In this blog we will discuss the symptoms, causes and treatment of Somniphobia.
The irrational fear of sleep is called Somniphobia. It is a type of specific phobia, categorized under anxiety disorders in the DSM-V. Someone suffering from this type of phobia will find sleeping to cause extreme anxiety.
This extreme anxiety can be so intense, leading to one have panic attacks. Sufferers are unable to sleep or even go near the bed. The thought of sleeping can also induce fear.
Someone with Somniphobia will take all the energy consuming efforts they can, in order to avoid their fear stimuli, which is sleep. These acts of avoidance are repetitive, thus one can develop OCD in the future. This is so because the recurrent urge to avoid sleep can turn in to compulsions.
As the DSM-V suggests, these acts of avoidance, produced by anxiety, affect one’s social and occupational functioning. For example, someone with Somniphobia will refuse to sleep. They might not sleep for days until they are given some medical help. They develop insomnia and the family members suffer from the person’s ill health in terms of taking care of him.
Because of this lack of sleep, one might not be able to function properly academically or professionally. Thus, they will lose their jobs and will be unable to attend school. One’s physical health is also compromised and they may need frequent hospital visits.
Somniphobia is an abnormal, persistent fear of sleep. Also called as Hypnophobia or clinophobia is an irrational fear. One feels extreme anxiety even when near bed or upon the thought of sleep.
Symptoms of Somniphobia
Like in the case of all other specific phobias, Somniphobia too has anxiety as its focal symptom. Individuals suffering from an irrational fear of sleep suffer from extreme anxiety which, as mentioned earlier, can result in one having panic attacks.
When one undergoes extreme anxiety, the body experiences other physiological symptoms as well. Such as increased heartrate or palpitations.
Because this fear of Halloween is about something which is not physically present or seen and is highly subjective, sufferers of Somniphobia experience symptoms in different ways. One might have more severe symptoms than the other, based on their past experiences and intensity of the phobia. Though, as the DSM-5 suggest, one must experience anxiety lasting for at least 6-months.
Symptoms one experiences in Somniphobia are:
- Excessive anxiety when going near bed or told to sleep
- Excessive anxiety when thinking about sleeping
- Inability to manage anxiety
- Full-blown panic attacks
- Avoiding sleeping
- Fear of dying in sleep
- Increased heartbeat
- Muscle tension
- Feelings of dizziness
- Feeling depressed
- Excessive sweating
- Hot/cold flashes
- Butterflies in the stomach
- Drying up of the mouth
For one to be diagnosed with Somniphobia, a person should experience at least 3-5 of these symptoms (including anxiety).
Causes of Somniphobia
Like every other specific phobia, Somniphobia is a result of either genetics or a past traumatic experience.
Someone who has a family history of anxiety disorders or specific phobias has a higher chance of developing Somniphobia than someone who doesn’t. This is because they are genetically predisposed to develop it.
Genes and neurotransmitters also play a significant role in this genetic predisposition.
This genetic tendency to develop a mental disorder/specific phobia can also be referred to as a Diathesis-stress relationship. According to this, one with a genetic predisposition will not develop symptoms of Somniphobia until and unless there is some trigger event, instigating anxiety or fear of ghosts.
One might develop Somniphobia as a result of the fear of death. Someone who is fearful of dying is likely to develop Somniphobia because they assume they’ll die in their sleep. This is a result of some environmental trigger event. The sufferer might’ve seen or heard about their loved ones or anyone dying while sleeping. This can induce fear of sleep because they’re of the same happening to them.
Other reasons can be, for example an individual fearing darkness. They will resist closing their eyes because of this fear. Also, someone can develop Somniphobia if they are afraid of seeing dreams/nightmares. One who sees nightmares will dread sleeping because of the anticipation that they’ll see those dreams/nightmares every time they sleep.
Therefore, Somniphobia is caused by both genetics and environmental trigger events.
Treatment of Somniphobia
Somniphobia, like all other specific phobias has no exclusive type of treatment that is specifically designed to treat it. Like all the other specific phobias, Somniphobia is treated by a number of different therapies including, Exposure Therapy, Cognitive-behavioral Therapy (CBT) and or medications that lower downs the anxiety or other physical symptoms.
