fear, the nervous system begins preparing for another bad night before sleep even has a chance to happen. This does not mean the person is weak or doing something wrong on purpose. Most people with chronic insomnia are trying very hard to sleep. The problem is that trying harder often makes sleep worse. Sleep does not respond well to pressure. When bedtime becomes a performance test, the body tends to become more alert, not less. In my practice, insomnia is often the symptom, not the root cause. The visible problem may be lying awake, waking at 3 A.M., or feeling exhausted in the morning. Underneath may be anxiety, trauma, PTSD, grief, depression, chronic pain, medication reliance, alcohol use, or a nervous system that has not learned how to stand down. How Does Insomnia Become a Learned Pattern? The brain learns by repetition. If you repeatedly get into bed and fall asleep easily, the bed becomes associated with rest. If you repeatedly get into bed and spend hours awake, frustrated, worried, or afraid, the bed can become associated with alertness. This is why many people with insomnia feel sleepy on the couch but wide awake when they get into bed. That pattern can be confusing and discouraging. It does not mean the person is broken. It means the nervous system has learned an association. Learned associations can be unlearned, but usually not by forcing sleep. Over time, the person may begin expecting insomnia. They may start thinking about sleep earlier in the evening. They may worry about whether tonight will be another bad night. That expectation alone can activate the body’s threat system. What Is Conditioned Arousal? Conditioned arousal means the body has learned to become alert in situations where it should be relaxed. With insomnia, the bed, bedroom, darkness, silence, or clock can become cues for wakefulness. A person may turn off the light and immediately feel the mind speed up. They may check the clock and feel a surge of anxiety. They may wake during the night and instantly think, “Here we go again.” These reactions are not random. They are part of the insomnia habit loop. One of the central goals of treatment is to break that association. The bed needs to become a cue for sleep again, not a cue for worry, effort, calculation, and defeat. What Role Does Sleep Anxiety Play? Sleep anxiety is the fear of not sleeping. It often develops after repeated bad nights. The person starts monitoring sleep, predicting failure, and treating wakefulness as proof that something is wrong. This is one of the most common patterns I see in chronic insomnia. A person wakes up during the night and immediately begins calculating: “How many hours do I have left? How bad will tomorrow be? What if I cannot function?” Those thoughts are understandable, but they send a threat signal to the nervous system. For many patients, being awake is not the main problem. Panic about being awake is the problem. Recovery often begins when wakefulness stops feeling like an emergency. Why Is Sleep Hygiene Usually Not Enough? Sleep hygiene can help, but it is rarely enough for chronic insomnia by itself. Many patients already know the basics. They keep the room dark, avoid caffeine late in the day, limit screens, and try to keep a consistent routine. Those habits are useful, but they do not necessarily treat conditioned arousal, trauma activation, pain, depression, anxiety, or fear of wakefulness. If the nervous system has learned that bed means danger or failure, a darker room will not fully solve the problem. Good insomnia treatment looks at the whole pattern. What is the person doing before bed? How do they respond when they wake up? Are they checking the clock? Are they spending long periods awake in bed? Are they using alcohol, medication, or supplements out of desperation? These details matter because they can reinforce the habit. Can Medication Keep the Insomnia Habit Going? Medication may be appropriate in some situations, especially during acute grief, medical crisis, or severe short-term distress. Medication decisions should always be coordinated with the prescribing physician. The concern is long-term reliance when the underlying insomnia pattern remains untreated. Medication may sedate the body without retraining the nervous system. Some patients sleep but do not feel restored. Others develop tolerance, rebound insomnia, dependence, or fear that they cannot sleep naturally. The goal is not to shame medication. The goal is to help patients develop skills so sleep does not depend entirely on an external substance. Sustainable improvement usually comes from addressing the causes and the learned patterns that keep insomnia alive. How Does CBT-I Break the Insomnia Habit? CBT-I, or Cognitive Behavioral Therapy for Insomnia, is the gold-standard behavioral treatment for chronic insomnia. It helps change the thoughts, behaviors, schedules, and conditioned responses that keep the insomnia habit going. CBT-I may include stimulus control, sleep scheduling, reducing time awake in bed, changing catastrophic thoughts about sleep, decreasing clock watching, and improving the way the patient responds to nighttime wakefulness. This is practical work. It is not just talking about sleep. My approach is directive, collaborative, practical, and solution-focused. We identify what is maintaining the insomnia, create a plan, assign homework, review what happened, and fine-tune the tools. You are driving the car with your therapeutic goals, and I am the passenger helping guide the route. What I Often See in Practice I often meet people who are very capable during the day and discouraged at night. They work, parent, lead, solve problems, and care for others. Then they get into bed and feel helpless. Functioning is not the same as wellness. Many patients have turned sleep into a nightly contest. They try to win

