Scared of going to sleep
What is it, Causes, Symptoms & Treatment
Overview
What is sleep anxiety?
Sleep anxiety is fear or worry about going to sleep. You may be apprehensive about not falling asleep or not being able to stay asleep. Some people also have a distinct phobia, or fear, about sleep called somniphobia. They may think something bad will happen to them while they sleep, or that they shouldn’t sleep because they need to stay alert and watchful.
Sleep and psychiatric disorders, such as anxiety, often go hand in hand. If you have an anxiety disorder, you may find it hard to fall asleep or stay asleep. Similarly, if you have a sleep disorder, you might feel anxious or fearful before bed because you’re afraid you won’t get the rest you need. One condition usually makes the other worse, so it can feel like a never-ending cycle.
Who gets sleep anxiety?
Sleep anxiety can affect adults, teens and children. You may be more likely to develop anxiety at night if you have a sleep disorder such as:
- Insomnia.
- Narcolepsy.
- Restless legs syndrome (RLS).
- Sleep apnea.
- Sleepwalking.
People with the following mental health disorders may also develop nighttime anxiety:
- Anxiety disorders.
- Bipolar disorder.
- Depression.
- Drug addictions or alcoholism.
- Panic disorder.
- Post-traumatic stress disorder (PTSD).
- Schizophrenia.
How common is sleep anxiety?
Anxiety is the most common mental health disorder in the U.S., affecting about 40 million people. Research suggests that most people with mental health disorders such as anxiety also have some form of sleep disruption.
Symptoms and Causes
What causes sleep anxiety?
Anxiety is a natural part of being human. We’re meant to feel afraid or worried in dangerous situations. Stress and anxiety trigger our bodies to release hormones that help us react quickly to escape harm. But if you have chronic anxiety, you might feel stress or worry all the time.
You may feel fearful of everyday situations like driving to work or even falling asleep.
Chronically high levels of these hormones, especially before sleep, can make it hard for your body to relax. You may have difficulty falling asleep. If you do fall asleep, you may wake up during the night with stressful or worrisome thoughts and not be able to fall asleep again.
The combination of a anxiety and insomnia can also be caused by a condition where there isn’t enough thyroid hormone in your bloodstream and your metabolism slows down (hypothyroidism).
Research suggests that anxiety can affect rapid eye movement (REM) sleep. This is the phase of sleep when you tend to have vivid dreams. If you have anxiety, the dreams may be disturbing or turn into nightmares that wake you.
Just as anxiety can affect sleep, sleep can affect anxiety. Sleep anxiety is a common characteristic of insomnia, wherein the individual begins to experience anxiety during the day and evening about poor sleep, which may help cause another night of bad sleep.
What are the symptoms of sleep anxiety?
When you can’t sleep due to anxiety, you may experience behavioral changes, including:
- Feelings of being overwhelmed.
- Inability to concentrate.
- Irritability.
- Nervousness.
- Restlessness.
- Sense of impending danger or doom.
Physical effects of anxiety before bed may include:
- Digestive problems.
- Fast heart rate.
- Rapid breathing.
- Sweating.
- Tense muscles.
- Trembling.
Some people also have nocturnal panic attacks. A panic attack is a sudden, intense burst of extreme fear. Nocturnal panic attacks only happen at night, and often wake you from sleep.
Diagnosis and Tests
How is sleep anxiety diagnosed?
Your healthcare provider performs a physical exam, reviews your medical history and evaluates your symptoms. They may ask you questions like:
- Do you eat or drink anything before bed?
- Does your anxiety always occur before bed?
- How long does it take you to fall asleep?
- How often do you wake up during the night?
- What activities do you do before bed?
What tests help confirm a sleep anxiety diagnosis?
In some cases, your provider may do a sleep study to find out if you have a sleep disorder.
Also called polysomnography, a sleep study is a test where you stay overnight in a sleep lab. Your healthcare provider evaluates how your body works during sleep by checking your:
- Blood oxygen levels.
- Body positioning.
- Breathing.
- Electrical activity in your brain.
- Eye movements.
- Heart rates and rhythms.
- Leg movements.
- Sleep stages.
- Snoring or other noises you make during sleep.
Management and Treatment
How is sleep anxiety treated?
There are a variety of ways to manage sleep anxiety, including:
- Cognitive behavior therapy (CBT).
- Healthy sleep habits (sleep hygiene).
- Medication.
How does cognitive behavioral therapy treat sleep anxiety?
CBT is a form of psychotherapy, or talk therapy. It teaches you how to change your behavior by changing the way you think. It’s a common treatment for people with anxiety. A special form of CBT called cognitive behavior therapy for insomnia (CBTI) focuses on helping people who have insomnia.
This therapy can take anywhere from six to 12 weeks to produce results.
