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Sleep anxiety: how to manage your symptoms at night

When people experience sleep anxiety - which is also known as somniphobia or sleep phobia - they fear going to sleep at night.

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

Within this blog, we will look at the reasons behind sleep anxiety, as well as the strategies that people can use to manage the symptoms that stop them from getting to sleep at night. We will also provide information on the support available for you at Priory Group hospitals and wellbeing centres, where we provide treatment for people with anxiety disorders, phobias and sleep disorders.

The reasons behind experiencing sleep anxiety

Sleep anxiety can happen for a multitude of reasons. A person may dread going to sleep because they are 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 a generalised anxiety disorder can also worry about sleep or the night time. They may become anxious a lot more at this time, without anything to distract them from their thoughts. And the idea of lying awake worrying at night may leave them feeling anxious about going to bed.

We are supposed to feel relaxed and tired when it is time for bed. But sleep anxiety can leave a person feeling the exact opposite. While it is human nature for our ‘fight or flight’ instinct to be activated when faced with a 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.

Strategies to help you manage your sleep anxiety

Remember the basics – good sleep hygiene

If you are struggling to get to sleep at night, think about whether or not you are doing the following:

  • 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 six 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 similar relaxing activities before bed

Keep a sleep diary

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 for.

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

Avoid using 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 is 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 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. Doing these types of relaxation strategies do require dedication and patience, but over time, they can start to help you to sleep better.

Seeking professional support for sleep anxiety

If you are experiencing sleep anxiety, and it is continuing to have a dramatic impact on your life despite all attempts to improve it, it is highly recommended that you seek professional support to get access to specific coping mechanisms to help you manage your symptoms. 

Firstly, you may want to go to your GP to talk through your problem. They will be able to listen and offer advice on the next steps available to you, which may include accessing a private healthcare service like Priory Group for an assessment, diagnosis and specialist treatment. You can also come directly to the Priory Group team, where our psychiatrists and therapists regularly work with people with anxiety disorders as well as sleep disorders such as insomnia.

Types of support available at Priory Group for sleep anxiety

At your local Priory hospital or wellbeing centre, our team will work with you to determine an effective form of treatment. This may include a therapy programme, and medication can also be prescribed when appropriate. 

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 going forward.

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

Exposure therapy

Depending on your assessment and diagnosis, CBT can also include exposure therapy. When you have developed coping strategies for dealing with anxious thoughts and feelings, you will gradually be encouraged to think about deep sleep, naps or sleep without the use of unhealthy coping strategies. This practice 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 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, stopping it from taking hold and intensifying, causing you to become anxious, stressed and worried.

Mindfulness is something that does take time, patience and dedication, but with the right support, it is something that can help you to manage your sleep anxiety and get the good quality sleep that you need and deserve.

Page reviewed by Dr Natasha Bijlani (FRCPsych, MBBS), Consultant Psychiatrist based at Priory Hospital Roehampton London

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