Sleep anxiety: understanding how anxiety can affect sleep

What is sleep anxiety?

Sleep anxiety is a sense of fear or apprehension about going to sleep. When people experience sleep anxiety - which is also known as somniphobia or sleep phobia - they fear going to sleep at night.

Some believe that sleep phobia is evolutionary, as before we had the trappings of modern life, we would have been most vulnerable when we were asleep. But nowadays, it's typically an unfounded fear that actually goes on to have a damaging effect on our health and wellbeing.

What are the symptoms of sleep anxiety?

The symptoms of sleep anxiety are similar to the more general symptoms of anxiety, only they will happen while you’re in bed or trying to get to sleep.

Symptoms of sleep anxiety include:

• A persistent sense of worry or apprehension
• Restlessness
• Feeling fearful
• Fast heart rate
• Sweating
• Tense muscles

You might also experience panic attacks at night (nocturnal panic attacks), which are sudden and intense bursts of extreme anxiety. Sleep anxiety can lead to a severe inability to get enough, or any, rest at night. This could lead you to develop insomnia as a result of anxiety.

Why am I scared of going to sleep?

Sleep anxiety can happen for a multitude of reasons. A person may dread going to sleep because they're worried about having nightmares or night terrors. Or they may believe that something bad will happen during the night, such as a burglary, fire or death.

A person with generalised anxiety disorder (GAD) can also worry about sleep or night time more generally. They may become anxious a lot more at this time, without anything to distract them from their thoughts. The idea of lying awake worrying at night may leave them feeling anxious about going to bed. There are a multitude of causes for anxiety that may have kick-started this, including:

• Genetic factors
• Trauma, either in adulthood or childhood
• Problems or drastic changes in your life (such as divorce, financial worries, or loneliness)

We're supposed to feel relaxed and tired when it's time for bed. But sleep anxiety can leave a person feeling the exact opposite. While it's natural for our ‘fight or flight’ instinct to be activated when we're faced with possible danger, people with sleep anxiety see ‘dangers’ associated with sleep such as nightmares, burglaries, or death, which causes their body to fill with adrenaline. This causes them to experience heart palpitations, shortness of breath, loss of concentration, racing thoughts, sweating and nausea. These anxiety symptoms can make it very difficult to get a good night’s sleep, which is something that we all need to maintain our physical and mental health.

How to cope with sleep anxiety 

For a better night’s sleep, try and incorporate some of these anxiety-busting strategies:

• Go to bed and wake up at the same time every night, even at weekends. Our body likes working to a rhythm, but listen to your body too. Lying in bed when you’re not sleepy won’t help your anxiety
• Don’t consume caffeine for at least 6 hours before you to go to bed
• Resist napping during the daytime, but if you have to, sleep for no longer than 20 or 30 minutes
• Get some exercise outdoors, but avoid exercising in the 2 hours before bed
• Make sure your bedroom is comfortable, cool and dark, and avoid spending time in your bedroom during the evening and daytime
• Get into a routine where you do some relaxing activities before bed, like reading a book or listening to music
• Avoid glaring screens in bed. They'll keep your brain active and the blue light it emits affects our ability to produce the sleep-inducing hormone, melatonin

Sleep diaries

Have a notebook dedicated to your sleep, and use it every day to jot down the activities you were doing before bed, the thoughts and feelings you were experiencing, how you slept during the night and how many hours you managed to sleep.

This can help you to get a better understanding of your sleep pattern, what makes your anxiety worse, and what alleviates your anxious thoughts and feelings. This recognition can then help you to take steps to improve your sleep anxiety going forward.

Avoid unhealthy coping strategies to fall asleep

You may be using coping tactics like keeping the light or TV on during the night, in an attempt to help you sleep.

Or you may have been using medication, alcohol, or drugs to go to sleep and if so, it's highly recommended that you stop. These won’t be addressing the real issues behind why you aren’t sleeping, and are only providing you with a short-term solution, which could turn into a long-term problem in the future.

Finding relaxation strategies for anxiety that work for you, such as muscle relaxation or visual imagery, can help to distract you from your anxious thoughts. You may even want to find some relaxing music to accompany this. Relaxation strategies need dedication and patience, but over time, they can start to help you to sleep better.

Treatment for sleep anxiety

If you're experiencing sleep anxiety, and it's having a negative impact on your life, it's important that you get help.  

Firstly, you may want to go to your GP to talk through your problem. They will be able to listen, offer a potential anxiety disorder diagnosis, and give advice on the next steps available to you. There are lots of effective treatments for anxiety disorders that can help you make a full recovery. They include:

Cognitive behavioural therapy (CBT)

CBT can help you to address the negative connotations that you associate with sleep or the night. It gives you an opportunity to take a step back, recognise how these thought patterns and beliefs are causing you to feel so anxious, and learn ways to challenge and address them.

CBT helps you to recognise that many of the fears you have around sleep are perceived rather than real threats, and gives you the tools to reframe them so they have less of an impact on you.

Exposure therapy

When you've developed coping strategies for dealing with anxious thoughts and feelings, you'll gradually be encouraged to think about sleeping without the use of unhealthy coping strategies. This practice of exposure therapy can help you to reduce your fear and anxiety around sleep, and help you to get into the practice of using your new healthy coping strategies in order to get a good night’s sleep.

Mindfulness

Mindfulness training can help you to learn how to take charge and quieten the fears that are causing your sleep anxiety. With mindfulness, the idea is that when you have an unhelpful thought, you acknowledge it in the moment and allow it to pass without acting upon it. This stops it from taking hold and intensifying, causing you to become anxious, stressed and worried.