• Cognitive-Behavioral Therapy (CBT)
It is one of the most frequently used treatment for patients with almost all kinds of mental disorders. Somniphobia is defined as the irrational fear of sleeping. Thus, the therapist helps the patient in replacing these irrational thoughts with more rational ones.
The patients are helped out in analyzing and justifying the way they feel about being exposed to sleep. Therapists assist them in uncovering the reasons behind their fear and later they provide them with alternate, pleasant thoughts.
The patient is told to maintain a thought diary (with ABCD column) which provides them a replacement for every irrational thought they have, when thinking about a particular situation. The ABCD stands for:
i. A (antecedents) a situation or triggering event.
ii. B (belief) the thought that comes to one’s mind when in that triggering situation.
iii. C (consequences) the symptoms/feelings caused by that event/thought
iv. D (dispute) alternate, rational thoughts provided by the therapist in an attempt to dispute/challenge those irrational beliefs.
This last section of the thought diary is what really plays a role in helping the person feel good/less anxious.
• Exposure Therapy
It is one of the most frequently used ways of treating patients with Somniphobia (or any other kind of specific phobia). In this therapy, the patient is exposed to the source of his fear over a certain span of time. To begin with the therapy, the therapist exposes the patient to the least triggering stimuli.
As the therapy progresses and the patient is able to control his anxious feelings, imagery can be used to take the treatment a step further. In this part of the treatment the patient is asked to visualize/imagine a situation in which he is sleeping. During this process of imagery, one actually feels being in that particular situation or place, experiencing various senses.
Once the person successfully, without feeling anxious clears this step of the therapy, he is then exposed to real sleep.
While the patient is being exposed to different intensities of stimuli during the various stages of therapy, the therapist simultaneously teaches them coping exercises. These include, breathing techniques or muscle relaxation methods to lower their anxiety, when in an actual fear/anxiety causing situation. This teaches them how to remain calm when exposed to the fear stimuli.
Before actually starting the exposure therapy, the therapist needs to figure out the intensity of the patients fear, as to deduce whether they will be able to undergo this treatment, without any physical or psychological harm caused to them during the exposure processes.
However, these steps desensitize one to their fear of sleeping, by exposing them to that stimuli repeatedly, until they learn to undergo the situation without anxiety/panic attacks.
• Dialectical Behavior Therapy (DBT)
This is another effective therapy used to treat Somniphobia. It is more commonly used with people suffering from personality disorders, but is also useful with patients suffering from this type of phobia. Coping skills are taught in the DBT group which lasts for about 6-months and can have a number of people (depending on how many join the group).
i. Half-smiling is the first module of DBT. It is a technique that is used with patients who are distressed because of their irrational thoughts. The technique is known as ‘Half-smiling’ because the person is first advised to think about the stimuli that fears or upsets them, and while doing so they are told to lift the corners of their mouths by subtly smiling. Smiling is not that will help one get rid of these unpleasant thoughts, it is the person’s ability to constrain itself from thinking about those thoughts while half smiling.
ii. Mindfulness, the second module, is another technique used in DBT groups which helps the individual in getting rid of those negative thoughts. Individuals are told to focus on the present and be attentive to what is going on around them at the moment. This helps in breaking the link between their mind and any negative thought that might come to them then. For example, a person is told to focus on his breath or on the smell of a certain food presented to them, making use of their olfactory sense.
iii. The third technique or module of the DBT is distress tolerance skills. This module teaches people to calm themselves down in healthy ways when they are distressed or emotionally overwhelmed. Individuals are allowed to make wise, rational decisions and take immediate action, rather than being captured by emotionally destructive thoughts that might make the situation worse. Reality acceptance skills are also learnt under this model so that people fully accept reality and later make plans on how to address the problem.
• Mindfulness-Based Stress Reduction (MBSR)
MBSR is a meditation therapy, is used to manage stress or anxiety. It is an 8-week program which includes group sessions. Mindfulness meditation and Hatha yoga are practiced in these sessions. Lectures and group discussions are also done to talk about mental health and increase interactivity.
