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External events are often blamed for difficulty in sleeping until the affected person concludes that sleep disturbance persists even after gradual elimination of the obstacle to sleep and even after the many attempts to obtain treatment have also proved unsuccessful. Such persons frequently develop a real anxiety about the bed. Even during the day the thought of going to bed produces an attack of anxiety. As a consequence, they develop a tendency to go to bed at an increasingly later hour, which only aggravates their difficulty in sleeping. Many, if not all, persons suffering from difficulty in sleeping tensely wait for sleep at night, completely forgetting that sleep cannot be forced. As early as 1905, Dubois wrote, "Sleep is like a dove. If you quietly extend your hand, it will light; if you reach for it, it will fly away."

The practice of going to bed at a later and later hour and the; increased desperation in waiting for sleep, of wanting to force sleep to come, can only aggravate functional sleep disturbance and make the initial psychic state a real and insurmountable barrier to falling asleep.