Understanding Why I Am Afraid to Try Falling Asleep

In my old age of 36, I've learned there's a gigantic difference between "going to bed" and "going to sleep." For me, my falling asleep fears with insomnia are a challenge.

Let me explain.

What my nightly routine looks like

"Going to bed"

I often go to bed at 7 or 8 PM. It's the point in the night in which my brain has shut down, I am finished having conversations of meaning, being productive, or acting as a contributing member of my household. And, I also don't want to risk the potential of accidentally falling asleep on the couch (also known as taking a nappetizer).

To me, this reaches the time of the evening when I fill my ice water cup, close up downstairs, go up to my bedroom, change into my pajamas, brush my teeth, take my evening medicines, and usually either put a show on Netflix or read via the kindle app on my iPad. Now, depending on how physically and or mentally wiped out I am, the single stage of going to bed can last anywhere from 15 minutes – to over 4 hours.

"Going to sleep"

Now, going to sleep is different.

It's a conscious choice that involves honoring some forms of sleep hygiene. This includes attempts not just to get into bed to relax or unwind, but actually tucking oneself under the covers with the loose hope that soon, one will drift off to dreamland – or actually fall asleep.

For me, this routine includes my heated blanket, the calm app on my phone, a weighted stuffed animal to brace against, a sleep mask to block out the light, and the actual headspace to believe that my mind can slowly shut down with the right pieces in place.

It is important for me to believe that obtaining sleep, whether for the short or long term, is not impossible for this battered and often broken body of mine.

My fear of trying to fall asleep includes:

This season, I've identified the fear that comes along with this second step, the trying to fall asleep.

Struggles with sleep hygiene

I've written at length about struggling with or straight out not believing sleep hygiene works for me. And to be honest, much of that has to do with turning off the tv, and removing both the visual and audio stimuli that can distract my brain enough until it falls asleep without focusing on a single thing.

Impact of traumas on my insomnia

It's something I've worked hard to focus on and to modify – slowly, understanding that living with insomnia hasn't happened in a bubble. My insomnia has both impacted and been impacted by the trauma I've endured and the trauma responses my brain has chosen as survival tactics.

Responding to trauma with nightmares

One of these responses to my trauma is nightmares. For a long time, even if I could drift off to sleep in a relatively reasonable amount of time, and without a disastrous amount of challenge, it was only an hour or 2 before I'd wake up screaming, in a cold sweat, heart racing, somehow reliving whatever it was that scared the living daylights out of me.

Using prescriptions to help with my fears

When I finally shared this with my psychiatrist (the provider that ultimately has come to manage all of my sleep medication), she recommended a prescription called Prazosin, something used for PTSD and nightmares.

Very quickly I learned that a low dose of this medication taken just shortly before trying to go to sleep – helped, a lot, with the waking up in the middle of the nightmares.

My middle-of-the-night uncontrollable anxiety suddenly had some support, and I was sure I'd turn a corner with how I felt on trying to fall asleep in general.

But, I still have falling asleep fears

I'm frustrated and saddened to say that I've now been on this medication for almost a year, and while I am eternally grateful for the ways it has helped my sleep (and my mental health), it hasn't removed the fear – which I think I'm starting to understand – is really just a constant series of "what if's?" running through my brain right at bedtime.

• What if I can't fall asleep?
• What if I don't stay asleep?
• What if I toss and turn?
• What if the nightmares break through the medication?
• What if I wake up feeling alone, lonely, and afraid?
• What if I can't fall back asleep?

I've sat with this fear for a long time now, and today I'm wondering – is it just me? Or have you experienced something like this too?