During CBT or CBTI, you may learn to:
- Avoid behaviors or environmental factors that trigger your anxiety or make sleeping difficult.
- Better understand how sleep and anxiety affect your brain and the rest of your body.
- Change negative or inaccurate thinking about bedtime or sleep.
Your therapist may teach you how to sleep with anxiety by using biofeedback. Biofeedback trains you to control your body’s functions. You learn to relax your muscles, regulate your breathing, lower your heart rate and focus your attention. Your therapist might use special sensors to measure these bodily functions, or they may give you exercises, such as deep breathing and meditation, to do at home.
How can healthier sleep habits treat sleep anxiety?
Sleep habits, or sleep hygiene, are your routines around bedtime that can affect your sleep. Your healthcare provider may ask you to keep a sleep diary for several weeks.
This is a daily log of your sleep habits. It can help identify things that might make it harder for you to fall asleep or stay asleep.
Some common ways to improve your sleep hygiene include:
- Avoid drinking lots of fluids before bed, especially alcohol.
- Do relaxing activities before bed, such as meditation or listening to soft, peaceful music.
- Don’t consume caffeine in the late afternoon or evening.
- Don’t go to bed unless you feel sleepy.
- Go to bed and wake up at the same time each day.
- If you don’t fall asleep within 20 minutes, get out of bed.
- Make sure your bedroom is comfortable, quiet and softly lit.
- Only use your bed for sleep and sex. For example, avoid watching television or doing work in bed.
- Set a goal of getting at least seven hours of sleep every night.
- Stop using electronic devices at least 30 minutes before bedtime.
- Try not to eat right before bedtime. If you’re hungry, have a light snack and not a big meal.
How can medication treat sleep anxiety?
Your healthcare provider may recommend medication to treat anxiety or other mental health disorders. Medication can also help improve the symptoms of sleep-related disorders such as restless legs syndrome or insomnia.
But some medications might actually increase your anxiety or make sleeping harder when you first start taking them. If you experience these side effects, talk to your healthcare provider. Many over-the-counter sleep aids can also be habit-forming. Don’t start any medication for anxiety or sleep without your healthcare provider’s supervision.
Prevention
How can I prevent sleep anxiety?
You may be able to reduce your risk of sleep anxiety by:
- Eating a healthy diet.
- Exercising regularly.
- Practicing good sleep hygiene.
- Taking medications for mental health disorders or sleep disorders as prescribed by your healthcare provider.
Outlook / Prognosis
What’s the prognosis (outlook) for people with sleep anxiety?
Most people can successfully manage their sleep anxiety with the right treatments.
But remember that some treatments, such as medication or CBT, can take time to be effective. Don’t stop treatment prematurely if you think it isn’t working.
Are there long-term complications of sleep anxiety?
Prolonged anxiety or lack of sleep can affect your body in many ways. Sleep anxiety puts you at a higher risk for the following long-term complications:
- Diabetes.
- Heart attack.
- Heart disease.
- Heart failure.
- High blood pressure.
- Arrhythmia (irregular heartbeat).
- Obesity.
- Stroke.
Living With
How can I make living with sleep anxiety easier?
Anxiety or sleep problems can affect every aspect of your life, from your performance at work to your interactions with others. It may help to talk about your sleep anxiety with a therapist, co-workers, friends or loved ones. Support groups can also connect you to a community of people dealing with similar experiences.
A note from Cleveland Clinic
Sleep anxiety is a feeling of fear or stress about falling asleep or staying asleep.
Sleep problems and mental health disorders such as anxiety are closely intertwined. One can often make the other worse, so it can feel like a never-ending cycle. But anxiety and sleep problems are both treatable. Talk to your healthcare provider about your symptoms and work together to build the right treatment plan. Common treatments include cognitive behavioral therapy (CBT), good sleep hygiene and medication.
What is it, Causes, Symptoms & Treatment
Overview
What is sleep anxiety?
Sleep anxiety is fear or worry about going to sleep. You may be apprehensive about not falling asleep or not being able to stay asleep. Some people also have a distinct phobia, or fear, about sleep called somniphobia. They may think something bad will happen to them while they sleep, or that they shouldn’t sleep because they need to stay alert and watchful.
Sleep and psychiatric disorders, such as anxiety, often go hand in hand. If you have an anxiety disorder, you may find it hard to fall asleep or stay asleep.
Similarly, if you have a sleep disorder, you might feel anxious or fearful before bed because you’re afraid you won’t get the rest you need. One condition usually makes the other worse, so it can feel like a never-ending cycle.
Who gets sleep anxiety?
Sleep anxiety can affect adults, teens and children. You may be more likely to develop anxiety at night if you have a sleep disorder such as:
- Insomnia.
- Narcolepsy.
- Restless legs syndrome (RLS).
- Sleep apnea.
- Sleepwalking.
People with the following mental health disorders may also develop nighttime anxiety:
- Anxiety disorders.
