What Is Somniphobia?

Introduction

Sleep is a fickle friend of humankind. While some of us have no trouble falling asleep as soon as our heads hit the pillow, there are those of us who also have real problems falling asleep. There are a variety of sleep disorders that have been studied and researched for decades, one of them being somniphobia. In this article, we’re going to breakdown everything you need to know about somniphobia. We’ll explore what it is, some common symptoms, who is likely to get it, and much more! So, read on to learn everything there is to know about somniphobia.

What Is Somniphobia?

Somniphobia is the extreme fear of sleep. People with somniphobia may worry, stress, or obsess all day long about going to sleep at night. Sometimes, these individuals are afraid of what will happen once they do fall asleep, fearing nightmares and sleep paralysis.

Somniphobia is a specific form of phobia. A specific phobia is an uncontrollable, irrational, and lasting fear of a certain object, situation, or activity.  Most people who face specific phobias know that their anxiety is somewhat over-exaggerated compared to the actual threat the situation poses to them. However, it can still be difficult to manage their phobia symptoms. An estimated “9.1% of Americans” faced specific phobias sometime in the last year.

Common Symptoms of Somniphobia

Somniphobia can cause a variety of symptoms, both mental and physical. These symptoms can make it especially difficult for someone facing somniphobia to go to sleep at night. Let’s explore the mental and physical symptoms separately.

Mental Symptoms

• Individuals suffering from somniphobia may feel fear and anxiety every time they think about sleeping.
• They may experience increasing distress and dread as bedtime approaches closer and closer.
• They have trouble focusing on things besides sleep-related worry and fear.
• It’s possible that they feel irritable and have mood swings throughout the day.
• They may have trouble remembering things.

Physical Symptoms

• Those facing somniphobia might feel nausea and other stomach issues related to persistent fear around sleep.
• They might experience tightness in the chest and increased heart rate when they think about sleep.
• They might have a panic attack.
• Their sleep anxiety may cause sweating, chills, and hyperventilation or other trouble breathing when they think about sleeping.
• In children, it’s possible that they exhibit excessive crying, clinging, and tantrums.
• They may also not want to be alone at night.
• They may get up multiple times throughout the night

Somniphobia vs. Sleep Anxiety

Both somniphobia and sleep anxiety involve excessive worry about falling asleep. However, those suffering from sleep anxiety may not worry for the same reasons as those with somniphobia. The former may feel dread because they’re worried about not getting enough sleep, while the latter worries about what may happen to them while they are asleep. Those with somniphobia are likely to experience more intense fear related to sleep than those with sleep anxiety.

Causes of Somniphobia

Now that we’ve examined what somniphobia is and we understand its key symptoms, we can move on to what causes this sleep disorder. While science is unsure why phobias exist for certain, they have some idea as to its root causes. According to Mayo Clinic, specific phobias are caused by one of three factors:

• Negative experiences: Many phobias develop due to having a negative experience or panic attack related to a specific activity or situation.
• Genetics and environment: There may be a link between a specific phobia and the phobia or anxiety of a person’s parents – this could be due to genetics or learned behavior.
• Brain function: Changes in brain functioning could also contribute to developing specific phobias.

They also list some other risk factors that may increase the likelihood of developing a specific phobia. Those are:

• Age. Specific phobias can first appear in childhood, usually by age 10, but could also occur later on in life.
• Relatives. If someone in the family has a specific phobia or anxiety, other family members are more likely to develop it, too. This could be an inherited tendency, or children may learn specific phobias by observing a family member’s phobic reaction to an object or a situation.
• Temperament. A person’s risk may increase if they are more sensitive, more inhibited, or more negative than the norm.
• Negative experiences. Experiencing a frightening traumatic event, such as being trapped in an elevator or attacked by an animal, could trigger the development of a specific phobia.
• Learning about negative experiences. Hearing about negative information or experiences, such as plane crashes, could lead to the development of a specific phobia.

While those are risk factors and causes of specific phobias in general, we still don’t know what causes somniphobia in specific. To understand this, we need to know what kind of individuals tend to develop somniphobia. Those with “nightmare disorder and post-traumatic stress disorder” are more likely to face a fear of falling asleep. Both of those disorders arise in connection with traumatic experiences. According to a study by Nicole A. Short, individuals with these disorders are “more likely to suffer from nightmares.”

