“That’s a weird one,” my doctor told me with a look of curiosity. This was 2017, and I was sitting in her office trying hard to hide my shame. I was deeply grateful that my face didn’t flush. I knew my sleep anxiety is weird. I just wanted an official mental-illness diagnosis so I could leave. She gave me one: I had generalized anxiety disorder and obsessive compulsive disorder, both of which came as no surprise based on the many phobias I’ve lived with my entire life.
I am now 32 and I still live with the sleep anxiety I developed in my teenage years. I also have a Ph.D in Infection and Immunity and am a full-time researcher in the field of respiratory immunology. I am a mental-health advocate, an award-winning teacher, an award-winning research presenter, a freelance writer, a doting aunty and godmother, an active window shopper, and a collector of ceramic pineapples. While my sleep anxiety has affected me deeply, I’m not convinced I would have been more productive without it.
My typical evening involves me getting home before the sun has fully set, where I will begin my unwinding rituals: my evening devotion time including prayer and some Bible reading, followed by a hot shower and dinner no later than 8 p.m. I allow myself to binge-watching some Netflix, then switch off the lights just after 10 p.m.
Once the lights are off, I still allow myself to peruse social media or watch relaxing YouTube videos (my current favorites being on soap-making). I do this despite the fact that there is evidence to show that bright screens can negatively affect our sleep patterns. But it is imperative that I close my eyes by 11 p.m. This unwinding ritual, which has remained unchanged for the past decade, is my comfort blanket and part of my coping strategy for the longest-lasting fear which I have still been unable to overcome. I’ve gotten so used to my routine and my arbitrary bedtime that divergence induces panic that is just not worth it.
It is imperative that I close my eyes by 11 p.m.
My unrelenting sleep anxiety is the fear that I might not be able to fall asleep. It first started when I was 15 , when my sister, with whom I had always shared a room, was preparing to go off to university. My sister and I had our beds arranged in an “L” shape so our pillows nearly met. One night, in a half-sleeping panicked state, I reached out my hand to make sure my sister was still there. She sprang up from bed afraid that a mouse (my hand) had jumped on her head. The next morning I confessed to what had actually happened. We laughed, and then I slept fine for some time.
But soon I was finding it hard to fall asleep. This period of time also coincided with me starting at a new secondary school. My worries intensified: what would it be like moving from an all-girls school to a mixed-gender one? I could be socially awkward, would it be hard for me to fit in? After struggling to fall asleep the night before my first day at this new school, the seed for my sleep anxiety was planted in the form of a kind of self-fulfilling prophecy: that I would struggle to sleep every single night. As is the case with most phobias, what began as a faint whisper soon firmly took root in the marrow of my mind.
As with many worries, the fear of not falling asleep was present but the object of the fear never materialized: I would, in fact, be able to eventually fall asleep every night. The next day, however, the fear would consume me, beginning with a creeping despondency that spread across my mind. By dusk it would be debilitating. I tried to tell my family, but I was scared and ashamed: why was I so weird? How could I even begin to articulate what I didn’t understand? What did I do to make myself this way? Why was I abnormal?
I had always been a worrier, but I relied upon the notion that I could eventually grow out of my phobias. They were seasonal, maybe. They were phases. Years before my sleep anxiety manifested, I’d already started being conscious of certain things that my childlike mind noted as societal norms that I didn’t adhere to. I’d ask my friends what time they went to bed, and would start feeling guilty that my bedtime was an hour later. I’d take note of innocent comments other children made about how I always “worried about everything,” and how they’d laugh at me for scratching at my hands when I was washing them just to make sure they were clean. I’d ensure that when I walked out of a room, I used the same route I did as when I entered in a bid to maintain spatial symmetry.
The fear of not falling asleep was present but the object of the fear never materialized: I would, in fact, be able to eventually fall asleep every night.
Just before I turned eight, I began to fear that my heart would stop beating at any moment but I would still be alive; my nervous little palm would automatically check for the reassuring lub-dub. I was able to overcome all these on my own with no help, so why was my sleep anxiety so different? Why was I failing at fixing myself?
Sleep anxiety meant that during my university years I wasn’t interested in nightlife. On the occasions when I did go out with friends, I always had a knot in the pit of my stomach, worried sick about how my sleep routine would be affected.
This has also meant that in my lab-based research career I’ve always gravitated towards projects in which I can control experiment timings. But I still find myself paying the price for the social aspect of my invisible illness. I still wasn’t able to tell the postdoctoral researcher who put so much dedication into training me during the first six months of my Ph.D about why I always grew quieter in the evenings. I remember her once telling me, very gently, that I would need to get used to flexibility in my schedule because it is natural that some experiments run longer than the allotted time. How I longed to tell her that I wasn’t lazy, I was just an adult woman scared from the pit of my stomach because it was already dark outside and my mind was screaming that my nighttime ritual would be affected.
It has taken me a decade to dull the sharp pain of my sleep anxiety. Moving on my own to the U.K. for my Ph.D required me to develop comfort in my own company and the ability to study and understand my mental illness. Currently, my sleep anxiety is a throb that never leaves me; I’ve accepted that it may remain with me always.
This acceptance has been crucial to the development of my coping strategies. Self-care to 32-year-old me encompasses being honest with myself, my family and friends about my mental illness (and only going into detail when I absolutely feel the need to), being honest about needing medication (50 mg of sertraline a day, for just over two years), being open to therapy (even though I have yet to find a therapist), being ok with crying (although I still prefer to do so privately), challenging myself to set boundaries, and challenging my catastrophic thoughts.
For example, what would be the worst thing that could happen to me if I never fell asleep? I’d be exhausted the next day, but I’m sure I could get by. Or what if I do indeed ever become an insomniac? I’m sure there are coping strategies I could use to help myself; I know some people who struggle with insomnia who thrive in life and in their careers. Knowing that 51 percent of the women surveyed in the U.K. Sleep Council’s Great British Bedtime report from 2017 also said that they have sleeping problems due to worry and stress has also put things into perspective for me. I realize that my extreme self-criticism has often led me to pathologize my experiences as unique, whereas there are so many others dealing with the same thing.
I had always been a worrier, but I relied upon the notion that I could eventually grow out of my phobias.
Mental health expert Ayomide Adebayo explained to me how my generalized anxiety disorder has perpetuated my sleeping anxiety. “The key feature in generalized anxiety disorder is, as the name implies, an anxiety sometimes described as ‘free floating’ — it’s not attached to anything in particular, but is just sort of almost permanently present,” he said. “It’s twice more common in females than males, and especially in young females with a history of childhood fears. It tends to be lifelong.”
Part of my self-acceptance has also required that I dig a little deeper to identify the root cause of some of my fears. And it has indeed been uncomfortable to admit that my craving for the construct of normalcy I built in my mind when I was younger catalyzed the development of my phobias. Of this, Adebayo said that “normalcy is the worst way to think about mental illnesses.” He continued: “And the reason why I think so is that ‘normal,’ in the context of a new (and long-term) problem really means ‘going back to how things used to be.’ The problem with that is there's no ‘back’ to go to. There's only forward, and a focus on ‘normal,’ on ‘going back‘ really ends up being an inability to move forward.”
Being determined to study and familiarize myself with the fears I experience has empowered me in its own way. Knowing that I’m able to call my little demons by their names has allowed me to identify ways and means in which they can be exorcised. It’s also important to me to speak about this just in case there are currently individuals experiencing this exact fear who need to know they are not alone. I also still have complicated feelings about how close to “normal” people think I am. Perhaps the key to my further healing is accepting that normalcy is, as Adebayo said, just as much a phantom not unlike many of the things that I fear.