Fear is a natural emotion, and almost every person suffers from it. This fear can be directed at anything or anyone, for example, fear of heights, spiders, or clowns. When these fears involve seemingly neutral objects and involve intense emotions, they are called phobias. Research suggests that up to 12% of adults experience phobia at some point in life. Classified as a type of anxiety disorder, phobias can significantly impact everyday life.
Somniphobia is a type of phobia where a person experiences severe fear and anxiety revolving around sleep. [1] Such people cannot sleep properly, which, in the long run, affects their lives and potentially leads to lasting consequences. Known as fear of sleep, somniphobia is a manageable condition through professional treatment and self-care.
What is Somniphobia, and What Causes it?
So far, experts are unclear about the potential causes of phobias. These issues are believed to come from environmental and genetic factors and usually develop in childhood. A person is more likely to develop a phobia if their close family members already suffer from it. Phobias are also more common in females and often co-occur with underlying anxiety disorders.
Phobia of sleep is a common symptom of posttraumatic stress disorder (PTSD) and nightmare disorder. Both conditions are directly connected with traumatic experiences and can trigger Somniphobia in people as they are too afraid to fall asleep and experience nightmares. Research has also found that people with underlying PTSD and a fear of sleep are more likely to experience nightmares. Such people may eventually develop sleep avoidance, which consequently turns into insomnia, a sleep disorder that makes it difficult to fall or stay asleep.
Another issue commonly linked with somniphobia is isolated sleep paralysis. This condition can make it impossible to move for a few moments as a person falls asleep or wakes up. Such experiences can be highly stressful and often cause nervousness associated with falling asleep. In some cases, isolated sleep paralysis may cause hallucinations, which further complicates things.
Common Symptoms of Somniphobia
Most phobias share many common symptoms. These symptoms typically appear when a person comes face to face with their feared object or thinks about it. Following are some common symptoms that a person with somniphobia may experience:
- Shortness of breath
- Profuse sweating
- Trembling
- Rapid heartbeat
- A desire to avoid sleeping in any circumstances
- Experiencing fear or panic when thinking about sleep or trying to sleep
The symptoms of somniphobia mentioned above are pretty similar to the symptoms of a panic disorder. The only difference between both issues is that panic disorders are generally not so closely linked to a specific situation or object.
Establishing the Diagnosis of Somniphobia: What are the Criteria?
According to the Diagnostic and Statistical Manual (DSM), the ultimate guidebook used by mental health professionals to diagnose psychiatric issues, diagnosing somniphobia requires meeting a specific set of criteria. These criteria include the following symptoms:
- Significant anxiety or fear associated with a situation or an object.
- Active avoidance of a given situation or entity and experiencing anxiety when it becomes unavoidable.
- The fear or anxiety is excessive compared to the threat posed by the case or object triggering it.
- Fear or anxiety always occurs when presented with a particular subject or object.
- The stress and fear around the specific phobia are lasting, typically for six hours or more.
- Distress due to phobia is significant enough to impair functioning in other areas of life, such as at school or work.
- The symptoms mentioned above remain unexplained by the presence of another mental health issue, such as social anxiety disorder or obsessive-compulsive disorder.
Managing Somniphobia: How to Overcome Fear of Sleep
Despite being a troublesome psychiatric issue, somniphobia remains treatable. Experts now use various techniques and therapies to help people overcome the symptoms of their fear of sleep. Some of these therapies include the following:
Exposure Therapy
This therapy involves a process where a person intentionally exposes themselves to a fearful situation or object while gradually increasing their level of exposure as they learn to regulate their anxiety in a much better way. As one of the most common forms of treatment for phobias, exposure therapy can be carried out in virtual reality and real life, depending on personal preferences. [2]
For people with somniphobia, the targeted phobia revolves around falling asleep. Such people work closely with a mental health professional to pinpoint experiences related to sleeping but cause comparatively little distress. For instance, an example can be changing into pajamas after coming home.