Another sleep disorder that could increase your risk of developing somniphobia is sleep paralysis. According to WebMD, sleep paralysis is the feeling of being conscious but unable to move. These experiences are understandably traumatic, and can contribute to an individual developing a fear towards sleep.

Who Could Get Somniphobia?

The biggest factor that puts an individual at risk for somniphobia is a history of parasomnia. Parasomnias are sleep disorders that involve a variety of unusual and often undesirable physical events that disrupt an individual’s sleep. A parasomnia can happen before or during your sleep, or even during arousal from sleep. If you have a parasomnia, you might experience abnormal movements, talk, express emotions or do unusual things. While you are truly sleeping, your bed partner might think you’re awake.

Other sleep disorders such as insomnia also increase risk for somniphobia. A person has a higher risk for developing somniphobia if they have:

• Generalized anxiety disorder (GAD)
• History of trauma that happened at night
• Narcolepsy
• Panic disorder
• Restless legs syndrome (RLS)
• Sleep apnea

How Is Somniphobia Diagnosed?

The Diagnostic and Statistical Manual is a publication by the American Psychiatric Association that outlines key criteria of mental health disorders and how to diagnose them. It is used by all mental health professionals to diagnose such disorders, including phobias. The DSM lists seven criteria for diagnosing a phobia:

• Unreasonable, excessive fear: The person experiences excessive or unreasonable, persistent and intense fear that is triggered by a specific object or situation.
• Immediate anxiety response: The fear reaction must be exaggerated in comparison to the actual danger, and appears almost instantaneously when presented with the stimuli.
• Avoidance or extreme distress: The individual goes out of their way to avoid the object or situation, or endures it with extreme distress.
• Life-limiting: The phobia significantly impacts the individual’s school, work, or personal life.
• Six months duration: The duration of symptoms must last for at least six months.
• Not caused by another disorder: Many anxiety disorders have similar symptoms. A mental health professional would first have to rule out similar conditions such as agoraphobia, obsessional-compulsive disorder (OCD), and separation anxiety disorder before diagnosing a specific phobia.

Once a healthcare provider is made aware that their patient thinks they are experiencing somniphobia, it’s likely that they will ask a series of questions related to the disorder. They may ask if there is a fear of sleeping that affects sleep quality, and if it distracts from completing daily tasks. They’ll inquire how long the symptoms have been occurring and if it has been interfering with the patient’s life in a major way. They’ll ask if it has led to excessive dread and anxiety, or if it has negatively impacted  physical and mental health.

How Common is Somniphobia?

Experts are unsure about exactly how many people in the United States experience somniphobia. Research does show that over “40 million adults in the United States have a chronic sleep disorder,” and more than “12% of adults in the U.S. have a specific phobia.” Hopefully those figures give you some idea as to how many individuals are affected by this disorder across the country.

Treatment Strategy #1: Exposure Therapy

The first strategy that can be effective in treating somniphobia is exposure therapy. The American Psychological Association states that exposure therapy is a “psychological treatment that was developed to help people confront their fears.” When individuals are afraid of something, they tend to avoid the feared stimulus for as long as they can. Although this avoidance might help reduce feelings of fear in the short term, it can make the fear worse in the long run. In such situations, a psychologist might recommend a program of exposure therapy in order to help break the pattern of avoidance and fear. In this form of therapy, psychologists create a safe environment in which to expose individuals to the things they fear and avoid. The exposure to the feared objects, activities or situations in a safe environment helps reduce fear and decrease avoidance.

Exposure therapy has been scientifically proven to combat symptoms of a variety of mental health disorders. Some of those include:

• Phobias
• Panic Disorder
• Social Anxiety Disorder
• Obsessive-Compulsive Disorder
• Post-traumatic Stress Disorder
• Generalized Anxiety Disorder

Three out of six of these disorders are at high risk for developing somniphobia, which is why exposure therapy is so effective in battling sleep anxiety. There are several variations of exposure therapy that can be done; a healthcare provider will know which one is best in a particular situation. Here are the different types of exposure therapy:

• In vivo exposure: This is directly facing a feared object, situation or activity in real life. For example, someone with a fear of spiders may be told to carry a harmless spider in their hand, or someone with a fear of heights could be brought to the roof of a tall building. For somniphobia, an individual might be brought to a sleep lab and observed throughout the day and night.

