Medically reviewed by
Dacelin St Martin, MD
Triple board-certified in Sleep Medicine,
Internal Medicine, and Pediatrics.
Epidemiology | Risk Factors | Comorbidities | Diagnosis | Management
Overview
Somniphobia is a fear of sleep or falling asleep. The Latin origin of the word “somniphobia” is “somnus,” which means sleep, and “phobos” means fear.
It’s also referred to as sleep anxiety. Somniphobia is a feeling of dread triggered by thoughts about sleep. The condition of somniphobia can originate from different causes and lead to significant health problems requiring treatment.
Please keep reading for more information on the causes, pathophysiology, risk factors, diagnosis, and possible treatments of somniphobia.
Epidemiology
Anxiety disorders are the most common psychiatric disorders worldwide.[1] Current estimates for the global prevalence of anxiety disorders is around 7.3 percent (4.8 percent to 10.9 percent).[2] Studies indicate that the lifetime prevalence of specific phobias worldwide ranges from 3 percent to 15 percent.[3]
Although there is no data in the literature regarding the frequency of somniphobia in the general population, we know that this rate is less than one percent.[4]
Specific phobias usually begin in childhood, but their prevalence reaches a peak in midlife and old age.[5] It’s known that particular phobias can last for years or even decades if left untreated.[5]
Risk Factors
Somniphobia is a relatively newly defined disease, and therefore risk factors specific to this disease are not well-known yet.
However, this disorder has a high comorbidity with other sleeping disorders. Common risk factors include:
- Female gender
- Advanced age (older than 60)
- Previous diagnosis of depression or anxiety
- Stress
- Shift work
- Long-distance travel
- A strong familial link
Comorbidities
Psychiatric Disorders
As with all phobias, somniphobia includes both fear and avoidance processes. These two factors feed each other and can sometimes put the person in a vicious cycle that is difficult to break.[3]
Somniphobia may be a strong predictor of other anxiety, mood, or substance use disorders. Therefore, the incidence of other common mental disorders could potentially be reduced by effective treatment of specific phobias, like somniphobia.
This approach is critical, as long-term psychiatric disorders are also known to have devastating effects on physical health, especially on the cardiovascular system.[6]
Sleep Disorders
Somniphobia is not usually seen as a stand-alone phobia. Commonly it can be seen together with other phobias, like thanatophobia (a fear of death), and can be triggered by them.[7] For example, the similarity between sleep and death is a source of fear for many. It’s thought that an exaggerated case of somniphobia may be triggered or exacerbated by an underlying fear of death.[8]
The fear of death prevents some people from falling asleep as they are afraid that they will not wake up. Thanatophobia-induced somniphobia could be triggered by an event like losing a loved one during their sleep.[9]
Another comorbidity is sleepwalking. Sleepwalkers fear falling asleep, even if their sleepwalking does not usually result in bad events.[10-11]
Like sleepwalkers, people who talk in their sleep may feel anxious about falling asleep too, and this anxiety manifests as somniphobia in them over time.
Finally, there is an effort not to fall asleep to avoid the frequently encountered nightmares.[12] When sleep is avoided, instead of making an effort to get rid of the nightmares, homophobia manifests as a result.
Sleep Paralysis is a condition characterized by a temporary inability to move (paralysis) the body immediately after waking up (known as hypnopompic paralysis) or, in rare cases, just before falling asleep (known as hypnagogic paralysis.[13]
On the other hand, parasomnia is when undesirable behaviors and abnormal movements occur while falling asleep, waking up, or sleeping.[14] They usually appear and disappear during childhood.
Sometimes parasomnia symptoms can continue into adulthood, while others only occur in old age.
People who suffer from sleep paralysis and parasomnia avoid falling asleep in time, which can manifest as somniphobia.
Diagnosis
For somniphobia, which is defined as a specific phobia under anxiety disorders in DSM-5, it’s of great importance to follow the symptoms at the diagnosis stage.
Symptoms encountered in some people diagnosed with somniphobia are as follows:
- Uncontrolled anxiety when going to bed or talking about sleep
- Uncontrolled anxiety when thinking about falling asleep
- Failure to manage anxiety
- Full-blown anxiety attacks
- Thanatophobia symptoms include avoiding falling asleep, increased pulse rate, dried mouth, anxious excitement, muscle tension, etc.
