Does worry about insomnia start before you even get into bed? Learn how the fear of not sleeping drives sleep away and what you can do to break this cycle.
It is half past nine in the evening. You are not even tired yet, but a familiar tension begins inside you: "What if I can't sleep tonight either?" Walking into the bedroom feels like walking into an exam hall. You turn off the light, close your eyes and wait for sleep. Ten minutes later you look at the clock on your phone: 23:12. The calculation starts in your head: "I have to get up at half past six. If I fall asleep now, that's seven hours and twenty minutes." Half an hour later you look again, the number shrinks, your heart speeds up. In the morning you wake not so much with tiredness as with the helplessness of having lost another night. The subject of this article is not so much insomnia itself as a hidden factor that feeds it: the fear of not sleeping. That is, not being able to sleep because you are afraid of not being able to sleep. We will talk about how this cycle is set up and how you can make room for sleep to come on its own again.
What Is the Fear of Not Sleeping?
Almost everyone sleeps badly for a few nights at some point in their life. The night before an exam, the rush of moving house, a busy period at work or a newborn baby can disrupt sleep for a while. For most people, once this period passes, sleep recovers by itself. In some people, however, after a few bad nights, sleep itself becomes a subject of anxiety.
The fear of not sleeping is when a person experiences intense worry that they will not be able to sleep and that this will have serious consequences for the next day or for their health. Some sources also use the term "somniphobia" for more severe forms of sleep-related fear; here, however, I am mainly talking about anxiety related to sleeplessness.
The most striking aspect of this picture is that sleep is something that does not come by force. Sleep arrives at a moment when the body feels safe and lets go of control. The more effort you make to sleep, the more awake the body stays. Just as the command "Relax right now!" relaxes no one, the thought "I must get to sleep immediately" pushes sleep away.
This is why many people with a fear of not sleeping may unintentionally doze off on the sofa in front of the television; but the moment they move to bed, their eyes spring wide open. Because on the sofa they are not trying to sleep, whereas in bed sleep has become a task.
Symptoms of the Fear of Not Sleeping
Common signs in people experiencing this fear include:
- Tension in the evening that increases as bedtime approaches
- Palpitations, a feeling of heat or restlessness when entering the bedroom or lying down in bed
- Frequently looking at the clock throughout the night and calculating the remaining sleep time
- Ever-increasing rituals for sleeping: a set time, a particular tea, a particular pillow, a completely dark and silent room
- Excessive focus on sleep-tracking apps or the sleep score on smartwatches
- Catastrophic thoughts that the next day will go badly: "I'll embarrass myself in the meeting, I'll have an accident, I'll get ill"
- Thinking "So the sleeplessness is finishing me off" whenever you feel tired during the day
- Avoiding evening social invitations, events that end late or travel because "my sleep will be disrupted"
- Being afraid of having to sleep somewhere else, such as a hotel or a relative's home
Experiencing some of these symptoms now and then is ordinary. But if sleep has settled at the centre of your life and a significant part of your day is spent thinking about sleep, you might consider that anxiety has been added to the sleep problem.
Why Does the Fear of Not Sleeping Develop?
A difficult period. The fear often begins after a real period of sleeplessness. Starting a new job, losing a loved one, financial difficulty, or sleepless nights after a major disaster such as the 6 February 2023 earthquakes can lead the brain to pair the bed with being on alert. Even when the stress passes, this learning remains.
The bed becoming paired with wakefulness. Lying awake in bed for long periods, looking at the phone, thinking and worrying leads the brain to code the bed not as a "place of sleep" but as a "place of thinking and tension". So even getting into bed sends a signal of wakefulness.
Catastrophic beliefs. Beliefs such as "If I sleep less than seven hours, I won't be able to do anything the next day", "Sleeplessness will make me ill" or "If I don't sleep for one night, I'll lose my mind" magnify the consequences of not sleeping. The heavier the consequences are perceived to be, the greater the pressure felt to sleep.
The need for control. People who are planned and orderly in many areas of life try even harder when they come up against sleep, which cannot be controlled. Yet sleep comes not through effort but through letting go.
Everyday circumstances. External factors such as shift work, getting up for suhoor (the pre-dawn meal) during Ramadan, sleep routines being shattered by a newborn baby, renovation in the flat upstairs or the noise of the building can also disrupt sleep for a while. Even after these periods are over, the belief "I can't sleep any more" may remain.
Screens and information pollution. News items describing the harms of sleeplessness and headlines of the "this risk rises in people who sleep less than seven hours" kind create a background that feeds the fear of not sleeping. Even if the information is accurate, an anxious mind reads it as a threat.
How Does This Anxiety Affect Daily Life?
The fear of not sleeping has an interesting side: what drains energy throughout the day is often not only the sleeplessness, but thinking about sleep. As soon as the person wakes in the morning, they evaluate the night: "How many hours did I sleep, how many times did I wake up?" During the day, every yawn and every lapse of attention is put down to sleeplessness. In the afternoon the thought "What if tonight is like this too?" begins, and by the evening the tension reaches its peak.
Let's say you are a teacher, and this anxiety reaches its most intense form on Sunday evenings. You are afraid of going into the first lesson of the week tired and of looking absent-minded in front of your students. You turn down the suggestion of a family meal out on Sunday evening, saying "I need to go to bed early." You get into bed at nine and lie awake until midnight. The more time you set aside for sleep, the lower the proportion of that time you actually spend asleep.
Relationships are affected too. A partner is affected by the restlessness of someone constantly tossing and turning in bed; some couples start sleeping in separate rooms because of this. Every night the person expects silence, darkness and order from their family so that their sleep rituals are followed; home life becomes shaped around sleep.
