What is somniphobia? the irrational fear of sleeping

Sleep does not always mean having good quality sleep. Sleep is a biological process characterized by a decrease in the level of alertness and the reduction in the speed of metabolic processes. Furthermore, sleep is made up of a specific architecture characterized by different phases: superficial sleep, deep sleep and REM sleep. Each phase of sleep is important and plays a fundamental role in maintaining health and restful rest.

However, this natural architecture can be altered in multiple conditions, such as in sleep apnea, anxiety and even the consumption of some medications and substances toxic like alcohol. Another condition that can alter this structure is somniphobia. A rare condition, also known as hypnophobia or clinophobia. In these cases, the person experiences an irrational and uncontrollable fear of going to bed that causes anxiety due to fear of nightmares, of not waking up or of something bad happening during sleep.

In Spain, difficulties in resting adequately affect a large part of the population and present differently depending on age. Adults frequently accumulate sleep deficits due to work demands or lifestyle habits, while young people often have irregular schedules that alter circadian rhythms. In fact, according to the Spanish Society of Neurology, 54% of adults sleep less than the recommended eight hourswhile, according to the Spanish Federation of Sleep Medicine Societies, almost 35% of young people have difficulty conciliating rest. Added to this situation is the general perception of the quality of rest, since less than 29% of Spaniards claim to have good quality sleep, according to data from the Cigna Healthcare International Health Study, compared to 31% of the global average. Taken together, these figures reflect a scenario marked by altered sleep patterns that can favor the appearance of anticipatory anxiety when sleeping, one of the elements found at the base of somniphobia.

“Those who suffer from somniphobia perceive sleep as a time of stress instead of rest. This interpretation causes the brain to activate alert systems just when the body should prepare to recover, altering the biological processes of rest and making emotional regulation and physical recovery difficult. Understanding this dynamic is essential to identify and treat this fear in time, before a fragmented sleep pattern is consolidated that persistently compromises the quality of rest,” explains Dr. Daniela Silva, specialist in Internal Medicine and E-Health Medical Manager at Cigna Healthcare Spain.

According to the experts at Ciana Healthcare somniphobia causes a series of physical, cognitive and behavioral manifestations that alter biological sleep mechanisms. The most common are usually:

• Shortness of breath or feeling short of breath when lying down. The anticipation of sleep activates the sympathetic nervous system, responsible for the alert response. This can cause faster and more shallow breathing that makes it difficult to relax the diaphragm and chest, generating a feeling of lack of air or chest pressure and preventing the body from reaching the state of calm necessary to initiate sleep.
• Excessive sweating and involuntary tremors. Activation of the stress axis (hypothalamus-pituitary-adrenal axis) increases the release of adrenaline and cortisol, which results in intense sweating, tremors and palpitations. These physical manifestations are signs that the body perceives the act of sleeping as a threat, preventing the muscles from relaxing and the body from preparing for rest.
• Anticipatory anxiety before going to bed and a tendency to delay bedtime. The thought of going to bed can generate intense arousal in people with somniphobia. This anticipatory anxiety not only keeps the brain on alert, but can also manifest physically through the brain-gut axis, causing nausea, stomach heaviness, or abdominal discomfort before sleep. As a consequence, the person tends to delay bedtime or prolong nighttime activities to avoid that time. which ends up reinforcing the lack of rest and perpetuating the problem.
• Catastrophic thoughts and fear of losing control during the night. The affected person may anticipate extreme scenarios, such as not waking up or experiencing problems while sleeping. These concerns generate constant hypervigilance, keeping the brain in a state of cognitive alert that makes it difficult to relax necessary to initiate sleep. Likewise, it alters the consolidation of the REM and deep phases, essential for physical repair, emotional regulation and memory.