In addition, these symptoms cause some daily results, like:
- Daytime fatigue
- Irritation
- Rapid mood changes
- Low concentration
- Inefficient work productivity
Therefore, if the person is experiencing the symptoms mentioned above, they should consult a doctor to get the necessary diagnosis and treatment.
A mental health professional will assess using appropriate diagnostic criteria and methods and discuss treatment options if they diagnose you with somniphobia.
Management
For people who have specific phobias, avoidance can reduce the constancy and severity of distress and impairment. However, if someone has somniphobia, avoidance can exacerbate symptoms.
As with other anxiety disorders, several treatment options are available for somniphobia. Examples of these treatment options include:
- Cognitive-behavioral therapy
- Exposure therapy
- Dialectical behavior therapy
- Mindfulness-based stress reduction
- Yoga/meditation and drug therapy
All treatment methods have their unique advantages and disadvantages. A treatment method that gives excellent results in one case may not have any positive effect in another. Therefore, the choice of treatment should be individualized and administered by a healthcare professional.
Somniphobia can cause you not to get enough sleep, which is a basic need for your body, and this can be a precursor of many mental and physical problems. Therefore, early detection and effective treatment of somniphobia are crucial.
If you think you may have somniphobia, please do not hesitate to contact your primary healthcare provider.
References:
- Andreescu, C., & Lee, S. (2020). Anxiety Disorders in the Elderly. Advances in experimental medicine and biology, 1191, 561–576. https://doi.org/10.1007/978-981-32-9705-0_28
- Baxter, A. J., Scott, K. M., Vos, T., & Whiteford, H. A. (2013). Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychological medicine, 43(5), 897–910. https://doi.org/10.1017/S003329171200147X
- Eaton, W. W., Bienvenu, O. J., & Miloyan, B. (2018). Specific phobias. The lancet. Psychiatry, 5(8), 678–686. https://doi.org/10.1016/S2215-0366(18)30169-X
- Stinson, F. S., Dawson, D. A., Patricia Chou, S., Smith, S., Goldstein, R. B., June Ruan, W., & Grant, B. F. (2007). The epidemiology of DSM-IV specific phobia in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychological medicine, 37(7), 1047–1059. https://doi.org/10.1017/S0033291707000086
- Silverman, W. K., & Moreno, J. (2005). Specific phobia. Child and adolescent psychiatric clinics of North America, 14(4), 819–x. https://doi.org/10.1016/j.chc.2005.05.004
- Tully, P. J., Harrison, N. J., Cheung, P., & Cosh, S. (2016). Anxiety and Cardiovascular Disease Risk: a Review. Current cardiology reports, 18(12), 120. https://doi.org/10.1007/s11886-016-0800-3
- McCabe, R. (2018). Specific phobia in adults: Epidemiology, clinical manifestations, course and diagnosis.
- Iverach, L., Menzies, R. G., & Menzies, R. E. (2014). Death anxiety and its role in psychopathology: reviewing the status of a transdiagnostic construct. Clinical psychology review, 34(7), 580–593. https://doi.org/10.1016/j.cpr.2014.09.002
- Kavas, M. V., & Oztuna, D. (2011). Thanatophobia in medical students: approach to death and dying patients attitude scale (ADDPAS) for undergraduate years in medicine. Journal of cancer education : the official journal of the American Association for Cancer Education, 26(4), 774–781. https://doi.org/10.1007/s13187-011-0197-z
- Arnulf I. (2018). Sleepwalking. Current biology: CB, 28(22), R1288–R1289. https://doi.org/10.1016/j.cub.2018.09.062
- Stallman, H. M., & Kohler, M. (2016). Prevalence of Sleepwalking: A Systematic Review and Meta-Analysis. PloS one, 11(11), e0164769. https://doi.org/10.1371/journal.pone.0164769
- Spoormaker, V. I., Schredl, M., & van den Bout, J. (2006). Nightmares: from anxiety symptom to sleep disorder. Sleep medicine reviews, 10(1), 19–31. https://doi.org/10.1016/j.smrv.2005.06.001
- Denis D. (2018). Relationships between sleep paralysis and sleep quality: current insights. Nature and science of sleep, 10, 355–367. https://doi.org/10.2147/NSS.S158600
- Fleetham, J. A., & Fleming, J. A. (2014). Parasomnias. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 186(8), E273–E280. https://doi.org/10.1503/cmaj.120808
