Hypophobia

For the human body to fully function, it is necessary to regularly restore the performance of all organs and systems. This happens during a night's sleep. It turns out that while we sleep, our brain works, restoring the interconnections that ensure the coordinated work of internal organs. On average, to compensate for the energy spent per day, you need to sleep for 7-8 hours a day, and saving time on sleep turns into impaired heart function and metabolic processes. In light of this, hypnophobia (panic fear of falling asleep) seems to be a serious problem. Subject to such an obsessive fear, a person experiences daily stress as the night approaches, and regular lack of sleep quickly enough leads to complete exhaustion, mental and physical.

Hypnophobia, also called somnophobia or clinophobia, refers to phobic anxiety disorders. In this case, the predominant symptom is the fear of falling asleep, and the need for sleep occurs daily. This is a natural need of the body, and it is impossible to avoid it, such as height, water, spiders or meeting with dogs, so this phobia is not only painful, but also fraught with serious complications.

Epidemiology

Various studies and polls, the topic of which were irrational fears at the household level, indicate that most of the world's population at some point in their lives are faced with traumatic situations, and about a fourth of such cases result in the development of a phobic disorder. This is the most common anxiety disorder that occurs in 22% of primary care patients. [1]

Causes of the hypnophobia

Basically, an irrational panic fear of falling asleep is associated with a fear of dying in a dream. It develops on the basis of any negative event related directly to the period of falling asleep or occurring in a dream, which caused a sharp awakening and fright. The evolutionary nature of the pathology is assumed, because in a dream a person is least protected. There, however, not everyone who has experienced any kind of stressful night time event develops hypnophobia.

 

Risk factors

Of great importance is the personality type of the individual. Persons with a stable psychotype are not susceptible to the development of this disorder. Most experts in the field of psychiatry consider personality characteristics to be the main factor in the development of hypnophobia, and the impact of stress factors is secondary. After all, the same event is far from causing a phobic disorder. The physical and mental state of the individual at the time of the traumatic situation also plays an important role.

Risk factors for socio-demographic, psychosocial and mental health are crucial for panic disorder and generalized anxiety disorder in the adult population as a whole. [2]

Risk factors for the occurrence of this mental disorder include the presence of cardiac and respiratory disorders - chronic diseases, manifested by acute obstructive sleep apnea, extrasystole, acute respiratory diseases with nasal congestion, polyposis, and the like.

Psycho-traumatic situations, for example, sudden death in a dream of a loved one, who usually lived with the victim; trauma received in a dream (often when falling from a bed); watched a movie at night or read a book of frightening mystical content can cause a vivid and memorable nightmare and lead to the development of hypnophobia. Even close contact with a person suffering from this pathology can be “contagious” for an impressionable individual.

The risk of hypnophobia, as well as other pathologies, increases during periods of rearrangement of the endocrine system (in adolescents and people during the period of decay of sexual function), with overwork and a decrease in immunity, latent cerebral ischemia.

Children with enuresis who are punished for wet bedding are often afraid to sleep, which, in turn, only exacerbates the situation.

Children's fears and impressions can lead to the development of uncontrollable fear of falling asleep already in childhood, and can remain deeply hidden in the subconscious and trigger the pathogenesis of hypnophobia in adulthood under the influence of additional stress.

Obsessive phobic disorder is usually considered as a violation of the functions of the limbic-reticular complex provoked by an acute or chronic emotional shock, primarily related to the hypothalamus. This section of the diencephalon is responsible for the integrity of the vital processes of the human body, which is ensured by the adequate interaction of the components, covering the emotional, autonomic-visceral, endocrine and motor spheres.

In addition, far from all, the same stress factor will cause a nervous breakdown. It should lay on fertile ground in the form of a tendency to anxiety, excessive anxiety, impressionability and emotional lability.

Genetic epidemiological studies have confirmed that these disorders are familial and moderately inherited. [3]

Symptoms of the hypnophobia

The clinical manifestations of the obsessive fear caused by the imminent need to fall asleep depend on the personality of the patient, and since each individual is unique, the symptoms are multivariate. They have one thing in common, they increase in the evening or when the patient is physically tired and realizes that he will need to sleep. At such moments, anxiety and anxiety in front of the inevitable is growing. People in different ways try to avoid a frightening situation: some do not sleep for several days, others try to load themselves up in such a way to fall and fall asleep right away. Patients complain that even in the daytime at the mere mention of a dream, they begin to feel anxiety, and sometimes a panic attack.

The first signs of the disorder are noticed by the patient himself when he is overcome by fear of sleep. If he does not share his experiences with loved ones, then for a long time outwardly this phobia may not manifest itself at all. You can simply notice that the person has become lethargic, constantly tired, angry and irritable. Constant lack of sleep leads to headaches, cardiac and respiratory disorders, depressed mood, the development of anxiety neurosis, depression. The patient’s hands begin to tremble, excessive sweating appears, thirst may torment him, in advanced cases, various somatic pathologies may develop from constant lack of sleep. [4]

What do seizures look like during hypnophobia? Seizures in the full sense of the word can not be called. Hypnophobia is not epilepsy. A person is afraid to go to bed, and everyone shows fear in his own way. Someone just sits at a computer for a long time, reads, does something else. Some resort to sleeping pills or alcohol.