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Person lying awake in bed at night, representing paradoxical insomnia and sleep state misperception

Paradoxical Insomnia (Sleep State Misperception): Symptoms, Causes, and Treatment

Cognitive Behavioral Therapy (CBT), Insomnia, PTSD, Sleep Psychology, Treatment for Sleep Disorders / admin

Paradoxical Insomnia (Sleep State Misperception): Symptoms, Causes, and Treatment By Dr. Charles R. Freeman, Ph. D. Many people wonder, what is paradoxical insomnia? Paradoxical insomnia, also known as sleep state misperception, sleep misperception, or subjective insomnia, is a sleep disorder in which people believe they are awake for much of the night even though they may actually be sleeping more than they realize. Many people with paradoxical insomnia feel convinced they are getting little or no sleep. They may report being awake for hours or even the entire night. However, sleep studies sometimes show that they are sleeping significantly more than they perceive. This disconnect between perceived sleep and actual sleep is what makes paradoxical insomnia unique. The experience is real. The frustration is real. The exhaustion is real. The problem is not that someone is imagining their symptoms. The problem is that the brain has become unusually focused on monitoring sleep and wakefulness. As a behavioral medicine psychologist specializing in insomnia, I frequently work with individuals who have spent years trying to figure out why they feel awake all night. Many are relieved to discover that their body has not lost the ability to sleep. Instead, the issue often involves anxiety, hypervigilance, trauma, and distorted sleep perception. Why Do I Feel Awake All Night Even When I Sleep? This is one of the most common questions I hear. People often tell me: “I know I was awake all night.” Yet after carefully reviewing sleep patterns, sleep logs, or sleep studies, we sometimes discover that sleep occurred much more frequently than they realized. Why does this happen? The answer lies in how the brain processes attention and awareness. People with chronic insomnia often become highly focused on sleep. They monitor it, evaluate it, worry about it, and try to control it. Unfortunately, the more attention we direct toward sleep, the more difficult it becomes to accurately perceive it. The brain remembers periods of wakefulness extremely well. It often does not remember periods of light sleep.As a result, someone may feel awake for six or seven hours while actually sleeping intermittently throughout the night. What Is the Difference Between Paradoxical Insomnia and Sleep State Misperception? There is essentially no difference between paradoxical insomnia and sleep state misperception. Sleep state misperception is the older clinical term, while paradoxical insomnia is the more commonly used modern term. Both describe the same phenomenon in which a person perceives significantly less sleep than objective measurements indicate. You may also encounter terms such as sleep misperception, subjective insomnia, and subjective sleep complaints. These terms describe similar experiences involving distorted sleep perception. What Causes Paradoxical Insomnia? Paradoxical insomnia rarely develops from a single cause. Most people have several contributing factors. Anxiety is one of the most common causes. The anxious brain is designed to scan for problems. At bedtime, sleep itself can become the problem. People begin worrying about how long it will take to fall asleep, how they will function tomorrow, and whether they will ever sleep normally again. The