A treatment provider can help a person identify their physical symptoms of anxiety, such as shortness of breath or rapid heartbeat, and keep track of when they subside. These experts also teach patients relaxation techniques and coping skills to get through stressful times with more ease. Over time, patients learn to move up the ladder, slowly moving from the least fearful experiences to the most fearful ones while aiming to conquer the fears by the end of the therapy duration. Research believes that exposure therapy can be effective in controlling phobias in. up to 90 percent of people.
Cognitive Behavioral Therapy
Also known as CBT, cognitive behavioral therapy is a treatment approach that focuses on changing the association between a person’s feelings, thoughts, and behaviors. Experts have been using CBT for decades to manage anxiety disorders, and there is ample research available to back its efficacy in controlling fear, panic, and anxiety. [3] Despite not being a first-line treatment for specific phobias, CBT is effective and safe for both children and adults struggling with somniphobia.
As a part of CBT, patients work closely with therapists to break the ongoing cycle of unhelpful thoughts associated with sleep. Moreover, it also lets them implement new, healthier, and more helpful behaviors and beliefs. For instance, if a person fears going to sleep because they think being asleep makes them unsafe or vulnerable, they can address these thoughts through cognitive restructuring techniques as a part of CBT. These techniques help them identify these unhelpful thoughts while replacing them with helpful ones.
Medication
So far, there is no medication used to manage somniphobia or fear of sleep. However, some people may benefit from drugs that reduce anxiety or fear. Remember that these medications must only be used after a doctor has approved them.
- Benzodiazepines: This class of drugs is used to treat panic disorders and anxiety; however, they can also help with somniphobia symptoms. Remember that benzodiazepines are highly habit-forming, which means you must use them with great caution.
- Oxytocin and Cortisol: Research has found that taking oxytocin or cortisol before exposure therapy can help people overcome specific phobias while improving overall treatment outcomes.
- D-Cycloserine: As a N-methyl D-aspartate (NMDA) receptor agonist, D-cycloserine has been investigated for its ability to limit fear response as a part of exposure therapy. However, more research is needed to confirm its role in treating somniphobia.
- Beta Blockers: These medications were initially invented to control blood pressure. Many people rely on this medication to temporarily reduce anxiety, such as before a stage performance.
Many people argue that taking sleep aids may help; however, their effects are only temporary, and they may not be effective in the long run. Adopting healthy lifestyle habits, such as regular exercise, limited caffeine, and healthy eating, can better manage the symptoms in the long run.
FAQs
When should I talk to my doctor regarding my phobia of sleep?
If you feel like you experience severe anxiety or panic when thinking about sleeping or try your best every night to delay sleep as much as possible, consider talking to a doctor. You may set up an appointment with a doctor and ask for a referral to a mental health expert if your symptoms fail to resolve with medical intervention and lifestyle changes.
Are there any tips to overcome anxiety about falling asleep?
Maintaining good sleep hygiene is imperative for overcoming somniphobia. For this purpose, consider following the tips mentioned below:
- Play relaxing music at bedtime or take a hot shower.
- Turn off all phones and digital devices at least one to two hours before bedtime.
- Avoid using stimulants, such as chocolate, nicotine, and coffee, close to bedtime.
- Turn off all work-related emails and avoid engaging in any to-do list items as your designated bedtime approaches.
- Consider exercising regularly.
- Consider meditating or following mindfulness techniques as a part of daily life.
References
1 Kazaglis L, Bornemann MA. Classification of parasomnias. Current Sleep Medicine Reports. 2016 Jun;2:45-52.
2 Eaton WW, Bienvenu OJ, Miloyan B. Specific phobias. The Lancet Psychiatry. 2018 Aug 1;5(8):678-86.
3 Bandelow B, Reitt M, Röver C, Michaelis S, Görlich Y, Wedekind D. Efficacy of treatments for anxiety disorders: a meta-analysis. International clinical psychopharmacology. 2015 Jul 1;30(4):183-92.