• Imaginal exposure: This is when you vividly imagine the feared stimuli, which in this case, is sleep. A person with somniphobia might be asked to close their eyes and imagine it’s bedtime. Their mental health professional might ask them how this makes them feel.

• Virtual reality exposure: In some cases, VR technology could be used when it is impractical to take the person to their feared stimulus in real life. For example, someone who is afraid of flying might be given a VR headset that simulates a flight. This is less applicable to somniphobia, as it’s not feasible to simulate a sleep environment.

• Interoceptive exposure: Inciting physical sensations that are harmless, yet feared by the patient. For example, someone with a panic disorder might be instructed to run in place in order to speed up their heart rate, showing them that this sensation is not dangerous.

Exposure therapy can also be paced in a three different ways: graded exposure, flooding, and systematic desensitization. Graded exposure involves forming a hierarchy of fears, and then starting with the mild fears and progressing towards the bigger ones. Flooding involves starting with the most difficult and feared exposure first. Finally, systematic desensitization is when feared activities are done alongside relaxing ones in order to associate the phobia with something relaxing.

This form of treatment brings a variety of benefits to those suffering from somniphobia. Those benefits include:

• Habituation: Over time, the person’s fear decreases as they habituate themselves with the feared stimulus.
• Extinction: The exposure to the feared stimulus may cause the phobia to completely disappear over time.
• Self-efficacy: Exposure therapy can show the individual that they are capable of handling their fear.
• Emotional processing:  The patient may learn to associate more positive feelings with their feared stimulus, allowing them to be more comfortable around it.

Treatment Strategy #2: Cognitive Behavioral Therapy

The next strategy that can help to treat somniphobia is cognitive behavioral therapy (CBT). This is a form of psychological treatment. Various research studies suggest that “CBT leads to significant improvement in functioning and quality of life” in patients suffering from mental health disorders, such as somniphobia.

Cognitive behavioral therapy is based on several central principles, including:

• Psychological problems are the result of faulty or unhelpful ways of thinking.
• Psychological problems are the result of learned patterns of unhelpful behavior.
• People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.

This form of talk therapy usually involves efforts to change thinking patterns. Some of these strategies include learning to recognize when one’s distortions in thinking are causing or exacerbating symptoms. Some other strategies are gaining a better understanding of the behaviors and motivations of yourself and others, using problem-solving skills to cope with situations, and developing a greater sense of confidence in oneself.

Treatment Strategy #3: Medications

While therapy-based strategies such as CBT and exposure therapy are effective, some individuals feel better off when they know they have medicines working in their favor. There are certainly medicative treatment options for those suffering from somniphobia. Some of those include:

• Beta blockers such as propranolol (Inderal) or atenolol (Tenormin) can alleviate physical symptoms, such as heart racing.
• Benzodiazepines such as alprazolam (Xanax) or lorazepam (Ativan) can battle somniphobia; they are sedatives that can help decrease mental and physical symptoms short-term.

Conclusion

Somniphobia is the extreme fear of falling asleep. Individuals suffering from somniphobia feel dread, fear, and worry all day long about going to sleep. They are generally afraid of what might happen to them while they are sleeping, such as nightmares, sleep paralysis, and even dying in their sleep. This condition can severely impact someone’s life, making it difficult to do tasks throughout the day and stay focused; they are so distracted by their sleep anxiety that they can’t do anything else.

We covered some common mental symptoms of somniphobia, such as fear and anxiety related to sleep, trouble focusing throughout the day, irritability, and mood swings. We also went over some physical symptoms, including nausea, sweating, tightness in the chest, and hyperventilation.

We discussed how somniphobia is diagnosed. Those who suffer from nightmare disorder and PTSD are far more likely to develop a fear of falling asleep, just like those with a history of parasomnia. It’s likely that a doctor will ask a series of questions related to  somniphobia in order to gauge whether or not someone may have the disorder.

Finally, we covered treatment options. Exposure therapy and cognitive behavioral therapy are both effective strategies that your mental health professional can help you with to overcome your somniphobia. They focus on overcoming the disorder using natural methods such as talk-therapy, instead of medications. Conversely, medications such as beta blockers and benzodiazepines can be just as effective in treating mental and physical symptoms of somniphobia.

While there is no cure for somniphobia, we hope this article went a long way in educating you about what this disorder is and how it is treated.