7 Good Reasons to Stay Sleepless: Insomnia and Secondary Gain

Published in The Huffington Post

sleeplessMaybe you’ve heard this one: A woman goes to see a psychologist and tells him her husband thinks he’s a chicken.

“Well,” says the psychologist, “we have effective treatments for that. Why don’t you bring him in?”
“I don’t know,” responds the woman. “We really need the eggs.”

Like many sleep specialists, I wondered why our effective treatments for insomnia didn’t seem to be significantly impacting the epidemic of sleeplessness. I wondered why so many of my patients struggled with following through on recommended treatments. And I wondered why so many people with insomnia didn’t even seek treatment and instead opted for drugs, substances, or just muscling through.

The answer to these questions is secondary gain — the indirect, potential benefits of not treating a health concern. Secondary gain is not a conscious or manipulative attempt to leverage illness. It is, rather, a kind of behavioral trap that snares and keeps us stuck against our will. Secondary gain does not mean we are in any way enjoying our sleep struggles. Like the golden handcuffs of an unsatisfying job or the emotional security of a dysfunctional relationship, the challenges of secondary gains around sleeplessness are both common and tricky to navigate.

The first step in addressing secondary gain is to identify the specific ways in which it affects us. Here are seven of the most common patterns of insomnia-related secondary gain I have observed:

1. Most obvious, spending less time asleep means more time awake. Being awake can allow us to feel more productive, can provide more time for ourselves, or can help us feel less pressured, less rushed. Independent of insomnia, restricting sleep has long been seen as a badge of honor.

2. Chronic sleep loss fogs our mind and blunts our emotions. As uncomfortable as the resulting daytime sleepiness might be, it can take the edge off waking life by rendering us desensitized or numb. In some ways, being chronically sleepy is similar to being somewhat inebriated.

3. Excessive daytime sleepiness provides legitimate excuses for avoiding personal, social, and professional obligations. Our unmanageable sleepiness can get us out of attending social events, can explain poor performance at work or school, can justify inattentiveness to family and friends, and can explain our failure to follow through on an exercise or weight management program.

Read the full article on The Huffington Post.