Somniphobia, also known as sleep anxiety, refers to experiencing excessive fear or dread surrounding the idea and act of going to sleep. Often an offshoot of insomnia, somniphobia causes challenging thoughts and feelings that trigger disruption in daily activities. People with somniphobia may also experience sleep disturbances like hallucinations, sleep paralysis, and nightmares. These issues exacerbate feelings of anxiety and dread.
What Is Somniphobia?
Somniphobia (also known as hypnophobia, clinophobia, sleep dread, or sleep anxiety) is a lesser-known specific phobia that refers to an overarching fear of sleep. This condition is like a crossover between generalized anxiety, insomnia, and specific phobias. Because sleep is essential to our well-being, this can lead to other physical or psychological impairments.
Somniphobia Vs. Sleep Anxiety
Both somniphobia and sleep anxiety are related to worries about falling and staying asleep. However, sleep anxiety comes into play when the anxious feelings are about how much sleep they get and their struggle to get enough quality sleep; whereas somniphobia is related to anxiety and fear around thinking that something terrible will occur when they do go to sleep. They may avoid sleep even though this may make their symptoms worse, as a lack of sleep can trigger intense nightmares and night terrors when one does fall asleep, further affirming the basis of the phobia.
Who Gets Sleep Phobias?
Sleep phobias are linked to several environmental and genetic factors, including:
- Those with a family history of this phobia or other phobias
- Those with a family history of sleep disorders
- History of trauma related to sleep or during the night
- Anxiety disorders
- Sleep disorders such as narcolepsy and sleep apnea
- Restless leg syndrome
- Self identification of being female
The main symptoms of somniphobia are fear, dread, or panic around what could happen when you’re asleep. People with somniphobia often experience sleep problems due to their fears. As the day gets closer to bedtime, distressing symptoms often escalate.
Common symptoms of somniphobia are:
- Feeling more distress at nighttime
- Experiencing panic attacks
- Feeling lightheaded
- Chest pains
- Fear of dying or losing control
- Abdominal pain
These symptoms range in severity. If you have a mild case of somniphobia, you may experience a few of these symptoms from time to time. If you have a more severe case, you may experience most of these symptoms every night, and as a result, get minimal to no sleep.
What Causes Somniphobia?
While the exact cause of somniphobia is unknown, there numerous factors that contribute to a fear of sleep, including negative sleep experiences like sleep paralysis, nightmare disorder, or a phobia of dying in your sleep.1 People with post-traumatic stress disorder (PTSD), which is associated with hyperarousal, nightmares, night terrors, and general sleep disturbances, may also be more likely to experience somniphobia.2
Risk Factors for Developing a Phobia of Sleep
People with generalized anxiety may be at an increased risk for sleep anxiety. Sleep problems like sleep apnea, sleepwalking, nighttime terrors, or experiencing a history of trauma at nighttime can all contribute to somniphobia, too. People with these problems may naturally feel anxious about re-experiencing them.
Risk factors for sleep anxiety include:
- Generalized anxiety disorder
- Sleep apnea
- Nighttime terrors
- History of trauma at night
How to Overcome Somniphobia
Like with all phobias, it’s important to recognize the problem and label it because acknowledgment facilitates change. If you identify yourself as having somniphobia symptoms, you have taken the first step to reducing symptoms. This acknowledgment can help you classify those symptoms and develop a reasonable strategy for managing them.
Here are 12 practical tips for coping with a sleep phobia:
- Go to bed at the same time each night: Consistency is an essential component of good sleep hygiene. Following a schedule helps maintain your body’s internal clock and respects your natural circadian rhythms. People who aim to go to sleep at the same time each night also tend to fall asleep faster.3
- Exercise consistently: Exercise can support deep sleep, allowing the brain and body to rejuvenate. Research shows that at least 30 minutes of moderate aerobic exercise promotes better sleep.4 Just be mindful of working out too close to bedtime, as the vigorous activity may overstimulate you.
- Minimize or eliminate naps: Aim to keep naps short if you take them at all. Do not take any naps within six hours of bedtime.
- Avoid caffeine or limit your intake by the afternoon: Caffeine is a psychoactive substance that can exacerbate anxiety and interfere with circadian melatonin rhythms.5 You can measure caffeine effects by examining its half-life, which can range from 4-6 hours. This means that consuming a cup of coffee around 3:00 pm may still have you feeling wired by 9:00 pm.
- Create a restful sleep environment: Make sleep feel like a luxurious experience. Invest in a high-quality mattress, sheets, and pillow. Keep your room free of clutter and avoid spending time in the bed outside of sex or sleep.
- Establish a calming ritual: One hour before bed, start winding down. Turn off all electronics. Follow a simple, realistic schedule each night, such as brushing your teeth, washing your face, and reading for half an hour.
- Avoid emotionally-charged material at night: Do not watch the news or read troubling stories. If a friend or partner wants to have a difficult conversation, postpone the talk until the following day.