Long-lasting sleep problems can also affect mood. Irritability, low spirits, difficulty concentrating and even feelings of hopelessness can emerge. This in turn becomes another factor that increases anxiety.
A situation that might be called a "sleepless identity" can also develop. The person begins to define themselves as "someone who can't sleep"; they talk about their sleeplessness in conversation and make their plans around it. This identity makes it harder to notice the possibility that sleep might improve on its own, and leads even good nights to be seen as "luck".
What Can You Do to Cope with the Fear of Not Sleeping?
Take the clock out of your line of sight
Looking at the clock at night leads to calculating the remaining time and to increased anxiety. Turn the clock around, and put your phone somewhere you cannot reach from bed. Setting an alarm to get up in the morning is enough; you do not need to know what time it is during the night.
Use the bed only for sleep
Stop looking at your phone, watching series and thinking about work in bed. If you feel you have not been able to sleep for about twenty minutes, get out of bed, occupy yourself with something calm in dim light, such as a paper book, and go back to bed when you feel sleepy. This method may feel hard at first, but it helps the brain pair the bed with sleep again.
Prepare an invitation to sleep, not a summons
Sleep does not come on command; but an environment suited to it can be prepared. An hour before bed, dim the lights, switch off screens, take a warm shower and do some light stretching. See this preparation not as a list of "things I have to do in order to sleep", but as a gentle transition to the end of the day.
Allow yourself to stay awake
It may sound strange, but saying "I don't have to sleep, I'm just lying down to rest" reduces the pressure around sleep. Even lying awake is rest for the body. As the pressure decreases, the chance of sleep coming on its own increases.
Test your catastrophic predictions
Note in a notebook the day after nights when you slept badly: what actually happened? Most people notice that, even if they were tired, their day went much better than they thought it would. These records provide concrete evidence against the belief "If I don't sleep, I won't be able to do anything."
Set a regular getting-up time
Regardless of how much you have slept, try to get up at the same time every morning, weekends included. Staying in bed until midday after a bad night, or taking long naps during the day, makes the next night's sleep harder.
Stop tracking your sleep for a while
The sleep scores given by smartwatches and apps can turn into a new exam paper for an anxious mind. Try not looking at this data for a while. How you feel in the morning is a more meaningful measure than a score.
Don't narrow your daytime life around sleep
Giving up evening invitations, walks and activities you love because "my sleep will be disrupted" places sleep at the centre of life. A daytime that is active, full and gets plenty of light also supports night-time sleep.
When Should You Seek Professional Support?
Talking to a professional can be helpful in the following situations:
- The sleep problem has lasted for several weeks and happens on most nights of the week
- Thinking about sleep takes up a lot of time during the day
- Your rituals for sleeping keep increasing and becoming more rigid
- Together with sleeplessness, you are experiencing low spirits, hopelessness or intense anxiety
- Daytime sleepiness is affecting your safety at work or your driving
If there are symptoms such as snoring, pauses in breathing during sleep, restlessness in the legs or uncontrollable attacks of sleep during the day, an assessment by a sleep specialist or the relevant doctor is important. Your doctor or a psychiatrist should decide whether medication is needed; avoid taking medication on your own initiative. For more information on managing sleeplessness in general, you can look at the article on how to overcome insomnia, and for the thoughts that rush in when you get into bed, the article on thoughts that come when you lie down.
How Is the Fear of Not Sleeping Approached in Therapy?
One of the psychological approaches most strongly supported by research for sleep problems is cognitive behavioural therapy for insomnia. This approach addresses both the behaviours that disrupt sleep and the anxious thoughts about sleep together.
The process usually includes the following elements:
- Sleep diary: Recording bedtimes and getting-up times, time taken to fall asleep and night-time awakenings over a few weeks
- Stimulus control: Reducing the time spent awake in bed so that the bed is paired with sleep again
- Adjusting the sleep window: Bringing the time spent in bed closer to actual sleep time; this work is done with a professional and planned for the individual
- Cognitive work: Examining beliefs such as "If I don't sleep, tomorrow will be ruined" and replacing them with more balanced thoughts
- Relaxation skills: Breathing and muscle relaxation techniques that reduce physical tension
- Allowing yourself to stay awake: Learning to let go of the effort of trying to sleep
The more sleep is chased, the further it runs; when you make room for it, it comes by itself.
This work can often bring about noticeable changes within a few weeks, but it is important to know that a temporary increase in tiredness may be experienced in the first weeks. You can find more information about individual work on anxiety on the anxiety and panic page.
Frequently Asked Questions
Will anything happen to me if I don't sleep at all for one night?
A sleepless night can cause tiredness, absent-mindedness and irritability the next day; but the body has the capacity to cope with temporary situations of this kind. Most people sleep more deeply on the nights following a sleepless one. Long-lasting sleep problems, however, should definitely be addressed.
Should I trust the sleep score on my smartwatch?
These devices can give a general idea, but they do not measure sleep in as much detail as a medical sleep study. For an anxious mind, a low score can be perceived as the harbinger of a bad day and can increase anxiety. If the score makes you tense, it may be better not to look at it for a while.
Is it good to take naps during the day?
A short rest can do some people good; but for someone with a sleep problem, long naps or naps taken close to the evening can make night-time sleep harder. If you need to nap, it is better to do it early in the day and keep it short.
Should I take sleeping pills?
Only your doctor or a psychiatrist can make this decision. Medication can provide short-term help in some situations; but when the thoughts and behaviours that feed the fear of not sleeping are not addressed, the problem frequently returns. That is why psychological approaches are often recommended as an important part of treatment.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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