What Is Fear of Sleep (Somniphobia)?

Somniphobia is a fear, or phobia, of sleep or falling asleep. It can be considered a specific phobia and classified as an anxiety disorder. Generally, specific phobias are associated with a fear of a particular person, place, object, situation, or activity. The fear is ongoing, unrealistic, and causes distress to the point of impacting daily functioning.

Read on to learn more about somniphobia, including characteristics, causes, and treatment options.

Definition of Somniphobia

People with this specific phobia experience significant distress and anxiety around falling asleep. Additional concerns related to fear of sleep may include:

• Wanting to avoid or reexperience nightmares
• Fear of darkness
• Fear of letting their guard down
• Fear of loss of control
• Inability to be vigilant or watchful because they are asleep
  

Characteristics of Somniphobia

People who have specific phobias, like fear of sleep, may experience symptoms when exposed to the object or situation that triggers their fear, or even when they anticipate being exposed to it.

Many adults who have a specific phobia are aware that their fear is irrational.

Characteristic physical and mental symptoms of specific phobias include:

• Heart palpitations
• Dizziness or light-headedness
• Chest pain
• A tingling sensation
• Getting chills or hot flashes
• Sweating
• Trembling
• Nausea
• Shortness of breath
• A sense of impending doom
• Fear of losing control or dying
• Feeling as if an experience is unreal

Those who have a fear of sleep may avoid sleep. Developing insomnia (a sleep disorder making it difficult to fall asleep or stay asleep) may exacerbate the fear.

Sleep behaviors may also be different for those who have a fear of sleep, including sleeping with the light on, sleeping during the day, and sleeping somewhere other than the bedroom.

Diagnosing Somniphobia

Often, a specific phobia isn't formally diagnosed unless the fear results in significant distress or a disruption to daily life.

A mental health professional who is familiar with anxiety disorders can evaluate whether a person has a specific phobia based on certain criteria. The diagnostic criteria used is outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the American Psychiatric Association's handbook for diagnosing mental health disorders.

According to the DSM-5, a person who may have a specific phobia can have a fear that is:

• Persistent, unreasonable, excessive, and occurs in anticipation of being in the presence of the object of their fear
• Causing significant anxiety that almost always occurs due to being exposed to the situation or object
• Out of proportion to the risk the object or activity poses in everyday life
• Resulting in avoidance of the object or activity or, if experienced, significant anxiety
• Impairing day-to-day functioning and relationships
• Lasting for six months or more
• Not better explained by another mental health condition

An evaluation may also assess what specific thoughts and concerns a person has around their fear of sleep to better inform treatment.

What Causes Somniphobia?

What causes a specific phobia isn't always clear. However, factors that may influence a person's risk for developing a specific phobia may be related to learned experiences, such as having a direct or indirect experience with the object or activity, previous trauma, or genetics.

With fear of sleep, there may be the presence of associated conditions, including:

• Recurrent isolated sleep paralysis (RISP): This occurs when the temporary inability to move arms and legs (also referred to as atonia) during REM (rapid eye movement) sleep briefly continues when a person awakens. This can cause significant distress and result in a fear of sleep.
• Nightmare disorder: This condition is characterized by experiencing recurrent nightmares that disrupt sleep. It is common to experience this disorder and also have another mental health diagnosis, such as an anxiety disorder, borderline personality disorder, or post-traumatic stress disorder (PTSD).
• Experiencing trauma or post-traumatic stress disorder: Having previously experienced trauma has been associated with a number of sleep disturbances, one of which is the fear of sleep. The fear can be related to having trauma-related nightmares or being hypervigilant (a common characteristic of those who have PTSD).
  

Treatment for Somniphobia

While avoiding the object or situation that triggers a fear may be possible for some, it isn't the case with sleep. Getting enough quality sleep is critical for overall health and well-being.

For those who experience distress and impacts on their daily functioning due to fear of sleep, there are some treatment options to explore. Some options may be combined, including prescription medication and therapy, depending on the factors associated with a person's fear of sleep.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) involves identifying, exploring, and challenging a person's thoughts and behaviors. Understanding the thoughts relating to a person's individual fear of sleep with the help of a mental health professional can be beneficial.

Cognitive behavioral therapy for insomnia (CBT-I) is an evidenced-based therapy for addressing sleep quality. In addition to challenging thoughts and behaviors that impact sleep, this method includes sleep hygiene and relaxation education, stimulus control, and sleep-restriction strategies. A study that researched people with PTSD using CBT-I found that the participants experienced a reduced fear of sleep and an increased quantity and quality of sleep.

If nightmares are one of the primary contributors to fear of sleep, these specific treatments may be recommended.

Exposure, Relaxation, and Rescripting Therapy (ERRT)

This type of multi-session therapy helps people who experience nightmares to confront the nightmares (exposure), practice relaxation strategies, and engage in new ways to describe the nightmares. This can include description in terms of the core themes around intimacy, trust, power, control, and self-esteem (rescripting).

ERRT has been shown to be effective at relieving distress associated with sleep and chronic nightmares.

Imagery Rehearsal Treatment (IRT)

For those who experience nightmares that contribute to their fear of sleep, IRT may utilize other ways to reduce nightmare and address the fear. This treatment also uses a rescripting strategy to explore the meaning of nightmares, rate them, and then find new, neutral ways to describe and rehearse them.

IRT may be paired with relaxation activities and sleep hygiene practices.

Summary

Somniphobia is the fear of sleep. Experiencing an ongoing, unrealistic fear of sleep can cause significant distress and negatively impact daily life. Though the specific cause of somniphobia isn't clear, it's associated with having experienced trauma, being diagnosed with PTSD, and having other sleep problems or mental health conditions. Working with a mental health professional to explore treatment options can help address the fear and any underlying conditions that contribute to it.

A Word From Verywell

Somniphobia can be a distressing condition, especially considering how important sleep is to a person's overall health and well-being. Working with a mental health professional can provide helpful strategies to address somniphobia and enjoy quality sleep again.