In mindfulness meditation the person is told to, for example to focus on the sensations felt while breathing or the rhythm of the chest rising and falling during the process. This distracts the person’s attention from something stressful to something which is neutral and soothing.
For quick and effective treatment, patients are also given a set of home works, for example 45 minutes of yoga and meditation sessions for 6 days a week and to record their results/feelings in a book or diary for 15 minutes a day.
They are not just one of the many treatment therapies used for Somniphobia, instead they are one of the most common ways of relaxation used by many people. Yoga tends to stimulate the meditative state of one’s mind while the person is in a particular yoga posture. Through yoga/meditation the mind is diverted towards something more productive and calm, allowing the person to escape the negative, distress causing thoughts.
Out of a number of yoga types, one can benefit from any yoga type/pose they like. Hatha yoga is one of the different types of yoga. The breathing techniques or the imagery one creates while in a yoga posture are the real factors that makes the person feel less anxious and diverts their mind, away from the thoughts about eating food.
• Drug Therapy
Drugs are used to reduce the physical symptoms caused by Somniphobia. Drugs are very quick in effectiveness, as they start showing progress in the patients’ health at least 2 weeks after the medicine is taken.
This type of biological treatment is usually more effective if the cause of the phobia is only genetic. However, these drugs/medicines are not to be taken without a doctor’s prescription or consultation.
Two types of drugs are used in the treatment of this phobia:
i. Anti-anxiety Drugs
Medicines like Valium are anti-anxiety drugs. They are most commonly used with patients who experience panic attacks and also lowers their anxiety by binding to receptor cells of the brain that cause these unpleasant symptoms.
ii. Antidepressant Drugs
These drugs, as the name suggest don’t only treat depression but are also very effective in treating phobias. Medicines like Lexapro reduce the anxious feelings of a person and makes him feel calm. They need to be taken on a daily basis but not without a doctor’s advice.
Whether the cause of Somniphobia, or any other type of specific phobia is genetics, environmental or both, the best and the most effective way of treating them is by using a combination of both biological treatments (drugs) with cognitive treatment (for example CBT/exposure therapy).
Titles to read
by DHIRAJ TANEJA
- DBT Made Simple: A Step-by-Step Guide to Dialectical Behavior Therapy (The New Harbinger Made Simple Series)
by Sheri Van Dijk
- Cognitive Behavioral Therapy Made Simple: 10 Strategies for Managing Anxiety, Depression, Anger, Panic, and Worry
by Seth J Gillihan PhD
- Cognitive Behavioral Therapy for Anxiety: How to Finally Break Free from Anxiety and Change Your Life Forever
by Jonathan Moran
Side Note: I have tried and tested various products and services to help with my anxiety and depression. See my top recommendations here, as well as a full list of all products and services our team has tested for various mental health conditions and general wellness.
What we recommend for Phobias
- If you are suffering from Phobias then ongoing professional counselling could be your ideal first point of call. Counselling will utilize theories such as Cognitive behavioural therapy which will help you address the fears you are facing.
Weighted Blankets may help you sleep better if your phobias are affecting your quality of sleep. Weighted blankets apply enough weight on you that they make you feel much more relaxed and calm at night.
Frequently Asked Questions
Q1) How do I stop being scared of sleeping?
Fear of sleeping is called as Somniphobia. To overcome this fear, one must consult a doctor in order for him to conduct different psychotherapies like CBT and exposure therapy.
Q2) How is Somniphobia diagnosed?
Using the DSM-V, one can diagnose Somniphobia if one meets the criteria. To be diagnosed with this fear of sleeping, an individual must have anxiety lasting for at least 6-months. This anxiety should also affect ones social and occupational functioning. Out of a list of symptoms of specific phobias, one should experience 3-5.
Q3) How is Somniphobia is caused?
Like all other specific phobias, Somniphobia is caused by either a genetic pre disposition or a trigger event, such as a past traumatic experience which induces fear of sleep.
Q4) Is Somniphobia common?
Being a specific phobia, it is not a very common phobia but about 12% of the US population has a specific phobia.
Examples of other interesting phobias