Insomnia without anxiety: what if I’m not afraid of not sleeping?

Often someone approaches me with the question: “You talk about insomnia being the fear of not sleeping, but I’m not actually afraid of not sleeping. I just can’t sleep!”

That’s a valid comment, and I want to expand on how I see this.

First of all, it makes sense to understand the difference between insomnia and sleep disruption, as they might not be the same thing. When a person doesn’t display any of the insomnia-specific patterns, it’s possible that the source of their sleep disruption lies elsewhere. Read: Sleep disruption vs. insomnia: what’s the difference?

But sometimes the insomnia cycle can simply look different.

I chose to use “fear” as an umbrella term so that the way I talk about insomnia doesn’t sound too clinical and dry. However, that word has its limitations. What I mean by fear of not sleeping goes beyond the emotion itself.

It’s the overall threat-based relationship with wakefulness

As I mentioned in my other articles, the insomnia cycle starts when we begin to label sleep disruption as a threat or a problem and adopt certain thinking and behavioural patterns in an attempt to avoid that threat.

In our mind, being awake at night for a certain amount of time becomes unacceptable, wrong or bad.

• For some people, sleeplessness represents a threat to their health or even survival. That might naturally produce an experience we easily recognize as fear or anxiety.
• For others, the perceived threat is different. Sleeplessness might threaten their ability to function tomorrow, their work, their mood, their plans, their relationships, their sense of control, or their ability to enjoy life. In those cases, the dominant emotion might be anger or frustration rather than fear.

But underneath these different experiences is the same basic perception: sleep disruption is a problem that has to be fixed asap.

How else can “fear” show up?

That relationship with wakefulness can give rise to many different experiences:

• Emotional: fear, anxiety, anger, frustration, sadness, hopelessness or a sense of urgency, etc.
• Thinking: catastrophizing, “what if” thoughts, absolutist thinking, self-criticism, pressure to sleep and constant problem-solving, etc.
• Behavioural: avoidance, safety behaviours, attempts to control sleep, changing plans around sleep or repeatedly trying different solutions, etc.
• Physical and attentional: heart palpitations, sweating, muscle tension, heightened alertness and self-monitoring, etc.

So a person might not experience the insomnia cycle as fear at all, but recognize many other things on this list. These responses can still contribute to and maintain the cycle of insomnia.

Not everything on that list automatically means insomnia

Let’s use the example of frustration. The emotions itself doesn’t automatically mean we are in the insomnia cycle.

Sleep disruption can simply be inconvenient. Someone without insomnia might be awake for hours and think: “This is really annoying. I wish I could sleep.” They might feel frustrated, tired and unhappy about it. But they don’t necessarily begin fighting with the experience or reorganizing their life around preventing it from happening again. The sleep disruption remains a transitory experience.

For someone with a threat-based relationship with sleeplessness (i.e. fear of not sleeping), the same awakening or delayed sleep onset can carry an additional meaning: “This is utterly wrong. This shouldn’t be happening. Something is wrong with me. I need to fix this.”

That meaning can then be followed by behavioural changes that reinforce the perception that wakefulness is a serious problem requiring immediate action.

So when I say that insomnia is the fear of not sleeping, it doesn’t mean you have to start searching for some hidden fear that you don’t actually feel. Your experience of the cycle might look different.

Instead, it can be more helpful to look at your overall relationship with wakefulness. What does being awake mean to you? What happens internally when sleep doesn’t come? And what do you feel compelled to do about it?

In recovery, we work with that perception of wakefulness and gradually change how we respond to it. That’s what allows us to ease the pressure and stop fuelling the cycle.