Treatments for Insomnia (OCR GCSE Psychology): Revision Note

The impact of neurological damage to the hypothalamus

• Sleep plays a vital role in both physical and psychological health

  • Because of this, understanding and treating sleep disorders is essential

• The hypothalamus, including the suprachiasmatic nucleus (SCN) regulates the sleep–wake cycle

• If the hypothalamus is damaged (e.g., through surgery, tumour, stroke, accident, or age-related degeneration), the brain’s sleep signals become disrupted

• The SCN normally triggers the release of melatonin at night to promote sleep

  • Damage to the hypothalamus prevents normal melatonin rhythms, making it difficult to fall asleep and leading to neurological insomnia

• Insomnia caused by neurological damage cannot be reversed, so treatment focuses on retraining the body to sleep through behavioural strategies such as:

  • relaxation techniques

  • sleep hygiene education

The nervous system & relaxation

• Insomnia is strongly linked to the activity of the nervous system, especially when the body remains in a state of heightened arousal

How the nervous system contributes to insomnia

• The sympathetic nervous system activates the fight-or-flight response

• Stress, anxiety, and worry raise levels of adrenaline and cortisol, keeping the brain alert

• When the sympathetic nervous system is overactive, the body cannot switch into the relaxed state needed for sleep

Relaxation techniques that help manage insomnia

• Relaxation techniques reduce sympathetic nervous system activity and activate the parasympathetic nervous system, which promotes rest and recovery

Common relaxation techniques

• Deep breathing (4-7-8 technique)

  • Inhale through the nose for 4 seconds

  • Hold for 7 seconds

  • Exhale for 8 seconds

    • Repeat 3–4 times

  • It works as it:

    • slows the heart rate

    • reduces physical tension

    • activates the parasympathetic nervous system

• Progressive muscle relaxation (PMR)

  • Involves tensing and releasing muscle groups from the feet upward

    Muscles are held tight for a few seconds, then released suddenly

  • It works, as it relieves physical tension that interferes with sleep

• Clearing the mind

  • Visualising calming scenes

  • Mindfulness or meditation to interrupt worry cycles

  • Writing down thoughts or worries before bed

  • This works as it lowers cognitive arousal and prevents racing thoughts

The physical environment & sleep hygiene

• Insomnia can also be caused or worsened by environmental factors — the conditions in which a person tries to sleep

Environmental causes of insomnia

• Light exposure (blue light from phones/tablets) suppresses melatonin

• Noise from traffic, snoring partners, or busy households interrupts sleep

• A temperature that is too hot or too cold interferes with comfort and sleep cycles

• Uncomfortable bedding (poor mattress, lumpy pillows) causes waking and physical discomfort

• Irregular routines confuse the body’s internal clock

Sleep hygiene techniques that improve the sleep environment

• Keeping a consistent sleep schedule

  • Going to bed and waking at the same time daily regulates the body clock

• Reducing light exposure before bed

  • Avoid screens one hour before sleep

  • Use dim lighting in the evening

• Creating a quiet and comfortable environment

  • Use earplugs or white noise machines

  • Ensure bedding is supportive and comfortable

  • Keep the bedroom cool (around 16–18°C)

• Using the bed only for sleep

  • Avoid studying, eating or scrolling on the phone in bed

  • Helps the brain associate the bed with sleeping rather than wakeful activity

• Avoiding stimulants and alcohol close to bedtime

  • Limit caffeine and nicotine throughout the day

  • Avoid stimulants 6–8 hours before bedtime

  • Avoid alcohol, as it disrupts later sleep cycles