Acute hypnophobia manifests itself as panic attacks (an outbreak of intense fear with a rapid heartbeat, hyperhidrosis, shortness of breath, trembling, ripples and flashes in the eyes, bouts of nausea) with one thought about the need to go to bed. A person can be thrown into a fever, and then chills, he may feel a shortage of air, tingling in the fingers and toes, dizziness until fainting. Even the perception of the world can be distorted for a while.

Many patients come up with certain rituals that allow them to reduce anxiety and fall asleep. Nevertheless, hypnophobic sleep is superficial, its duration is insufficient for a good rest, and a prolonged lack of sleep negatively affects not only the mood and performance, but also the state of health of all internal organs.

Complications and consequences

Agree, experiencing a strong and uncontrollable fear every night before going to bed is not easy. Quickly enough, you can become a complete neurotic. And hypnophobics tend to hide their condition from others, disguising it as different activities, and explaining their condition to themselves with overloads and stresses. This is strictly not recommended. If you can’t cope with your condition for several nights in a row, it is recommended that you immediately contact a psychotherapist. A recent phobia will be much easier to cope with than when it was already overgrown with rituals and somatic manifestations.

Regular sleep deprivation poses a serious health hazard, affects performance and communication with others. At first, a person constantly feels tired and exhausted, becomes inattentive, forgetful. He is tormented by dizziness and migraines. Weakness is manifested by sweating and tremors, the need to perform even everyday duties begins to cause irritation in him, some additional things - bouts of anger. Constant weakness, inability to cope with everyday tasks causes a depressive mood, severe neurosis can develop, the likelihood of accidents increases. The quality of life tends to zero.

Without treatment, the health condition worsens - the cardiovascular system, eyesight, and endocrine organs are primarily affected.

Diagnostics of the hypnophobia

Hypnophobia is diagnosed based on patient complaints. There are no other methods. In the initial stages of patients, only the fear of having to fall asleep is worried. In more advanced conditions, when the patient has somatic complaints, the doctor can prescribe laboratory and hardware studies to assess the patient’s health status. [5]

Differential diagnosis is carried out with suspicions that the symptoms of hypnophobia are caused by any pathological factors, such as a brain injury, drug or alcohol intoxication, and others. In this case, certain diagnostic procedures may also be prescribed. [6], [7]

Treatment of the hypnophobia

Sometimes a person can cope with hypnophobia on their own, however, in most cases, the help of a psychotherapist is needed, who can "pull" to the surface and dispel fears that prevent sleep. This is the main way to treat the disease. Individual lessons are usually required. Of great importance is the help and support of loved ones, the patient’s attitude to the need to resolve the problem. [8]

In addition to sessions with a psychotherapist, it is recommended that the patient switch his attention to some new exciting activity, change his lifestyle to a more measured and correct one.

In more complex cases, hypnosis sessions can help get rid of the pathology. This method allows you to have a fairly quick effect on the cause of fear and change the attitude towards it, leveling the level of danger. The patient's condition often improves significantly after the first hypnosis session.

Very rarely, drug therapy with anxiolytics with hypnotic effect is used. However, it can give an unpredictable effect, and it can only be used under medical supervision. Despite the fact that benzodiazepines are widely used in the treatment of generalized anxiety disorders (GAD), their short-term benefits are overshadowed by their reduced long-term effectiveness, minimal treatment of mental symptoms and worsening of the general condition of the patient. Selective Serotonin Reuptake Inhibitor (SSRI) Paroxetine is indicated for the short-term treatment of GAD, although there is no adequate evidence to support the use of most SSRIs for GAD. Denlafaxine, a serotonin and norepinephrine reuptake inhibitor, provides treatment options that result in both short-term and long-term symptom improvement, achieving not only a clinical response, but also remission and prevention of relapse. [9]

Combined therapy is also used to treat severe patients - hypnosis in such cases helps to reduce the duration of the course of taking drugs. [10]

As independent methods, as well as in order to prevent the return of phobia, yoga, meditation, and auto-training are used.

Prevention

The main risk factor for the development of a phobic disorder, experts call the personality characteristics of a particular individual, such as anxiety and suspiciousness, increased suggestibility. Neurosis-like disorders occur in people who do not have enough information that is necessary in order to cope with a life situation unsettling. Therefore, the best prevention of uncontrollable fear of bedtime will be education and training from childhood, aimed at overcoming various difficulties, that is, the formation of a rationally thinking stress-resistant personality. 

In addition, before going to bed, it is recommended not to read or watch thrillers, horror films, but to focus on something fun and pleasant.

A healthy lifestyle, strong immunity, walks before bedtime in the fresh air, for example, with your beloved dog, playing sports increase stress resistance. People, even in our difficult times, who find the strength in themselves for all this, as a rule, do not suffer from hypnophobia.

Forecast

The pathological fear of falling asleep is quite amenable to correction. The main recommendation of specialists is not to miss time. If you notice symptoms of hypnophobia, you should not resort to sleeping pills or alcohol, which, according to many, helps to relax and fall asleep. Start with a visit to a therapist. You may not need much training.