Sleep Fundamentals || T is for the Three P Model (for insomnia)

To sleep or not to sleep, that is the question.

 

What is the 3P (Three P) model for insomnia?

In 1991, researcher AJ Spielman created a model to identify the three factors—the Three P model—that lead to the sleeplessness we have come to understand as insomnia.

Predisposition

This “P” points to the factors that we may be born with that can make it more likely to develop insomnia or to become more vulnerable to it. This includes our age, gender, race or other social or economic factor. Even our personality or predisposition (how “high strung” or “laid back” we are) can affect our risk factors for insomnia.

Predisposition might be considered the baseline for potential insomnia.

Precipitation

This “P” points to environmental factors that may result in sleep loss. These could be stressors (occupational stress, the loss of a loved one, divorce) or physical or mental illness that precipitate spells of insomnia.

These might be thought of as the reasons why we lose sleep, based on external influences. They can lead to acute, or temporary insomnia. 

Perpetuation

This “P” points to self-imposed behavioral factors that may result in sleep loss. Choosing to sleep at odd hours, drinking or smoking at bedtime, shift work, poor sleeping arrangements, cross-country travel are all behaviors or choices we make that can perpetuate.

These might be thought of as the reasons why we lose sleep, based on internal influences. They can lead to both acute (temporary) or chronic (ongoing) insomnia.

This basic model has helped guide sleep physicians and their patients for years in their quest for resolution of ongoing sleeplessness, which is perhaps the most common sleep disorder anywhere in the world.

Why the 3P (Three P) model for insomnia?

Looking at these factors can help identify how severe a person is when they suffer sleeplessness based on this theoretical model.

Temporary insomnia can occur in anybody. However, adding additional precipitating and perpetuating factors can lengthen periods of sleeplessness until they become chronic. We all have, to some degree, a risk for developing insomnia. However, it’s these types of precipitation and perpetuating factors which determine whether it lasts.

Usually, those with acute insomnia caused by precipitating events eventually return to normal sleep with the resolution of their stress issues.

However, if they make perpetuating choices or practice poor sleep hygiene behaviors, this can exacerbate preexisting sleeplessness. When insomnia is diagnosed, therapy to address its perpetuating factors becomes necessary to treat it.

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