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When the prospect of going to sleep becomes frightening

Most of us never think about getting into bed and going to sleep; it’s just what we do. But for many people, the closer it is to bedtime, the more their anxiety rises, and for some, this develops into a full-blown fear that takes over their lives. Fear of sleep, also known as somniphobia (sleep phobia), can be debilitating and life-changing.

Sleep is an essential biological process. At a basic level, your body knows how to do it, but for a mixture of reasons, something changes, the experience of poor sleep is distressing, and the fear that it will happen again stops you from falling asleep. Very quickly, it escalates into a serious issue.

Descriptions of fear of sleep range from an “internal metronome of fear that speeds up as it gets dark” or an “increase in anxiety when finishing dinner as the evening draws to a close”. At its worst, the panic rises as soon as the sufferer wakes in the morning, and the fear becomes an overriding noise crowding out everything else in life. Panic attacks are not uncommon, and sufferers describe the extreme lengths they will go to solve the problem. One of the worst aspects of fear of sleep is that it is a self-perpetuating cycle: the fear stops you from sleeping, but the lack of sleep makes you fearful. It is a horrible condition with which to be living.

What causes the fear?

Like many night-time disorders, somniphobia has many potential causes, and there may be more than one.


Stress and anxiety

Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe. Everyone has feelings of anxiety at some point in their life, and it can manifest itself in various ways. It is normal to experience anxiety, worry and fear from time to time; sometimes, the underlying biological mechanism of anxiety is useful to help us manage a challenging situation. This reaction is known as ‘fight or flight’ or the stress response.

Your brain responds to a threat or danger by releasing stress hormones such as adrenaline and cortisol, which places the nervous system into a state of hyperarousal. Even if the threat is not real, these hormones still cause the physical symptoms of anxiety. Once the threatening situation has stopped, your body will usually return to normal. If you have an anxiety disorder, these feelings of fear and danger can be ongoing and interrupt your daily routine long after the threat has gone. They can make you feel as though things are worse than they are.

For some people, their anxiety manifests in fears about their health; for others, anxiety about appearance, but there are those for whom anxiety is expressed via their relationship to sleep.

Other reasons might be ongoing experiences of frightening and vivid nightmares that seem as real as if you were experiencing them while awake.

Sleep disorders (such as narcolepsy or sleep apnea) that disrupt sleep reduce sleep quality and trigger a fear of sleep.

Previous trauma

Often we don’t know why the fear has emerged; this can be highly distressing but is not unusual. Fear is often formed without our conscious knowledge, and a single moment in time, even if long forgotten, can leave us with a lifelong unease. The same is true of your sleep; if you have different associations, no matter how insignificant or significant they may seem to you, this could be the root cause of your problem.

Can you learn to sleep without fear?

Yes, but seek professional help. This is where therapy, medication and cognitive behavioural therapy for insomnia come together in a powerful combination.

There are three fundamental rules to a good night’s sleep:

1. A comfortable sleep environment with the opportunity to get the sleep that you need.

2. Appropriate light levels: as a rule, bright light in the morning resets your circadian clock and low light in the evening increases your sleep pressure, making you feel sleepy.

3. A relaxed mind, relaxed body. At one level, this seems simple but for many people, knowing how to or being able to relax is a challenge.

Finally, you are not alone. If you have developed a fear of sleep, it is vital to reach out for help.

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