- Bipolar disorder.
- Depression.
- Drug addictions or alcoholism.
- Panic disorder.
- Post-traumatic stress disorder (PTSD).
- Schizophrenia.
How common is sleep anxiety?
Anxiety is the most common mental health disorder in the U.S., affecting about 40 million people. Research suggests that most people with mental health disorders such as anxiety also have some form of sleep disruption.
Symptoms and Causes
What causes sleep anxiety?
Anxiety is a natural part of being human. We’re meant to feel afraid or worried in dangerous situations. Stress and anxiety trigger our bodies to release hormones that help us react quickly to escape harm. But if you have chronic anxiety, you might feel stress or worry all the time. You may feel fearful of everyday situations like driving to work or even falling asleep.
Chronically high levels of these hormones, especially before sleep, can make it hard for your body to relax. You may have difficulty falling asleep. If you do fall asleep, you may wake up during the night with stressful or worrisome thoughts and not be able to fall asleep again.
The combination of a anxiety and insomnia can also be caused by a condition where there isn’t enough thyroid hormone in your bloodstream and your metabolism slows down (hypothyroidism).
Research suggests that anxiety can affect rapid eye movement (REM) sleep.
This is the phase of sleep when you tend to have vivid dreams. If you have anxiety, the dreams may be disturbing or turn into nightmares that wake you.
Just as anxiety can affect sleep, sleep can affect anxiety. Sleep anxiety is a common characteristic of insomnia, wherein the individual begins to experience anxiety during the day and evening about poor sleep, which may help cause another night of bad sleep.
What are the symptoms of sleep anxiety?
When you can’t sleep due to anxiety, you may experience behavioral changes, including:
- Feelings of being overwhelmed.
- Inability to concentrate.
- Irritability.
- Nervousness.
- Restlessness.
- Sense of impending danger or doom.
Physical effects of anxiety before bed may include:
- Digestive problems.
- Fast heart rate.
- Rapid breathing.
- Sweating.
- Tense muscles.
- Trembling.
Some people also have nocturnal panic attacks.
A panic attack is a sudden, intense burst of extreme fear. Nocturnal panic attacks only happen at night, and often wake you from sleep.
Diagnosis and Tests
How is sleep anxiety diagnosed?
Your healthcare provider performs a physical exam, reviews your medical history and evaluates your symptoms. They may ask you questions like:
- Do you eat or drink anything before bed?
- Does your anxiety always occur before bed?
- How long does it take you to fall asleep?
- How often do you wake up during the night?
- What activities do you do before bed?
What tests help confirm a sleep anxiety diagnosis?
In some cases, your provider may do a sleep study to find out if you have a sleep disorder. Also called polysomnography, a sleep study is a test where you stay overnight in a sleep lab. Your healthcare provider evaluates how your body works during sleep by checking your:
- Blood oxygen levels.
- Body positioning.
- Breathing.
- Electrical activity in your brain.
- Eye movements.
- Heart rates and rhythms.
- Leg movements.
- Sleep stages.
- Snoring or other noises you make during sleep.
Management and Treatment
How is sleep anxiety treated?
There are a variety of ways to manage sleep anxiety, including:
- Cognitive behavior therapy (CBT).
- Healthy sleep habits (sleep hygiene).
- Medication.
How does cognitive behavioral therapy treat sleep anxiety?
CBT is a form of psychotherapy, or talk therapy. It teaches you how to change your behavior by changing the way you think. It’s a common treatment for people with anxiety. A special form of CBT called cognitive behavior therapy for insomnia (CBTI) focuses on helping people who have insomnia. This therapy can take anywhere from six to 12 weeks to produce results.
During CBT or CBTI, you may learn to:
- Avoid behaviors or environmental factors that trigger your anxiety or make sleeping difficult.
- Better understand how sleep and anxiety affect your brain and the rest of your body.
- Change negative or inaccurate thinking about bedtime or sleep.
Your therapist may teach you how to sleep with anxiety by using biofeedback. Biofeedback trains you to control your body’s functions. You learn to relax your muscles, regulate your breathing, lower your heart rate and focus your attention. Your therapist might use special sensors to measure these bodily functions, or they may give you exercises, such as deep breathing and meditation, to do at home.
How can healthier sleep habits treat sleep anxiety?
Sleep habits, or sleep hygiene, are your routines around bedtime that can affect your sleep. Your healthcare provider may ask you to keep a sleep diary for several weeks. This is a daily log of your sleep habits. It can help identify things that might make it harder for you to fall asleep or stay asleep.
Some common ways to improve your sleep hygiene include:
- Avoid drinking lots of fluids before bed, especially alcohol.
- Do relaxing activities before bed, such as meditation or listening to soft, peaceful music.
- Don’t consume caffeine in the late afternoon or evening.
