Understanding Somniphobia, or Fear of Sleep

Good sleep is an essential part of good health. But if you have somniphobia, it can be distressing to even think about sleeping. In many cases, this phobia may stem less from a fear of sleep itself and more from a fear of what might happen while you’re asleep.

Somniphobia can cause a range of other mental and physical symptoms.

Mental health symptoms specific to somniphobia might include:

• feeling fear and anxiety when thinking about sleeping
• experiencing distress as it gets closer to bedtime
• avoiding going to bed or staying up as long as possible
• having panic attacks when it’s time to sleep
• having trouble focusing on things besides sleep-related worry and fear
• experiencing irritability or mood swings
• having a hard time remembering things

Physical symptoms of somniphobia often include:

• nausea or other stomach issues related to persistent anxiety around sleep
• tightness in your chest and increased heart rate when thinking about sleep
• sweating, chills, and hyperventilation or other trouble breathing when you think about sleeping
• in children, crying, clinginess, and other resistance to bedtime, including not wanting caregivers to leave them alone

It’s not possible to entirely avoid sleeping. If you’ve had somniphobia for some time, you’re probably able to get some sleep most nights. But this sleep may not be very restful. You might wake up frequently and have trouble getting back to sleep.

Other signs of somnophobia revolve around coping techniques. Some people opt to leave on lights, a television, or music for distraction. Others may turn to substances, including alcohol, to reduce feelings of fear around sleep.

Experts aren’t sure about the exact cause of somniphobia. But but some sleep disorders could play a part in its development, including:

• Sleep paralysis. This sleep disorder occurs when you wake up from REM sleep with your muscles paralyzed, making it hard to move. You might experience nightmare-like hallucinations, which can make sleep paralysis very frightening, especially if you have recurring episodes.
• Nightmare disorder. This causes frequent, vivid nightmares that often cause distress throughout your day. You might find yourself thinking back to scenes from the nightmares, feel afraid of what happened in your dream, or worry about having more nightmares.

If you have either of these sleep disorders, you may eventually start dreading going to sleep because you don’t want to deal with distressing symptoms.

Experiencing trauma or post-traumatic stress disorder (PTSD), which can both contribute to nightmares, can also cause a fear of sleep.

You might also fear things that could happen while you’re sleeping, such as a burglary, fire, or other disaster. Somniphobia has also been linked to a fear of dying. Worrying about dying in your sleep might eventually lead to a fear of falling asleep at all.

It’s also possible to develop somniphobia without a clear cause. Phobias often develop in childhood, so you may not remember exactly when your fear began or why.

You’re more likely to develop a specific phobia if you have a close family member who also has a phobia or a family history of anxiety.

Having a sleep disorder or serious medical condition might also increase your risk. If you’re aware there’s a risk of death associated with your health concern, you could become anxious about dying in your sleep and eventually develop somniphobia.

If you believe you have somniphobia, it’s best to start by talking to a mental health professional. They can give you an accurate diagnosis and support you through the process of overcoming it.

Usually, phobias are diagnosed if fear and anxiety cause distress and difficulty in your everyday life.

You may be diagnosed with somniphobia if your fear of sleeping:

• affects sleep quality
• negatively affects physical or mental health
• causes persistent anxiety and distress related to sleep
• causes problems at work, school, or in your personal life
• has lasted more than six months
• causes you to put off or avoid sleep as much as possible

Not all phobias require treatment. In some cases, it’s fairly easy to avoid the object your fear. But sleep deprivation can have serious physical and mental health consequences. That’s why treatment is generally recommended for any condition that keeps you from getting restful sleep.

Treatment may depend on the underlying cause of somniphobia. For example, if you have a sleep disorder, addressing that issue may resolve your somniphobia. But for most cases, exposure therapy is the most effective treatment option.

Exposure therapy

In exposure therapy, you’ll work with a therapist to gradually expose yourself to your fear while working on ways to reduce fear and anxiety.

For somniphobia, exposure therapy may include discussing the fear, using relaxation techniques, and then imagining what it would be like to get a good night sleep.

Next, it may involve viewing images of people asleep who appear to be comfortably resting. Then, when you’ve mastered these cues, you may be encouraged to take brief naps — with a partner, parent, or trusted friend present in the house — to reinforce that you can wake up safely.

Another option for further exposure therapy is sleeping in a sleep lab or with a medical professional who stays awake while you sleep, whether it’s a nap or overnight.

Cognitive behavioral therapy (CBT)

CBT may also help. This approach helps you identify and work through fears related to sleep. You’ll learn to challenge the thoughts when you experience them and reframe them so they cause less distress.

These thoughts might be related to sleep itself, or the specific fear that causes anxiety around sleeping.

One approach your therapist may recommend is sleep restriction. This involves going to bed and getting up at specific times, regardless of how much sleep you actually get. This helps your body develop better sleep patterns, which can be helpful for somniphobia when combined with CBT.

Medication

While there’s no medication that specifically treats specific phobias, certain drugs can reduce symptoms of fear and anxiety and may be helpful when used along with therapy.

A psychiatrist may prescribe beta blockers or benzodiazepines for short-term or occasional use:

• Beta blockers help decrease physical symptoms of anxiety. For example, they can help you maintain a steady heart rate and keep your blood pressure from rising.
• Benzodiazepines are a type of sedative that can help with anxiety symptoms. They can be addictive, so they’re not meant to be used for a long time.

Your doctor may also recommend a short-term sleep aid to help you get better sleep while addressing your phobia in therapy.

Somniphobia, an intense fear of sleep, may prevent you from getting the sleep your body needs to function. If you have somniphobia, you’re likely to experience physical health issues related to lack of sleep along with the anxiety and distress phobias usually cause.

If you think you may have somniphobia, talk to your primary healthcare provider. They can give you a referral to a mental health professional with experience diagnosing and treating phobias.