What is Somniphobia?

According to statistics, one in every 23 people has a phobia. This is around 4.25% of people and around 2.5 million sufferers in the United Kingdom alone. Though many people are familiar with common phobias like the fear of spiders (arachnophobia) and the fear of enclosed spaces (claustrophobia), they’re not so familiar with somniphobia.

What is somniphobia?

Somniphobia, from the Latin somnus meaning sleep or slumber, is an irrational and extreme fear of sleep. Somniphobia is classed as a specific phobia, which means that a person has an irrational and intense fear of sleep, despite it posing no danger. Even though someone with this phobia might realise and know it’s irrational, they cannot help their reaction to it.

Some people spend all day worrying about sleep and what the night will bring; it can cause problems with concentration and focus as a result. They might be so anxious about going to sleep that they obsess about what they can do to avoid going to sleep.

This fear of sleep can have many causes. It can be a result of experiencing sleep disturbances like sleep paralysis, sleepwalking, or nightmares. It’s more likely to occur in people who’ve experienced trauma. For somniphobes, even thinking about sleep can bring on anxiety symptoms that are hard to manage.

Somniphobia is not the same as sleep anxiety. The former is a fear of sleeping, with symptoms that cause people to avoid sleeping because they worry about something happening to them when they’re asleep. The latter is someone who worries about struggling to sleep and not getting enough sleep. Ironically, both conditions cause insomnia.

Other similar phobias include noctiphobia (fear of the night), nyctophobia (fear of the dark) and thanatophobia (fear of death).

How common is somniphobia?

There are no studies on the number of people affected by somniphobia specifically but it’s thought that around 12.5% of adults have a specific phobia. According to more general statistics, 60% of people in the UK say they sleep badly and only 6% get the recommended eight hours a night. Alarmingly, 31% of the UK population suffers from insomnia. It’s unknown how many of these have somniphobia.

Who is at risk of somniphobia?

Anyone can develop somniphobia, but some people are more prone to it than others. Those most at risk are people with a history of parasomnia.

Parasomnia is an umbrella term for unusual sleep behaviours and problems and there are several types:

• NREM-related – This includes confusional arousal, night terrors, sleep-related eating disorder, sleepwalking and sleep-related sexual abnormal behaviour.
• REM-related – This includes REM sleep behaviour disorder, nightmare disorder and recurrent isolated sleep paralysis.
• Others – This includes bedwetting, sleep-related hallucinations and exploding head syndrome.

Other sleep problems like insomnia can also increase your risk, especially if you have any of the following:

• A history of trauma happening at night (burglary, assault, fire).
• Narcolepsy.
• Generalised anxiety disorder (GAD).
• Panic disorder.
• Sleep apnoea.
• Restless legs syndrome (RLS).

You’re also more at risk if you have a family member with the condition or another specific anxiety or phobia.

Finally, if you have a diagnosed sleep disorder or a serious health problem that has an increased risk of death during sleep (like epilepsy, for instance), you might develop somniphobia.

How to deal with somniphobia

The good news is that you can learn to deal with and overcome somniphobia. Unlike other phobias like galeophobia (a fear of sharks) or ornithophobia (a fear of birds), you cannot avoid sleep as it is essential to our health and wellbeing. What’s more, chronic sleep loss is problematic because it increases other health risks like diabetes, heart disease, stroke, high blood pressure and obesity. As such, somniphobia, more than most other phobias, has a direct impact on a person’s health.

Besides seeking treatment and support, there are things you can do to practise good sleep hygiene to help deal with somniphobia.

These include:

• Taking regular exercise.
• Turning off devices like phones and tablets at least one hour before bedtime.
• Incorporating meditation and mindfulness into daily routines.
• Listening to relaxing music when you go to bed.
• Not looking at emails (especially work ones) or trying to complete tasks too close to bedtime.
• Avoiding nicotine, chocolate and coffee before bed.

What triggers somniphobia?

When you have somniphobia, there can be many triggers. The biggest one is the need to sleep and feeling tired.

Somniphobia can be made worse by:

• Not having a night-time routine. Going to bed at the same time each night despite your phobia will be beneficial.
• Leading a sedentary lifestyle. Exercise is beneficial in many ways. It will support deep sleep and help you sleep better. In terms of the phobia, you’ll be naturally less anxious after vigorous exercise.
• Allowing yourself to nap. Napping can make you less tired of an evening and can make somniphobia worse as you’re lying in bed worrying.
• Caffeine or other stimulants. Caffeine is known to interfere with sleepiness and increases anxiety. As such, it can make somniphobia worse.
• A cluttered, untidy sleep space. If the bedroom is full of clutter, it will heighten anxiety and you won’t be able to relax at night-time.
• Using a screen right up to bedtime. It’s much better to have a wind-down routine that’s the same each evening so you can go through the steps to keep yourself calm. Reading is an excellent pre-sleep activity as it can help take your mind off your racing thoughts.
• Watching, reading or listening to emotionally charged content. Avoid watching the news, reading articles or listening to things that might be upsetting or frightening before bed.
• Stress. Though stress can’t be avoided altogether, it’s important to try and practise stress management and meditation to help deal with it.
• Alcohol. Though many people use alcohol to help them sleep, it can be problematic and cause sleep disturbances.

What are the symptoms of somniphobia?

Somniphobia has lots of different symptoms and individuals are all affected differently.

Some of the psychological and mental health symptoms might include:

• Feeling anxious and scared when thoughts about bedtime or sleep occur.
• Feeling distressed closer to night-time.
• Avoiding sleep and staying up late.
• Experiencing panic attacks at bedtime.
• Being unable to concentrate due to constant worrying and fear about sleep.
• Being irritable and experiencing mood swings.
• Poor memory.