- Don’t go to bed unless you feel sleepy.
- Go to bed and wake up at the same time each day.
- If you don’t fall asleep within 20 minutes, get out of bed.
- Make sure your bedroom is comfortable, quiet and softly lit.
- Only use your bed for sleep and sex. For example, avoid watching television or doing work in bed.
- Set a goal of getting at least seven hours of sleep every night.
- Stop using electronic devices at least 30 minutes before bedtime.
- Try not to eat right before bedtime. If you’re hungry, have a light snack and not a big meal.
How can medication treat sleep anxiety?
Your healthcare provider may recommend medication to treat anxiety or other mental health disorders. Medication can also help improve the symptoms of sleep-related disorders such as restless legs syndrome or insomnia.
But some medications might actually increase your anxiety or make sleeping harder when you first start taking them. If you experience these side effects, talk to your healthcare provider. Many over-the-counter sleep aids can also be habit-forming. Don’t start any medication for anxiety or sleep without your healthcare provider’s supervision.
Prevention
How can I prevent sleep anxiety?
You may be able to reduce your risk of sleep anxiety by:
- Eating a healthy diet.
- Exercising regularly.
- Practicing good sleep hygiene.
- Taking medications for mental health disorders or sleep disorders as prescribed by your healthcare provider.
Outlook / Prognosis
What’s the prognosis (outlook) for people with sleep anxiety?
Most people can successfully manage their sleep anxiety with the right treatments. But remember that some treatments, such as medication or CBT, can take time to be effective. Don’t stop treatment prematurely if you think it isn’t working.
Are there long-term complications of sleep anxiety?
Prolonged anxiety or lack of sleep can affect your body in many ways. Sleep anxiety puts you at a higher risk for the following long-term complications:
- Diabetes.
- Heart attack.
- Heart disease.
- Heart failure.
- High blood pressure.
- Arrhythmia (irregular heartbeat).
- Obesity.
- Stroke.
Living With
How can I make living with sleep anxiety easier?
Anxiety or sleep problems can affect every aspect of your life, from your performance at work to your interactions with others. It may help to talk about your sleep anxiety with a therapist, co-workers, friends or loved ones. Support groups can also connect you to a community of people dealing with similar experiences.
A note from Cleveland Clinic
Sleep anxiety is a feeling of fear or stress about falling asleep or staying asleep. Sleep problems and mental health disorders such as anxiety are closely intertwined.
One can often make the other worse, so it can feel like a never-ending cycle. But anxiety and sleep problems are both treatable. Talk to your healthcare provider about your symptoms and work together to build the right treatment plan. Common treatments include cognitive behavioral therapy (CBT), good sleep hygiene and medication.
How to overcome the fear of sleep (somniphobia)?
Some people have a strong and deep fear of objects, beings, circumstances, events that others seem relatively harmless. For example, a person may be pathologically afraid of spiders, clowns, heights, or something else that in itself does not pose any threat and therefore does not cause unlimited, uncontrollable and unreasonable fear in other people.
Such strong fears of seemingly neutral objects or situations are called specific (isolated) phobias. Some of the specific phobias can significantly affect our daily life. One of them is somniphobia, it is also hypnophobia or clinophobia. People suffering from somniphobia are afraid to fall asleep - just the thought that they will have to sleep at night terrifies them.
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The mere thought of sleep terrifies a person with somniphobia
If for most of us a cozy bed and a warm blanket is an opportunity to relax, get away from problems and fall asleep peacefully, then for those suffering from somniphobia, the upcoming night's rest is not a reward, but a punishment tantamount to execution. No wonder they are terrified of falling asleep. The result is a chronic lack of sleep, which negatively affects the quality of life, psyche and physical health - memory is disturbed, immunity weakens, weight increases, and a number of other serious problems arise. nine0003
Fear of sleep - what is it? How to understand that you have somniphobia and how it can be caused?
Fear of sleep - what is it?
A somniphobic sufferer experiences extreme anxiety at the mere thought of sleep. Since the process of going to sleep and sleep itself is associated with fear, stress, horror, such a person falls asleep with great difficulty, even if he is very tired.
And if he still manages to get some sleep, the rest turns out to be fragmented and of poor quality.
A person cannot fall asleep, even if he is very tired nine0003
Signs and symptoms
Symptoms and manifestations of fear of sleep are usually divided into psychological and physical.
Psychological symptoms of somniphobia:
- Increasing distress as bedtime approaches.
- Feeling of anxiety and fear at the thought of sleep.
- Panic attacks occurring at the time when it is necessary to go to bed.
- Memory deterioration.
- Irritability or mood swings. nine0026
- Difficulty concentrating on anything other than worrying about sleep.
These obsessive thoughts and stressful conditions, combined with lack of sleep, have a strong negative effect on the body.
Physical symptoms of somniphobia:
- Nausea resulting from and against stress.