more they worry, the more alert they become. The more they worry, the more alert they become. Sleep Performance Anxiety Many individuals develop anxiety specifically about sleep. They begin treating sleep like a performance task. Every night becomes a test. The harder they try to sleep, the more frustrated they become when sleep does not happen immediately. Ironically, trying harder often makes sleep more difficult. Hypervigilance is a state of excessive alertness. Some people become aware of every sound, movement, thought, and awakening during the night. The brain remains in monitoring mode rather than allowing sleep to unfold naturally. The brain remains in monitoring mode rather than allowing sleep to unfold naturally. Trauma and PTSD Trauma is one of the most overlooked causes of chronic insomnia. Many trauma survivors develop nervous systems that remain on alert even when no danger exists. This pattern is common among veterans, first responders, survivors of abuse, individuals with childhood trauma, and people who have experienced significant loss. Sleep requires a degree of surrender. Trauma teaches the brain to remain vigilant. Those two processes often conflict. Chronic Stress Long-term stress can keep the nervous system activated long after the stressful event has passed. Financial concerns, caregiving responsibilities, relationship difficulties, work stress, and health problems can all contribute to sleep misperception. Learned Insomnia One of the most important concepts in sleep psychology is conditioning. After enough nights of struggling with sleep, the bed itself can become associated with frustration and wakefulness. Instead of becoming a cue for sleep, it becomes a cue for alertness. This pattern often continues long after the original trigger has resolved. What Are the Symptoms of Paradoxical Insomnia? Paradoxical insomnia symptoms commonly include: Feeling awake most of the night Believing you sleep far less than you actually do Lying awake for hours Constantly checking the clock Anxiety about sleep Racing thoughts at bedtime Difficulty trusting your body’s ability to sleep Obsessive monitoring of sleep Frustration around bedtime Many people also experience: Generalized anxiety PTSD Depression Perfectionism Chronic stress Is Paradoxical Insomnia Dangerous? Paradoxical insomnia is generally not dangerous in the same way that untreated sleep apnea can be dangerous. The condition can, however, have a significant impact on quality of life. Many people experience increased anxiety, irritability, difficulty concentrating, reduced confidence, depression, relationship strain, and reduced work performance. The longer the problem continues, the more people may begin fearing bedtime itself. Some become preoccupied with sleep and structure their entire lives around trying to sleep better. In many cases, the anxiety surrounding sleep becomes more impairing than the sleep problem itself. How Is Paradoxical Insomnia Diagnosed? Diagnosis typically involves a comprehensive evaluation. A sleep specialist may review sleep habits, sleep diaries, medical conditions, medications, mental health history, and sleep study results when appropriate. Sleep studies are not always necessary, but they can sometimes reveal that a person is obtaining considerably more sleep than they realize. For many patients, this information is surprisingly reassuring. It demonstrates that the sleep system is functioning better than they thought. What Is the Best Treatment for Sleep State Misperception? The most effective treatment for paradoxical insomnia is usually Cognitive Behavioral Therapy