- Practice meditation: Meditation can promote restful sleep. Consider using a meditation app with guided scripts, or simply close your eyes and practice deep breathing.
- Practice stress management: Be mindful of people or situations that trigger stress in your life. Practice healthy coping skills that help reduce your stress response or agitation.
- Spend time outside during the day: Expose yourself to natural sunlight during your waking hours. This can help maintain and even boost your circadian rhythms.
- Avoid alcohol: Alcohol may cause you to feel drowsy, but it can also cause sleep disruptions and trigger sleep-induced breathing irregularities.6
- Practice a positive sleep mantra: As you get ready to settle in for bed, affirm yourself with a calming statement like “I am going to have a calm night of rest.” Find a phrase that feels optimistic without being entirely unrealistic.
How Is Somniphobia Diagnosed?
Somniphobia may be diagnosed by a combination of providers including mental health professionals and sleep experts. They may ask you a series of questions while simultaneously exploring sleep issues in therapy to understand your symptoms.
Practicing these self-help strategies can make a tremendous difference in your quality of sleep. Keep in mind these strategies require time, consistency, and effort. However, they may not be enough. If you don’t notice an improvement, or if your symptoms have worsened, it’s worth seeking professional treatment. Fortunately, phobias are treatable, and there are many different treatment options, including different types of therapy, eye movement desensitization and reprocessing (EMDR), and medication.
Exposure therapy is an evidence-based treatment that helps people confront their phobias gradually and safely.7 For example, you might start by taking a short nap with a trusted professional or loved one. Eventually, you will work your way to sleeping through the night. When treating somniphobia, your therapist will also likely establish a fear hierarchy, enabling you to rank your sleep-related fears from least scary to most terrifying.
Cognitive-Behavioral Therapy (CBT)
CBT is a well-known therapy that works under the assumption that thoughts, feelings, and behaviors are interconnected. Ideally, by learning how to change your negative thoughts about sleep, you will experience fewer distressing symptoms. Using a CBT approach, your therapist may encourage techniques like tracking your emotions before and after sleep, progressive muscle relaxation, and challenging your cognitive distortions (i.e., examining the evidence related to your fears).
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a manualized training approach for treating trauma. Because many people with somniphobia also meet the criteria for PTSD (or have a history of trauma), this can help reduce symptom severity. A therapist will help you identify your target (the distressing memory) and encourage you to share. At the same time, they will engage in a series of bilateral stimulations. Over time, this process helps desensitize you to traumatic material.
Imagery Rehearsal Treatment (IRT)
IRT is a subtype of CBT. This intervention helps to address nightmares and night terrors related to low quality sleep or sleep anxiety. This helps to unpack and recover from past traumas related to sleep.
Exposure, Relaxation, and Rescripting Therapy (ERRT)
ERRT is also a subtype of CBT. It is designed specifically for sleep issues, specifically for the treatment of nightmares and night terrors due to trauma. It is a brief therapy approach lasting five sessions. During ERRT, people learn about their sleep issues and trauma, the impact, find coping mechanisms and relaxation interventions that work for them and the use of rewriting their story and experience with the basis of their sleep trauma.
If you suspect you struggle with somniphobia, speak with your healthcare provider or psychiatrist about potential medications such as sedatives. Sleep medications also help with symptoms related to insomnia, as they promote drowsiness. Please note that you should always consult with your doctor before beginning any medication, and that these medications should only be used for short periods of time, as many can be habit forming.
Common sleep medications include:
They might also prescribe psychiatric medications like antidepressants (Prozac, Lexapro, Zoloft) or anti-anxiety drugs (like Klonopin or Xanax). While these medications don’t act on somniphobia symptoms directly, they can decrease symptoms that may exacerbate sleep problems. Your prescription would depend on your specific sleep condition, any comorbid conditions (depression, anxiety, insomnia, etc.), and your history with medication.
How to Get Help for Fear of Sleeping
Finding the right therapist is the first step towards working through your fear of sleep. While all therapists must have extensive training and expertise, it’s crucial to find someone who helps you feel safe and comfortable. Start your search by looking through an online therapist directory. Each clinician will list their specialties, fees, and years of experience.
When contacting a therapist, it’s wise to have an idea of your presenting issue. What’s causing you the most distress right now? Likewise, what goals do you hope to achieve? Remember that sustainable results take time. It’s normal for it to take a few sessions before you start feeling like you’re making progress.
Can Somniphobia Be Prevented?
While phobias can’t necessarily be prevented, they can be managed with therapy, medication, and healthy coping with a strong support system.
Final Thoughts on the Fear of Sleep
Somniphobia is undoubtedly a challenging condition; however, you are not alone in your experience. Practicing the proper techniques and engaging in the appropriate forms of treatment can help you overcome this struggle. It’s possible to experience a restful night of sleep. Reach out to a healthcare provider for support today.