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Suffering from anxiety and phobia of dying in sleep. What am I suffering from?

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Practicing since : 2003
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Hello, I have had trouble sleeping a full 8 hours since Friday(Last week) .
Im getting maybe 2 hours or 4 hours here and there. I suffer from anxiety as well and have a phobia of dying in my sleep. I have not let my phobia really affect me before like this but as this problem drags on with not getting my usual 8 hours , I am just worrying more and more that I will eventually die due to exhaustion. Please help!! Oh and I also do see a therapist regularly but she has been on holiday for 3 weeks. I must add aside from the Anxiety and Depression I have no previous medical problems.
Posted Mon, 24 Dec 2012 in Anxiety and Stress
Answered by Dr. Jonas Sundarakumar 3 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

I understand that you are going through a difficult time due to your inability to sleep properly. Now, difficulty in sleeping (known as "insomnia" ) can be due to a variety of causes. Some of the common problems causing insomnia are:
- Stress
- Anxiety
- Depression
- Poor sleep habits
- Other medical problems, chronic pain, etc.

Now, the first step in managing insomnia is a detailed assessment to establish the probable cause. Further treatment is then targetted according to the cause. In your case, you mention that you don't have any medical problems. However, you seem to be suffering from phobic / anxiety disorders, which, I feel could be playing a major causative role in your current sleep problem. Your phobia also seems to be related to your sleep - where you have a fear of dying in your sleep. So, these psychological problems could very well be a possible factor in causing or worsening your current sleeping difficulty.

I would suggest that you continue to engage a be more dedicated in therapy (maybe you need more intense or frequent therapy), in order to overcome your anxiety and phobia. In the meantime, to tackle your insomnia, I would also advise you the following techniques, which can be helpful in improving sleep irrespective of the cause of insomnia:
- Fix a specific bedtime and an awakening time. Do not allow bedtime and awakening time to drift.
- Avoid napping during the day.
- Avoid coffee, tea or any caffeinated drinks or alcohol 4 hours before bedtime.
- Avoid heavy, spicy, or sugary foods for dinner. Have a gap of at least 1 hour between dinner and bedtime.
- Exercise regularly, preferably in the early evening, at least 4 hours before bedtime.
- Set up a comfortable environment which is dark, quiet and disturbance-free. Block out all distracting noise, and eliminate as much light as possible.
- Reserve the bed for sleep only. Don't use the bed for studying, working or for other rectreational activities.
- Try a light snack before bed. Warm milk and foods high in the amino acid tryptophan, such as bananas, may help you to sleep.
- Practice relaxation techniques before bed. Relaxation techniques such as yoga, XXXXXXX breathing and others may help relieve anxiety and reduce muscle tension.
- Don't take your worries to bed. Leave your worries about studies, work, daily life, etc., behind when you go to bed. Some people find it useful to assign a "worry period" during the evening or late afternoon to deal with these issues.
- Establish a pre-sleep ritual. Pre-sleep rituals, such as a warm bath or a few minutes of reading, can help you sleep.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
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