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How CBT-I Treats Chronic Insomnia

CBT and CBT-I, Cognitive Behavioral Therapy (CBT), Insomnia, Sleep Psychology, Treatment for Sleep Disorders / admin

How CBT-I Treats Chronic Insomnia By Dr. Charles R. Freeman, Ph.D. How CBT-I treats chronic insomnia is practical: it changes the thoughts, behaviors, sleep schedules, and nervous-system patterns that keep insomnia going. It does not simply give you more sleep hygiene rules. CBT-I helps retrain the brain and body so the bed becomes associated with sleep again instead of effort, fear, frustration, and clock watching. CBT-I stands for Cognitive Behavioral Therapy for Insomnia. It is considered the gold-standard behavioral treatment for chronic insomnia because it addresses the learned patterns that keep people awake. For many patients, insomnia is not only a nighttime problem. It becomes a conditioned response. Many people come to treatment after trying the obvious solutions. They have changed the mattress, darkened the room, stopped caffeine, used supplements, downloaded sleep apps, or tried medication. Some of those steps may help temporarily. But if the nervous system has learned that bedtime means pressure, danger, or failure, sleep hygiene alone is usually not enough. What Is Chronic Insomnia? Chronic insomnia usually means ongoing difficulty falling asleep, staying asleep, waking too early, or sleeping enough hours but waking unrefreshed. It also affects daytime functioning. People may feel more irritable, anxious, foggy, discouraged, sensitive to pain, or less able to concentrate. One of the most important points I make with patients is that insomnia is often the symptom, not the root cause. The visible problem may be lying awake at night, waking at 3 A.M., or feeling exhausted in the morning. Underneath may be anxiety, trauma, PTSD, grief, depression, chronic pain, over-responsibility, medication dependence, alcohol use, or a nervous system that has not learned how to stand down. Sleep is one of the foundations of health. I often describe exercise, nutrition, sound sleep, and meaning or purpose as four legs of the table. When sleep is unstable, the whole table starts to wobble. Poor sleep then worsens anxiety, pain tolerance, irritability, mood, memory, and decision-making. Those problems can feed back into worse sleep the next night. How CBT-I Treats Chronic Insomnia Differently Than Sleep Hygiene Sleep hygiene focuses on general habits: keeping the room dark, avoiding late caffeine, limiting screens, and keeping a routine. Those habits can help, but many people with chronic insomnia already know them. They do not need another checklist. They need treatment for the fear, conditioning, and nervous-system activation around sleep. CBT-I looks at the whole insomnia loop. How much time are you spending awake in bed? What happens when you wake up? Do you check the clock? Do you calculate how bad tomorrow will be? Do you try to force sleep? Do you nap out of desperation and then struggle again the next night? These patterns matter because they teach the brain what bedtime means. When the bed becomes a place of effort, the nervous system becomes alert. A person may feel sleepy on the couch but wide awake in bed. That does not mean the person is broken. It means the brain has learned an association. CBT-I helps unlearn that pattern. What Is CBT-I Not? CBT-I is not positive thinking. It is not simply relaxation. It is not willpower. Many people with insomnia are already trying very hard. In fact, trying harder often makes sleep worse because sleep does not respond well to pressure. CBT-I is also not about blaming the patient. Chronic insomnia is usually maintained by patterns the person developed while trying to survive bad nights. Staying in bed longer, checking the clock, canceling activities, napping, overthinking, or relying on sleep aids may all make sense in the moment. The problem is that these strategies can unintentionally keep the insomnia cycle alive. How CBT-I Treats Chronic Insomnia by Reducing Sleep Anxiety Sleep anxiety is the fear of not sleeping. It often develops after repeated bad nights. A person starts monitoring sleep, predicting failure, and treating wakefulness as proof that something is wrong. Instead of going to bed with trust, they go to bed bracing for another battle. For many patients, being awake is not the enemy. Panic about being awake is the enemy. Waking up during the night becomes much more disruptive when the person adds clock checking, frustration, self-criticism, and fear about tomorrow. A major goal of CBT-I is to help wakefulness stop feeling like an emergency. That does not mean you enjoy being awake. It means you stop teaching your nervous system that a bad night is a catastrophe. When the body stops escalating after an awakening, sleep often becomes less fragile. How CBT-I Treats Chronic Insomnia With Stimulus Control Stimulus control is one of the core parts of CBT-I. The goal is to help the bed become a cue for sleep again. If someone spends months or years lying in bed awake, worried, frustrated, or afraid, the bed can become associated with alertness instead of rest. In treatment, we look at what happens in bed and what the brain has learned. If the bed has become the place where you worry, calculate, scroll, work, argue with yourself, or wait desperately for sleep, the nervous system may start preparing for that struggle every night. Stimulus control helps interrupt that association. The specific plan depends on the patient, but the clinical principle is straightforward: we want the bed connected with sleep and calm, not wakeful effort. This is not punishment. It is retraining. How CBT-I Treats Chronic Insomnia With Sleep Scheduling CBT-I often includes careful work with sleep scheduling. Many people with chronic insomnia spend too much time in bed trying to catch sleep. That sounds logical, but it can backfire. More time in bed can mean more time awake, more frustration, and stronger conditioning between the bed and insomnia. A structured sleep schedule can help consolidate sleep. The patient learns when to go to bed, when to get up, and how to build more consistent sleep pressure. This is not about rigid perfection. It is about helping the biological sleep system become more predictable again. Patients sometimes resist this part because

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Why Sleeping Pills Sometimes Stop Working