- Palpitations and oppression of the chest at the thought of sleep.
- Sweating, hyperventilation (rapid breathing) or chills at the thought of sleeping. nine0026
- Increased levels of stress hormones such as cortisol.
- In children - crying, refusal to sleep.
- Chronic fatigue and daytime sleepiness.
Daytime sleepiness and chronic fatigue are a consequence of chronic lack of sleep in somniphobia
Many of the above symptoms are very similar to those of panic disorder. The key difference between panic disorders and phobias is that panic disorders are not as closely related to a specific object or situation. Like the manifestations of any specific phobia, the symptoms of somniphobia appear only in a situation that causes fear, or when approaching it. nine0003
Why might a person be afraid to fall asleep?
Experts don't know exactly why people develop phobias. Including the mechanism of development of somniphobia is not completely clear.
Phobias in general are believed to arise from a combination of genetic and acquired factors.
They usually develop during childhood. The likelihood of their occurrence may be higher if close family members also suffer from phobias - due to hereditary predisposition or due to common life experience. Phobias are more common in women and may exist alongside other anxiety disorders. nine0003
Most experts say that somniphobia is not related to sleep itself - a person is afraid of something that might happen during a night's rest. Fear of sleep and falling asleep can be caused by various factors and is often the result of the problems listed below.
Chronic nightmares
Most of us sometimes have bad dreams, but some people have them quite often. Night terrors can feel so real that the person does not want to go to bed for fear of having similar dreams again. In particular, because of the fear of nightmares, children are often afraid to go to bed. nine0003
Nightmares often cause somniphobia in a child
Depression and anxiety
People who suffer from an anxiety or depressive disorder may also develop somniphobia.
Such a person often experiences a general fear of sleep and at night, he may have difficulty falling asleep, nightmares. In the daytime, it is easier for him to switch from negative thoughts to solving work or household tasks, communication. There are fewer distractions at night than during the day, so his anxiety increases at night. nine0003
Increased symptoms of depression and anxiety at night
In addition, people with anxiety and depressive disorders often worry about the fact that they will not be able to control themselves during sleep.
Traumatic incidents
Fear of sleep may develop after a psychotrauma. For example, after the death of a loved one, a physical attack, or any other experience that leads to PTSD (post-traumatic stress disorder). nine0003
The tendency of people with PTSD to develop somniphobia has objective reasons - this disorder is often accompanied by nightmares, sleepwalking or other sleep disturbances, which may be accompanied by a general fear of sleep.
The loss of a loved one is a powerful psychotraumatic factor
Symptoms of post-traumatic stress disorder often flare up at night - fear of recurrence of episodes of exacerbations and increased vulnerability due to lack of control over one's thoughts during sleep also become causes of hypnophobia. nine0003
Sleepwalking
Sleepwalking or somnambulism is the most common parasomnia, in which a person, continuing to sleep, gets up and walks. When traveling at night, somnambulists are not aware of their actions, so the disease is usually first detected by a family member, loved one, or even a random roommate (for example, in a sanatorium or hotel). When a sleepwalker learns about his problem, he usually feels embarrassed about what he did during sleep. He is also worried that this will happen again in the future. In this regard, a person suffering from sleepwalking is afraid to go to bed. nine0003
Sleepwalkers may develop somniphobia
Some somnambulists are injured during unconscious night wanderings, sometimes so severe that they have to be hospitalized.
The fear of getting seriously injured can also develop into a fear of sleep, especially if a person lives alone.
Fear of death
Some people are afraid to fall asleep and never wake up again. Even in the absence of any reason whatsoever to die in a dream, the fear of death can cause somniphobia. nine0003
If you have obstructive sleep apnea (OSA), you may also be afraid of dying at night. For example, sleep apnea sufferers sometimes have an unreasonable fear that their CPAP machine will fail, causing them to stop breathing and never resume.
A person with OSAS may be afraid that the CPAP machine will break, they will suffocate and die in their sleep.
Sleep paralysis
Sleep paralysis is a sleep disorder in which a person wakes up and cannot move, as if paralyzed: the mind is awake, but the body is at rest and "does not obey the orders" of the brain. Although doctors emphasize that these episodes of immobility are harmless, they can be very frightening for people experiencing them.
nine0003
In addition, such patients often report seeing or hearing strange, frightening hallucinations during an attack. It also provokes the appearance of fear before falling asleep, which can lead to the development of anxiety during sleep, awakening and fear of falling asleep again.
Sleep talk
Sleep talk is common and usually harmless. When talking at night, people usually say something incomprehensible or meaningless. However, if you are keeping a secret or worrying about revealing something intimate while unconscious, this can lead to a phobia. nine0003
Horror movies
Watching a scary movie, especially before going to bed, can make your mind run through potential dangers that could happen during the night. These fears range from being attacked by fictional monsters to more realistic scenarios such as burglary.
