I Have a Paralysing Fear of Falling Asleep

This article originally appeared on VICE Italy.

My fear is known as somniphobia, clinophobia or sleep anxiety – basically, it’s a rare anxiety disorder that results in a deep phobia of falling asleep. Somniphobia can arise as a side effect of other sleep disorders – like night terrors or sleep paralysis – or as an outcome of unresolved trauma and post-traumatic stress disorder (PTSD).  

"More than 90 percent of patients with PTSD also have clinical sleep disturbances,” says psychology PhD Federica Pallavicini, who researches how gaming and VR can serve as mental health tools at the University of Milan-Bicocca. “The most common symptoms include trauma-related nightmares, difficulty falling asleep and disorientation upon waking up.”

That’s not what happens to me and I don’t have insomnia either. My main problem is when I try to sleep, I feel a rush of adrenaline at the exact moment I lose consciousness. I get the feeling I’m being dragged down into a fall which threatens to disintegrate all that I am and have ever been. With all my might, I’m compelled to cling onto the glimmer of consciousness surviving in my exhausted body. A "no!" often comes out of my throat like a gag reflex or a deep breath before apnoea (where your breathing stops and starts as you sleep), and my arms stretch out to ward off the darkness descending on me. 

The origins of my sleep disorder is almost certainly traumatic – I started experiencing this around age eight, when my mother died in a hospital room at night, after a long illness. My father told me the next morning and I thought she’d disappeared into thin air while I slept. Since then, my clinophobia has come back periodically - triggered by anxious or depressive phases. Sometimes, I experience it for months or even years at a time. 

“Some of us glide smoothly and quickly through the stages of falling asleep, remembering nothing,” says Michele Colombo, a researcher who studies brain waves in altered states of consciousness at the University of Milan’s department of biomedical sciences. “Others go back and forth between the states, bringing with them subconscious and altered perceptions.” 

It’s during this transitional state between wakefulness and sleep, that people experience disturbances like sleep paralysis or, in my case, a falling sensation. In essence, our body misinterprets physiological symptoms associated with falling asleep - like the release of muscle tension - through the lens of dreaming. “The mind, lost in streams of half-asleep thoughts and disconnected from the body, reacts to these signals of alertness and loss of posture and interprets them as a fall into the void,” Colombo explains.

It’s exactly this sensation of a downward fall that terrifies me and pins me down in desperate fear of dying. After years of therapy and various drug treatments, I can’t help but feel that this terror will follow me for the rest of my life. I expect to find it triumphant on my deathbed, right before closing my eyes for the last time. And the idea that my last thought will probably be steeped in fear worries me even more than death itself. 

In Western society “there’s been a real rupture in the relationship between people and death, starting from the 20th century,” says Philosophy Phd Chiara Teneggi, who works at a recovery centre for cancer patients and has tried to integrate the teachings of yoga into their therapy. The Western approach to death and illness “can be summed up in two sentences,” she continues. “It’s not appropriate to talk about death and we’ll think about illness when, and if, it comes." 

On the other hand, meditation offers a different approach to processing phobias, teaching us to perceive our thoughts as background noise and, above all, “not to be afraid of fear,” as she puts it. This is what my therapists have repeatedly told me, too. Therapy teaches your brain not to engage with the anticipatory fear that triggers panic - that’s the only thing that can actually help you heal.

Among psychotherapeutic approaches, cognitive-behavioural therapy (CBT) and, more recently, eye movement desensitisation and reprocessing (EMDR) seem to give the best clinical results for treating anxiety and trauma-induced phobias. Another common technique is exposure therapy, where a subject is introduced to the source of their trauma, in a controlled manner, to gradually diminish the fear factor. Virtual reality exposure therapy (VRET) is a new variation of the method and has already been used to treat PTSD in US veterans from the wars in Afghanistan and Iraq. 

"Virtual reality is a useful tool to teach the patient relaxation techniques, such as guided breathing and biofeedback,” Pallavicini says. “The technology lends itself to gradually inserting the person in the situation that traumatised them, in a safe and therapist-controlled environment. This helps them process their trauma at a cognitive level and develop new strategies to cope with it.”

Some of these VR-based tools were developed specifically for sleep disorders, including InterDream which immerses people into a multimedia art installation that promotes falling into a pre-sleep state. “There’s also a growing number of apps that can be used from the comfort of one's home, such as mindZense Sleep or Guided Meditation VR,” Pallavicini adds.

I sometimes wonder if this kind of therapy could help me too. But despite these amazing technological developments, I just can’t imagine a technique capable of helping me consciously face unconsciousness. It all seems like a contradiction. 

I see a total split between being conscious and not being conscious and for this same reason I can’t meditate, however hard I try. I can’t conceive being able to contain both my presence and my absence simultaneously. But maybe the key to overcoming my crippling phobia lies exactly in those moments, when I don’t know who I am or what I’m doing.