Sleep is one of the most important pillars of our health, yet so many of us struggle to get enough of it. On a recent episode of Unstress Health with Dr. Ron Ehrlich, I had the pleasure of speaking with clinical psychologist and sleep specialist Rosemary Clancy, who shared fascinating insights into sleep disorders, the science behind insomnia, and practical strategies we can all use to improve our sleep.
Understanding Insomnia and Sleep Misperception
What I found particularly interesting in my conversation with Rosemary is how many people assume they have insomnia simply because they feel they haven’t slept enough. She introduced me to the concept of paradoxical insomnia, also known as sleep-state misperception, which causes individuals to believe they’re sleeping far less than they actually are. According to Rosemary, sleep studies often reveal that people with this condition experience more sleep than they perceive. This disconnect between subjective experience and objective data can increase anxiety and further compromise sleep quality.
One of the most effective treatments for insomnia that Rosemary advocates is Cognitive Behavioural Therapy for Insomnia (CBT-I). This evidence-based approach helps us reframe our thoughts about sleep, reduce anxiety, and develop better sleep habits. Instead of relying on sleeping pills or quick fixes, CBT-I focuses on long-term solutions, including sleep hygiene and behavioural adjustments—something I’ve long advocated for in my approach to holistic health.
The Role of Sleep Pressure and Circadian Rhythms
Many people don’t realize that sleep isn’t just about closing our eyes at night—it’s a 24-hour process that begins the moment we wake up. Rosemary explained how sleep pressure builds throughout the day, driven by a chemical called adenosine, which accumulates the longer we stay awake. Engaging in physical activity, exposing ourselves to natural light in the morning, and maintaining a consistent sleep schedule all help regulate our circadian rhythms, the body’s internal clock that governs our sleep-wake cycles.
However, as I’ve often discussed on my podcast, modern technology can interfere with this natural process. Rosemary confirmed that blue light exposure from screens can delay melatonin production, making it harder to fall asleep. While some recent studies suggest that device use may not be the primary culprit, reducing screen time before bed and establishing a relaxing bedtime routine can still significantly improve sleep quality.
Sleep Apnoea and the Challenge of CPAP Therapy
One often overlooked aspect of sleep disorders, particularly in women, is obstructive sleep apnoea (OSA). While many of us associate sleep apnoea with loud snoring in overweight men, Rosemary emphasised that women in midlife often go undiagnosed due to different symptoms. Instead of snoring, they may experience insomnia, daytime fatigue, and mood disturbances.
The gold standard for treating sleep apnoea is CPAP therapy, which uses continuous positive airway pressure to keep airways open during sleep. However, as a healthcare practitioner, I’ve seen firsthand how compliance rates are notoriously low, with many users struggling to adjust. Rosemary highlighted how behavioural therapy and habit formation could improve CPAP adaptation, making it more comfortable for long-term use.
Mandibular advancement devices and nasal breathing techniques (such as mouth taping) can be effective alternatives for those who can’t tolerate CPAP. These approaches help keep the airway open naturally, improving oxygen flow and reducing sleep disturbances—something I’ve been interested in throughout my career, focusing on airway health, and breathing.
Final Thoughts: Overcoming Sleep Anxiety
Rosemary and I discussed one of the biggest barriers to better sleep: sleep anxiety, the fear of not sleeping well. This fear creates a cycle of hypervigilance, where we obsess over our sleep, ironically worsening our ability to rest.
Rosemary suggests acceptance and commitment therapy (ACT) as a powerful tool. Instead of forcing sleep, ACT encourages us to accept wakefulness when it occurs and to engage in non-sleep deep rest (NSDR) techniques, such as body scanning and relaxation exercises.
In my practice and through my book A Life Less Stressed, I’ve always emphasised that prioritising sleep isn’t just about getting more hours—it’s about improving sleep quality and removing the stress around it. By understanding how sleep works, addressing common sleep disorders, and using proven strategies like CBT-I, sleep hygiene, and airway optimisation, we can all reclaim the restorative power of sleep.
If you found this information valuable, please subscribe to my podcast Unstress Health with Dr. Ron Ehrlich for more conversations with experts like Rosemary on how to lead healthier, less stressed lives.
Until next time, this is Dr. Ron Ehrlich. Stay well.