Watching a horror movie at night is the path to somniphobia
Possible consequences of somniphobia
Like any other phobia, the fear of sleep affects the behavior and personality of a person, negatively affects his social activity.
However, the effects of somniphobia are not limited to this. Chronic sleep deprivation significantly impairs quality of life by causing:
Daytime sleepiness . Not getting enough sleep at night, you will inevitably feel tired the next day, you will constantly be sleepy.
Chronic fatigue . The longer you live with this phobia, the more likely you are to develop chronic fatigue syndrome.
Mood swings . Lack of sleep negatively affects mood, making us irritable and quick-tempered.
Problems with memory, attention, coordination . Without proper sleep, the brain does not have time to process the information received and “place it on the shelves”. As a result, cognitive abilities are impaired, including memory impairment, the ability to perceive and analyze new information. In addition, dizziness and difficulty concentrating may occur.
Violation of attention and decreased reaction due to chronic sleep deprivation can provoke an accident
Treatment
Not every phobia needs treatment, but they should be taken seriously.
If you do not pay due attention to your unreasonable obsessive fears, they can limit your life, up to the development of extreme anxiety and deep depression. nine0003
It is especially important to get rid of a phobia if it leads to a lack of sleep. Sleep is vital for brain health, heart function, weight control, and lack of it can seriously affect your well-being. If you manage to take the right steps to overcome somniphobia and improve your sleep, this will ultimately lead to better overall health.
Mild somniphobia can be started with home treatments.
Improve your sleep hygiene
Your sleep problems may be due to poor sleep hygiene. Improve it by following simple rules:
- Always keep a schedule - go to bed at the same time. This will help your "internal clock" run smoothly and make it easier to fall asleep.
- Do not drink coffee before bed.
- Try to make your bedroom as comfortable and associated with sleep as possible.
Remove all irritants from it - TV, computer, smartphone, other sources of noise, light, entertainment. Curtain the window with blackout curtains, change the uncomfortable bed and bedding. Adjust the air temperature - you should not be cold or hot. nine0026 - Try calming yourself before bed with a ritual such as drinking herbal tea, reading a book, or taking a bath.
Regular drinking of herbal tea before bed can help get rid of fear of sleep
Unfortunately, improving sleep hygiene alone is unlikely to cure somniphobia.
Avoid "treatment" with alcohol or drugs
Experts advise against overcoming the fear of falling asleep and sleeping with alcohol and drugs. Their effect is very short-lived, incomplete and incorrect. As a result, you will shave a bad habit, the problem will not go away, and your health will be undermined. nine0003
Keep a diary
Write down your dreams and feelings during sleep, as well as thoughts, feelings, and other factors that increase or decrease anxiety in a diary.
This will help you find the sources of your fear and how to deal with them.
Write down your feelings before bed and during sleep in a diary - this will help to cope with a phobia
You are not alone
You may be ashamed of your phobia, feel like an outcast. It is important to remember that you are not alone. First, there are other people who, just like you, struggle with the fear of sleep. Second, a trusted friend or family member can be a great source of support if you tell them about your condition. nine0003
The support of a loved one can help reduce the fear of sleep
Use relaxation techniques
Deep breathing, muscle relaxation, or guided imagery can help relieve anxiety before bed.
- If you've tried to manage your sleep anxiety on your own and haven't gotten better, it may be time to seek professional help from your doctor. He will conduct the necessary diagnostics and determine how best to solve your problem. nine0130
Is there a cure for somniphobia?
There are no specific drugs for the treatment of phobias, but some drugs can reduce anxiety and improve sleep.
As a rule, medication in the treatment of fear of sleep is combined with various psychotherapeutic methods.
Psychotherapeutic methods of dealing with fear of sleep
Exposure therapy . The principle “look into the eyes of your fear” is used - in a controlled environment, a situation is simulated that causes an attack of hypnophobia. The duration of this situation (exposure) is determined individually and can range from 40 to 90 minutes. The result of such long-term immersion in your fear under the supervision of a psychotherapist while working on reducing the level of anxiety is a gradual getting rid of the fear of sleep.
In the treatment of somniphobia, psychotherapeutic methods are used
Cognitive Behavioral Therapy (CBT) . This psychotherapeutic technique focuses on changing the relationship between your thoughts, feelings and behavior. Numerous studies show that, through the use of cognitive rewiring techniques (identifying unwanted thoughts, eliminating them, and generating beneficial ones) and changing behavior, CBT is effective in helping people reduce anxiety, fear, and panic.
Although cognitive behavioral therapy is not a first-line treatment for specific phobias, it can be a safe and effective option for adults or children struggling with somniphobia. nine0003
Frequently asked questions
What causes somniphobia?
Like all other specific phobias, somniphobia is caused either by a genetic predisposition or by a traumatic “triggering” event.
