Ask someone with long-term sleep difficulties when the problem began, and they can usually identify a cause. It may have been a bereavement, a newborn baby, a difficult period at work or a problem with pain.

Ask whether that situation is still happening, and the answer is often no. The original trigger has passed, but the insomnia has remained.

A common way of understanding this pattern divides the contributing factors into three groups:

• Predisposing factors: what made you more vulnerable to sleep problems in the first place. You may naturally sleep more lightly, have a tendency to worry or have a family history of sleep difficulties. You may not be able to change these factors, and this program does not try to.
• Precipitating factors: what originally triggered the problem. This may have been a bereavement, caring for a newborn or a particularly difficult year. The trigger is often easy to identify and may now be in the past.
• Perpetuating factors: what is keeping the sleep problem going now.

The third group is the main focus of this program.

This means that what caused you to sleep badly last night may be different from what first disrupted your sleep two years ago. They are two separate problems that share the same name.

The original problem may have ended and may no longer be something you can change. The current problem is still present and is often shaped by patterns that can be changed.

Here is the difficult part: many of those patterns began as reasonable attempts to cope.

You might go to bed earlier to catch up on sleep. You might stay in bed longer at the weekend, take naps, cancel plans to conserve energy, drink alcohol to help yourself fall asleep or remain in bed hoping that sleep will eventually return.

Each of these responses makes sense when you are tired. However, they can also make the following night more difficult.

One reason is that they increase the amount of time you spend in bed beyond the amount of sleep your body is ready for. As Lesson 1 explained, repeated periods of wakefulness in bed can teach your body to associate the bed with being awake.

This needs to be stated clearly because it can easily sound like criticism: this is not a problem with your character, and it is not something you should have known.

It is a trap with a reasonable-looking entrance. The things on this list are understandable responses to not sleeping. The difficulty is that the most obvious response and the most effective response can point in opposite directions. The experience itself does not make that clear.

This program cannot change what originally started the problem. Instead, it will focus on what is keeping it going now: patterns that are present, specific and more within your control.