Dangers of Prescription Drugs, Insomnia, Sleep Psychology / admin

Why Sleeping Pills Sometimes Stop Working By Dr. Charles R. Freeman, Ph.D. Many people begin taking sleeping pills, sleep pills, sleeping tablets, or other medication for insomnia and experience significant improvement. Over time, some find that their insomnia medications become less effective, leading them to wonder why their sleep problems have returned. The people start wondering why sleeping pills stop working. Sleeping pills sometimes stop working because the brain adapts to them over time. This process, known as tolerance, means that the same dose gradually produces less effect. More importantly, most sleep medications do not address the underlying causes of insomnia, which may include anxiety, trauma, PTSD, grief, chronic stress, pain, or learned sleep patterns. When those issues remain unresolved, sleep problems often return despite continued medication use. If you are reading this article, there is a good chance you have experienced a frustrating pattern. A medication worked well in the beginning. You fell asleep faster, slept longer, and finally experienced some relief. Then something changed.The medication seemed less effective. You started lying awake longer. You woke up during the night. Perhaps your physician changed the prescription. Perhaps you increased the dose. Some people begin adding over-the-counter sleep aids, Benadryl, melatonin, or alcohol in an attempt to recreate the results they once experienced. For a while, things improve. Then the sleep problems return. As a behavioral medicine psychologist specializing in insomnia, this is one of the most common situations I see in clinical practice. The good news is that there is usually nothing wrong with you. The problem is often that the medication is treating a symptom while the actual cause of the insomnia remains unaddressed. How Sleeping Pills Differ From Restorative Sleep One of the most important concepts I discuss with patients is that sedation and healthy sleep are not the same thing. Many people assume that if they are unconscious for eight hours, they are getting restorative sleep. Unfortunately, sleep is more complex than that. Sleep involves multiple stages that support memory, emotional processing, physical recovery, concentration, and mood regulation. A person may spend many hours asleep yet still wake up exhausted, mentally foggy, emotionally depleted, or dependent on medication. The goal is not simply to be knocked out. The goal is restorative sleep. Those are very different outcomes. Why Sleeping Pills Stop Working Over Time The brain is designed to adapt. If you drink coffee every day, you often need more caffeine over time to achieve the same effect. Many sleep medications work in a similar way. Over time, the brain compensates for the presence of the medication, and the original dose becomes less effective. Patients often describe a familiar pattern. At first, one pill works well. Later, they need a higher dose to achieve the same effect. Eventually, the medication seems to provide little benefit at all. This pattern is not a sign of weakness or failure. It reflects the brain’s natural ability to adapt. The challenge is that increasing medication often creates greater dependence without addressing the underlying factors that contributed to insomnia in the first place. Common Sleeping Pills, Sleeping Tablets, and Insomnia Medications Many people seeking help for insomnia have used medications such as Ambien (zolpidem), Lunesta (eszopiclone), Xanax (alprazolam), Klonopin (clonazepam), Ativan (lorazepam), or various over-the-counter sleep aids. These medications may provide short-term relief for some people. The challenge is that they often do not address the underlying causes of chronic insomnia. As tolerance develops, some individuals find themselves increasing the dose, combining medications, or adding alcohol and other sleep aids in an effort to sleep. This approach rarely addresses the factors that contribute to insomnia and often fails to provide lasting improvement. Why Sleeping Pills Cannot Treat the Root Causes of Insomnia One of the central themes of my clinical work is that insomnia is often the symptom rather than the entire problem. Think of an iceberg. The sleep problem is the portion visible above the water, while a variety of underlying factors may exist beneath the surface. These can include anxiety, PTSD, childhood trauma, nightmares, hypervigilance, grief and loss, depression, chronic pain, obsessive thinking, and relationship stress. Sleeping pills may temporarily reduce symptoms, but they typically do not address the deeper issues that contribute to ongoing sleep difficulties. Lasting improvement often requires identifying and addressing the factors that continue to keep the nervous system activated and interfere with healthy sleep. Many people focus entirely on the visible symptom while the deeper causes remain untouched. I have worked with individuals whose insomnia began after divorce, military deployment, childhood abuse, medical illness, financial stress, or the loss of a loved one. The sleeping pill may temporarily suppress the symptom. It does not necessarily resolve the underlying wound. Why Does Ambien Not work Sometimes? One of the most common questions patients ask is, “Why does Ambien not work sometimes?” In many cases, the answer involves tolerance. Over time, the brain adapts to the medication, causing the same dose to produce less of an effect. Chronic stress, anxiety, trauma, PTSD, and conditioned wakefulness can also interfere with sleep and reduce the effectiveness of Ambien. Some people find that the medication initially helps them fall asleep, but months or years later they begin waking during the night or lying awake despite taking the same dose. In these situations, the underlying causes of insomnia often remain active while the medication temporarily suppresses symptoms. When sleep difficulties stem from anxiety, hypervigilance, chronic pain, grief, or learned patterns of nighttime alertness, medication alone may not provide lasting improvement. Effective treatment of insomnia often requires addressing both the sleep problem itself and the factors that continue to drive it. When the Bed Becomes Associated with Wakefulness Another common contributor to chronic insomnia is conditioning. If you spend months or years struggling in bed, the brain may begin associating the bed itself with frustration, anxiety, and alertness. Instead of becoming a cue for sleep, the bed becomes a cue for wakefulness. People start monitoring the clock. They worry about tomorrow.They wonder why they are still awake. At that point, even powerful medications may provide only temporary relief because the nervous system has

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