The Insomnia/Perfectionism Connection

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Do you hold yourself to high (sometimes impossibly high) standards? Do you tend to be self-critical and cringe at making mistakes? Is it even difficult sometimes to take pleasure in your own hard-won achievements?

These are signs of perfectionism, and perfectionists are more susceptible to insomnia than people who can shrug off their mistakes.

The theory that perfectionism and other personality traits (such as neuroticism and internalization of negative feelings) are the main drivers of insomnia has not withstood the test of time. But the evidence for an association between perfectionism and insomnia remains fairly strong. Even so, a team of Swiss researchers has found that when they take stress, poor coping strategies, and poor emotion regulation into account, perfectionism’s role in explaining insomnia all but disappears. There’s a message here for those of us who want to improve our sleep.

Where Perfectionism Comes From

Like many personality traits, perfectionism appears to have both environmental and genetic components. “It is likely that a perfectionistic orientation develops over time, and family history may contribute to the development of perfectionism,” wrote Cal State University researchers David R. Hubbard and Gail E. Walton, who in 2012 reported interviewing 36 students about perfectionism and the motivation to achieve. Two aspects of experience differentiated the perfectionists from their nonperfectionist peers:

  1. The perfectionists felt pressure from their families to succeed.
  2. Their parents were overly critical of their mistakes when they were growing up.

But inherited genetic material may also make people more inclined to perfectionism. When researchers at Michigan State administered a series of tests to 292 young female adults in the Michigan State University Twin Registry, they found that both anxiety and maladaptive perfectionism (concern about mistakes and doubts about actions) were moderately heritable—on par with the heritability of general intelligence. A second twin study found that identical twins were more alike than fraternal twins in how much they idolized skinny celebrities—another sign of perfectionism.

A Relationship Between Perfectionism and Sleep

Chronic insomnia is attributable to a mix of factors: physiological and psychological, environmental and behavioral, inherited and learned. The dysfunctional processes underlying perfectionism (manifesting as doubts about abilities, concern about mistakes, and so forth) might be similar to those that underlie trouble sleeping, the Swiss researchers reasoned. So they gave a battery of pencil-and-paper tests to 346 college students to see what relationships would emerge.

Statistical analyses showed that perfectionistic traits were associated with trouble sleeping and the same daytime complaints of people with persistent insomnia: tiredness, reduced concentration, and low mood. But when perceived stress, poor coping strategies, low emotion regulation, and low mental toughness were factored into the equation, perfectionism’s contribution to sleep disturbance was nil. In other words, the researchers conclude, “It is not perfectionism per se, but rather the underlying psychological mechanisms that best explain the association between perfectionism and poor sleep.”

Why Is This Important?

Let’s assume you have insomnia. A therapist you’re working with thinks the problem is personality-related and sets out to address it by helping you modify your perfectionistic tendencies.

Changing personality traits originating in childhood and/or predisposed at birth is a real challenge. It might not be impossible to free yourself from a harsh inner critic that developed under the watchful eyes of Mom and Dad, yet the effort it would take—several months (if not years) of psychotherapy—would be great and the results, uncertain. As for improving your sleep, well, good luck there. Psychotherapy has never been found to be an effective treatment for insomnia.

Targeting the psychological mechanisms underlying chronic insomnia directly would be a faster, more effective approach to improving sleep, the researchers conclude, particularly in insomnia sufferers with perfectionistic tendencies. Cognitive-behavioral therapy for insomnia (CBT-I) does this. Its cognitive restructuring component is aimed at dismantling the mental and emotional underpinnings of persistent insomnia. So CBT-I is a better treatment option than psychotherapy if your goal is better, sounder sleep.