Insomnia due to fear of death in sleep

The woman was slim, her movements were very energetic and she gave the impression of a very healthy person. She denied any medical problems and proudly stated that she was a teacher and was very active all her life as a college professor. She just retired a year ago. By the way, her ability to not sleep also began at about that time.

She has a son and she worries a lot about him because he is not as strong as she is and he gets depressed easily. Her physician gave her Ambien which “knocked her down” and she stopped taking it. Her medical examination revealed unstable blood pressure, arthritis – predominantly in the neck area – but there were no other significant findings.

We talked long during her examination, and she stated casually that she is going to an “extrasense healer” who is helping her to prevent what had happened to her friend. “What happened to your friend?” I asked.

“She died in her sleep. She was about my age,” she added quietly.

“Do you know the cause of her death?” I asked.

“Sure, I do. God stopped her heart in sleep. You know, doc,” she continued with suddenly increased speed and almost whispering, “I feel that my ability to not sleep is a message from God. He tells me that soon I will fall asleep for good, and until then I should be active and enjoy life. I make myself busy during the night, writing poems and seeing movies in my head. You know, I am very creative…”

“What makes you think that God is sending you a message? You are not very religious, as you told me.”

“When I retired, at the same time my son had big troubles. One night, suddenly I woke up from deep sleep and I felt that my heart stopped! I recalled that my friend complained on the same feelings before her death, and she told me that this is a sign that God will soon take her to him. And he did.”

“So, you do not sleep because you are afraid that your heart will stop in your sleep?”

Her face became sad and all her body lost her previously happy appearance. Now she looked old and frightened.

A sleep evaluation confirmed REM-related significant heart arrhythmias.

She was placed on mild dosages of heart and anxiety medications as well as an intensive psychotherapy with biofeedback. After one month she calmed down, her heart rate became stable and she started to sleep well without sleeping pills.

Editor’s Comments

This woman had a highly stressful time during a critical period in her life. During this time people are very sensitive with selective attention to emotionally painful situations. It is very typical to over-interpret “signals” and “messages.” It is a time for irrational superstitions, which have the power of hypnotic suggestions.

This patient had stress-related heart arrhythmia coinciding with similar symptoms in her friend before her death. She understandably projected the same idea on herself in spite of the fact that she was educated and not religious.

Similar situations happen to almost all of us. The main point is to not keep it inside (because fears have tendency to grow) and ask for professional help.