Are sleep phobias related to insomnia?
Yes, these two phenomena are connected. Fear of sleep can lead to insomnia.
What causes untreated somniphobia and its consequence - lack of sleep?
Prolonged lack of sleep can lead to serious health problems, including increased risk of:
- depression;
- diabetes;
- heart attack;
- hypertension;
- obesity;
- stroke.
Why am I afraid to sleep alone?
Perhaps this is due to the nightmares that haunt you at night.
Or you may feel fear if you used to sleep with a partner, and now you have to sleep alone. Similar problems occur in people who are forced to fall asleep in a new place - the so-called "first night effect", when one half of the brain is resting, while the other "remains alert." nine0003
Do children have somniphobia and what can be done about it?
Children, like adults, may experience sleep anxiety, such as fear of the dark or imaginary monsters. Take action - make your child feel safe and secure:
- do not allow him to watch scary TV shows, cartoons and movies;
- read good bedtime stories to your baby;
- put a night light in the nursery with a soft, dim light or slightly open the door of the room to the illuminated corridor; nine0026
- Allow your child to sleep with something comfortable, soothing, such as a favorite soft toy.
If the problem persists, contact a child psychologist or psychotherapist.
Insomnia is not terrible - the fear of it is dangerous | Kovrov G.
V., Posokhov S.I. Sleep disturbance is one of the most common and important problems of modern medicine. Sleep dissatisfaction occurs in 45% of the population. Poor sleep is the cause of a poor quality of life; many diseases develop during sleep, and disturbed sleep modifies their course. It is these facts that make it more efficient to develop sleep medicine. The most striking manifestation of sleep disorders is insomnia [1]. Insomnia is defined as a problem of falling asleep, maintaining sleep, with nocturnal or early awakenings, combined with feelings of lack of recovery after sleep, with a violation of the functional state of a person during the daytime (increased drowsiness, decreased performance, attention and memory, etc.). nine0275 The close relationship between poor sleep and the somatic state of the body today is beyond doubt. Previously, it was shown [2] that a high (up to 73.7%) prevalence of sleep disorders was found in patients undergoing inpatient treatment in the city clinical hospital.
Sleep disorders in patients with various diseases are also combined with depressive syndrome [3] and autonomic disorders, and more severe sleep disorders are observed in patients of older age groups. Currently, much attention is paid to the diagnosis of sleep disorders in cardiovascular pathology, endocrine diseases, pain syndrome and other neurological and somatic disorders. nine0275 Despite the fact that the principles of diagnosis and treatment of insomnia are described in detail in the literature, in outpatient and inpatient practice, the doctor faces several problems in diagnosing and prescribing treatment.
The main problem is the identification of hidden sleep disorders, which usually occur against the background of somatic and neuropsychiatric diseases [4]. In a situation where the patient actively complains about poor sleep, there are no diagnostic problems. But what to do with those patients who believe that poor sleep is associated with poor health, and sees no point in reporting this to the doctor.
But dissatisfaction with the quality of sleep in patients who do not complain about sleep may not differ from that of those who complain [4]. Undoubtedly, the task of the physician is to actively identify symptoms of poor sleep efficiency in such patients. High activity of complaints about poor sleep quality in patients may indicate that dysfunctional beliefs about their sleep have been formed or are being formed, which, from the point of view of psychologists, have a negative impact on treatment [5, 6]. Patients are generally convinced that all their psychological and somatic problems are due to poor sleep. This causes an increase in the level of anxiety, the development of fear of bed and the night in general. This is where patients' fear of insomnia does more harm than insomnia itself, leading to "bed anxiety." This is a very difficult category of patients. nine0275 And others believe that their poor sleep is not so bad as to complain. Thus, patients protect themselves from the appearance of negative thoughts, calming themselves at the same time, without giving any information to the doctors.
This is especially important when a general practitioner is treating, for example, arterial hypertension, and the absence of active complaints about poor sleep leads to ignoring the issue of sleep correction. It is still necessary to improve the quality of sleep if there are at least some manifestations of his disorder. The literature describes cases of improvement in the course of the underlying disease with the correction of insomnia. In particular, it is known that the use of hypnotics (zopiclone, melatonin) leads to a decrease in blood pressure against the background of improved sleep [3, 7, 8]. nine0275 So, if there is minimal suspicion of poor sleep quality in patients with any disease, it is necessary to clarify the nature of the violations and take measures to improve sleep, even if not all causes of insomnia are immediately clear.
To clarify the causes of insomnia, it is first of all important to assess the patient's psychological state (levels of anxiety, depression, dysfunctional beliefs).
