Fear of Sleep: Better Understanding Somniphobia

Somniphobia is characterized by an extreme fear of sleep. The condition causes people to worry or obsess during the day about how they can avoid sleep, which then carries over to bedtime. DocWire News spoke to Dr. Anne Marie Morse to learn more about this condition and how it can impact healthcare providers and their patients.

DocWire News: What is somniphobia, and what impact does it have on quality of life?

Dr. Anne Marie Morse

All right, sleep friends, I’m going to give you a new buzzword, a new fun word that you probably haven’t heard before. It’s somniphobia. That is right, it is the fear of falling asleep. And no, this is not similar to FOMO, the fear of missing out, although many times, people may not want to go to sleep because they don’t want to miss out on something. This actually means having the fear that when I close my eyes, something bad is going to happen. Unfortunately, this is a diagnosis that although we don’t necessarily make too commonly, we observe very frequently. I would say in pediatrics, somniphobia is something that we do commonly encounter, and many times, children just don’t have the right words to be able to appropriately characterize what it is. Many times, parents may misinterpret this as just bedtime resistance, and it may even be labeled as bedtime resistance insomnia.

But the fact of the matter is: something is driving this fear of going to sleep. It could be the fear of monsters under the bed. It could be a nightmare disorder. It could be a call to action to have a very, very serious concern about a child’s safety. The fear that that child is having a negative social experience at home, such as sexual abuse, should be something to consider. Now, somniphobia is not limited to the pediatric age group. Somniphobia is also something that can occur in the adult world. This is not a symptom that I don’t uncommonly see, especially when talking about my patients or people who I partner with who have a diagnosis of something like narcolepsy where there is a high likelihood of having REM dissociative features. REM sleep, or rapid eye movement sleep, is the period of sleep when you may have sleep atonia or REM atonia. A person may experience something that as they’re falling asleep or waking up, they get frozen or stuck.

They also are going to be highly likely to have very vivid dreams, and sometimes those are nightmares— and very vivid nightmares. These nightmares can sometimes almost feel like reality, and therefore, they’re having sleep-related hallucinations. They’re hearing things, seeing things, feeling things that aren’t really there. Individuals, again, may be mistaken as having a bedtime or sleep initiation insomnia with excessive daytime sleepiness because they’re resisting going to sleep at the time that they should be because of the fear of recurrent sleep paralysis, sleep-related hallucinations, or nightmares. Of course, they’re sleepy during the day because they’re not sleeping well at night. You might say, “Oh, there’s no worries about that. We’re just going to give you this pill to fall asleep.” This is the worst thing you can do for someone with somniphobia.

You are now removing the ability for them to have any control over whether or not they can go to sleep on their own, and therefore, it can actually be something that heightens the likelihood of them having a harder time falling asleep and having a greater degree of fear because the thing that they were afraid of—they now are being forced into. The call to action when you’re experiencing someone who has somniphobia is: number 1, really trying to understand what is the basis of their fear. That is going to provide the right direction for diagnostic and therapeutic interventions that are going to be necessary.

For many of these individuals, if not all, psychology partnership is going to be really critical. When somniphobia is due to nightmare disorder, doing things like image rehearsal therapy or some other form of cognitive behavioral therapy may be helpful in being able to reframe the dream experience and emotionally manage so that sleep is something that is more acceptable to experience. A psychology partnership may also help to appropriately diagnose something like narcolepsy that may be driving it. Finally, make sure that you’re not missing something when an individual actually is experiencing a purposely intentional harm that you may have the opportunity to intervene on. When looking at somniphobia, don’t look at it as something that’s just a nuisance and they just need to get over it. It is something that really can represent a critical opportunity to improve not only sleep but also the safety of the individual experiencing it.