People with somniphobia might also have physical symptoms.

These include:

• Nausea or upset stomach.
• Chest tightness.
• Rapid heart rate.
• Palpitations.
• Sweating.
• Chills or cold sweats.
• Breathing difficulties or hyperventilation.
• Feeling tearful (in children, this might be clinginess, crying, not wanting to be alone and bedtime resistance).
• Restless sleep.
• Being unable to get back to sleep after waking.

Other, less obvious symptoms of somniphobia include observing coping mechanisms like leaving the lights, television, or music on at night as a distraction. Others might start using substances like alcohol.

What causes somniphobia?

No one knows the exact causes of somniphobia and it’s likely to be a combination of several factors. For many people, their somniphobia stems from experiencing nightmares, hallucinations, or sleep paralysis. There are also people who experience this phobia due to developing a fear of dying in their sleep. This could be due to knowing someone has died in their sleep – even though they know the cause wasn’t anything to do with being asleep.

People who suffer from other conditions like PTSD (post-traumatic stress disorder) or another phobia are also more likely to develop somniphobia. PTSD will often cause sleep disturbances and cause people to relive their trauma at night. Thus, to avoid this, the person might avoid sleep or become fearful of it.

Here is some more information about some of the causal factors of somniphobia:

Sleep paralysis

This is a sleep disorder that involves waking from REM sleep with muscles being paralysed. Essentially, the person knows they’re awake, but they cannot move and might experience other hallucinations alongside it. This is a very frightening experience.

Nightmare disorder

This causes vivid, frequent nightmares and leads to distress throughout the day in terms of flashbacks or worry about recurrence.

PTSD – post-traumatic stress disorder

Having a traumatic experience or being diagnosed with PTSD can cause somniphobia. This might be due to worrying about disasters occurring while you’re asleep, like fire or burglary. It’s also linked to a fear of dying.

No clear cause

Some people have somniphobia but there is no clear cause. This could be because the phobia began in childhood and people don’t remember why or when it started.

How is somniphobia diagnosed?

Anyone who suspects they have somniphobia should seek help from their GP.

The healthcare provider will ask some questions that might include:

• How does the fear affect the quality of sleep you’re getting?
• Does the fear distract you from daily tasks?
• Has it lasted over six months?
• Does it interfere with school, work, relationships or other daily responsibilities?
• Does the fear lead to persistent anxiety and stress?
• Is it affecting your mental and/or physical health?

Depending on the severity of the phobia, you might be referred to a specialist.

Diagnostic criteria

The DSM – the Diagnostic and Statistical Manual – that health professionals use lists seven criteria for diagnosing a specific phobia, like somniphobia.

These criteria are:

1. The person has a significant anxiety or fear about the situation or object.

2. Anxiety or fear is always there when the situation or object is present.

3. The person avoids the situation or object actively and will experience anxiety or fear when they are unable to avoid it.

4. The phobia impairs functioning and causes distress.

5. The anxiety and fear have been there for over six months.

6. The level of fear and anxiety is excessive compared to the threat posed by the situation or object.

7. Symptoms are not otherwise better explained by another condition like social anxiety disorder or OCD (obsessive compulsive disorder).

How is somniphobia treated?

The treatment for somniphobia is similar to that of other specific phobias.

You might be recommended one of the following:

Exposure therapy

This is often the most effective treatment for phobias. It means working with a trained therapist to get you used to your fear. For somniphobia, it will help you feel more comfortable with the act of going to sleep.

If you undergo exposure therapy for somniphobia, you will work alongside a therapist and be gradually exposed to the fear. With somniphobia, most people are exposed to it anyway due to their need for sleep. However, exposure therapy will involve discussing the fear, learning relaxation techniques and imagining what a good night’s sleep would feel and look like. You might also be involved in seeing pictures or videos of people asleep.

The next stage will involve taking brief naps with someone present that can wake you up safely. Sometimes exposure therapy will involve spending some time in a sleep lab with a medical professional around to look at how you sleep.

Cognitive behavioural therapy, or CBT

This means talking through your fear with a professional to identify and specify the fears. The therapist will then teach the patient to challenge their distressing thoughts in order to lower their anxiety.

The thoughts explored during CBT might be related to the fear of sleep itself or the fear that’s led to being afraid to sleep, like dying.

The therapist might recommend restricting sleep. This means always going to bed at a specific time and getting out of bed at a set time, irrespective of whether or not or how long you manage to sleep. This process can help to reset a person’s body clock and develop improved sleep patterns.

EMDR – Eye movement desensitisation and reprocessing

This is useful if the person’s fear of sleep is a result of trauma. During EMDR, the person will remember the trauma whilst simultaneously being stimulated by movement. This means processing the trauma is less overwhelming.

Medications

Though there is no specific medication to aid somniphobia, medical professionals might prescribe medicines to help with the symptoms.

These might include:

• Beta blockers to reduce symptoms of anxiety like palpitations or a rapid heart rate.
• Benzodiazepines as a sedative to help reduce symptoms in the short term.

The long-term effects of somniphobia

Because sleep cannot be avoided for health reasons, somniphobes often have health problems caused by sleep deprivation.

They are at an increased risk of:

• Diabetes.
• Depression.
• High blood pressure.
• Stroke.
• Obesity.
• Heart attack.

Besides health problems associated with sleep deprivation, lots of people with somniphobia go on to use and misuse substances. As a result, they have an increased risk of substance use disorder.

Final thoughts

Somniphobia is distressing. Unlike other specific phobias, sleep can not be avoided, which means people can run into problems sooner than with other phobias.

The best advice for anyone suffering from somniphobia would be to speak to their GP to get help and be referred for treatment. Lots of people do manage to overcome specific phobias like somniphobia and so treatment is certainly worth pursuing.