Such diagnostics makes it possible not only to choose the appropriate treatment, but also to predict the effectiveness of curation. How many times have we met with patients who come to the doctor with ready-made attitudes and “recipes” for how they should be treated? Ready-made "recipes from patients" are sometimes useful, because they allow you to take into account the positive or negative experience of previous treatment, and sometimes they interfere greatly, especially when patients insist on their concepts and do not want to listen to the doctor. nine0275 The appointment of polysomnography performed in sleep centers, in particular, when making a diagnosis of insomnia, does not make sense at all, since the diagnosis of "insomnia" is a clinical concept. But in case of differential diagnosis with other forms of sleep disorders, clinically unclear causes of sleep disorders, long course and poor curability, the question of objectifying sleep disorders by polysomnography should be raised [9].
In the treatment of insomnia, regardless of the causes that caused it, the method of cognitive behavioral therapy is the most promising today [6, 10]. Of course, full-fledged psychotherapeutic assistance is difficult to implement. However, in outpatient practice at the reception, a number of simple but effective rules can be proposed:
1. Go to bed later. This recommendation is due to the fact that patients with insomnia, due to fear of not falling asleep, try to go to bed early, sometimes even at 21.00, in order to get ready for bed and fall asleep at 23–24.00, which violates the principles of sleep hygiene and leads to an increase in the time spent in bed.
2. Wake up earlier (waking up late is associated with patients' desire for sleep, but is also harmful, although early rise may be associated with increased anxiety in patients).
3. Do not go to bed and do not sleep during the day. nine0275 It is important to note that the high therapeutic effect of these simple recommendations will be significant only if they are regularly followed for a long time.
And not always, unfortunately, there is compliance or mutual understanding between the doctor and the patient, in the absence of which the effectiveness of the above methods can be significantly reduced [10].
When starting to prescribe drugs to correct sleep disorders, the doctor is faced with two extremes: either the patient has never taken sleeping pills, despite the chronic course of insomnia, or he has tried everything that is produced by pharmaceutical companies. nine0275 In the first case, treatment should begin with the safest preparations, in particular, with herbal remedies containing sedatives (valerian, motherwort, mint, esholcia, etc.). It is necessary to use phytotherapeutic preparations during the day in the morning and for a long time. It is very important to explain to the patient that drugs with a calming effect, although they are used to improve sleep, it is advisable to take them not only at night, but also during the daytime to relieve increased excitability and reduce anxiety.
At the age of over 55, melatonin is widely used for the treatment of insomnia [11]. Its safety and effectiveness have been shown in various studies. Recent studies have demonstrated its greatest effectiveness in patients with a low level of anxiety - both in patients with concomitant somatic pathology (hypertension, gastric ulcer, etc.), and without any diseases. nine0275 Prescribing other sleeping pills may have a number of limitations due to possible side effects. But their high efficiency in relation to "sleep" psychologically is undoubtedly higher. This can sometimes be important for a patient who, while taking sleeping pills, seems to him to have a real dream. All these drugs cannot be prescribed for a long time, but sometimes it is important to get a short-term effect in order to gain time to clarify the features of insomnia, while the patient does not develop fear of bed (one of the important and unpleasant symptoms of insomnia). nine0275 Known sleeping pills in most cases are GABA-ergic drugs that affect the course of slow sleep and reduce nocturnal awakenings.
Unfortunately, there is not enough information in the literature to predict the effect of a hypnotic drug on the sleep-wake cycle, depending on the individual characteristics of the organism or the presence of a concomitant disease. This significantly complicates the problem of choosing a drug, and doctors have to rely only on their experience in this matter. nine0275 But among all sleeping pills there is a drug that is fundamentally different in its mechanism of action - Donormil [12, 13]. Being a blocker of histamine receptors, it does not activate the sleep system, but depresses the wakefulness system. This fundamental difference from most hypnotic drugs allows Donormil to be more widely used in the correction of insomnia both as monotherapy and in combination with other hypnotic drugs (the mechanism of the hypnotic effect of which does not intersect) to cancel or replace an ineffective drug. This makes it a versatile sleep aid of its kind. Of course, Donormil also has a number of disadvantages due to the presence of contraindications and rarely insufficient effectiveness.
nine0275 In the event that a physician is faced with difficult-to-treat patients who have "tried everything", it is extremely important to determine the presence or absence of serious mental disorders. In practice, however, it turns out that such patients either were treated by psychiatrists (who, according to the patients, did not help or helped partially), or do not want to go to psychiatrists even for a consultation. In this difficult situation, it is still necessary to try to refer such patients to psychiatrists. Treating "insomnia" on your own can become a heavy burden. And if you can still work with patients who have a schizoid mentality, then with patients who have severe depression, the treatment of "insomnia" even with the help of antidepressants can be simply dangerous because of the risk of suicide. nine0275 Thus, it is possible to introduce the principle of sleep medicine "healthy sleep - a healthy body" into general medical practice only using the basics of sleep hygiene and other approaches of cognitive-behavioral psychotherapy.
