Theories on the causes of insomnia – the 3 Ps: Predisposition, Precipitating, Perpetuating

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We have seen that insomnia over time has moved from being seen as a symptom of another issue into being seen as an issue worth treating on its own. Since 2013 the DSM-5 has stated that regardless of whether it is a symptom, or the primary issue insomnia should be addressed in isolation. It is now known as ‘Insomnia Disorder.’


So, what are the 3 Ps? Insomnia while relatively easy to diagnose its cause is not so easy. There can be multiple factors, any one of which could be in isolation the reason or one of many reasons for triggering or causing insomnia. 

Because of this, since the 1980’s, the 3 P’s model for understanding reoccurring health issues was brought into sleep science.  The 3 Ps stand for predisposing, precipitating and perpetuating. 

Predisposition to insomnia

In itself, not a cause but undoubtedly a contributing factor is the predisposition to it.  But how do we develop or have an inclination to insomnia? Is it hereditary? Well, the jury is out on the latter point, but if your family are known poor sleepers, this could become part of your identity, of how you see yourself, by association or by falling into similar patterns and lifestyles as close family members. 

This falling into the identity of being ‘an insomniac’ or ‘suffering from insomnia’ is something we can perhaps change through Metacognitive NLP and meditation. By redefining ‘the story of me’ we all subscribe to. 

Precipitating factors in our insomnia

A precipitating factor is a trigger, that is something that causes or fires insomnia. It could be a life-changing event such as a breakup, the death of a loved one, a problem at home or work such as an argument and so forth. Often these are quite easy for the insomniac to self-diagnose or see for themselves after the sleepless episode. Often constant thoughts and feelings around the trigger being the thing that is keeping them up all night are and aid to diagnosing the precipitating factors. 

Perpetuating insomnia

The third and final P is that of perpetuation. This P as it sounds covers issues that may preserve, prolong or enhance the condition. Such as those thoughts that keep you up all night. On top of these can be issues such as anxiety and depression or contributing factors such as drinking too much coffee or lousy bedtime behaviour.

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