Clinophobia comes from two words, from the Greek words “klinein” (tilt) and “phobos” (fear), which describe an unjustified persistent fear of lying down.¹ Clinophobia falls under the umbrella of anxiety disorders with other phobias. It leads to physical problems such as muscle and joint pain, stiffness, and poor circulation.²

Not much research is present about how Clinophobia may affect people, so not much is known about the demographic most likely to experience it. However, there are links to sleep disorders, bedtime avoidance, and anxiety. This phobia can affect people in different capacities. This article will cover the impact of clinophobia.³

How does it start? 

Very little is known and reposted about clinophobia. However, in one case study of a 16-year-old girl with night terrors and nocturnal seizures resulted in somniphobia, a fear of falling asleep, and leading to clinophobia. The patient reported high levels of anxiety due to night terrors and fear of reoccurrence while sleeping, which caused them to avoid lying down to drift to sleep.⁴

Night terrors most often occur between the ages of four and twelve, with 6.8% of children experiencing night terrors and significantly decreasing to only 2.6% within the adult population.⁵ Night terrors are associated with amnesia and usually quickly forgotten; however, some individuals may retain some memory and a sense of fear or anxiety over the occurring episode. It is when night terrors lead to fear and anxiety that individuals may develop clinophobia and onset insomnia.⁵ 

The phycological impact

Clinophobia causes Sleep anxiety. Sleep anxiety refers to fear or worry about sleep. Individuals think something bad may happen thus they need to stay alert and watchful. Bedtime resistance and reluctance to lay down can lead to poor sleep and sleep disturbances, significantly affecting their happiness and well-being.³ 

Alongside sleep anxiety, individuals may experience other sleep disorders such as insomnia, narcolepsy, restless leg syndrome, sleep apnoea, or sleepwalking. Sleeping disorders and sleep disturbances have also been linked to bipolar disorder and higher rates of depression.⁵ It was found that up to 60% of patient patients experiencing major depression experience one or more symptoms of sleep disturbances, and up to 90% of inpatients hospitalised for severe depression experienced insomnia.⁵

In another study, it was found that clinophobia was comorbid with psychosis and depression, cognitive impairments due to sleeplessness and fatigue, and other phobias such as claustrophobia. This report also shows that the impact of clinophobia on personal life and sleep may impact their mood. For example, there are reports of conjugal disputes and a strain on personal relationships. Antidepressants have been found helpful in reducing sleep disturbances but also reducing symptoms of depression and anxiety in these instances.³ 

Often the patient’s bed is not being used, they may repurpose it to store clutter or hoard. This may be a symptom of Diogenes Syndrome which is also comorbid to clinophobia and is characterised by a lack of self-care.⁴ It may present as social withdrawal, poor personal hygiene, unsanitary living conditions, apathy, and hoarding. Diogenes syndrome is usually a result of trauma and most commonly occurs in the older population of 60 and above.⁶

The physical impact 

Not lying down and sleeping while sitting can cause discomfort and stiffness. The main concerns may be more alarming, partly due to the postural concerns and in part due to the lack of sleep.^3,7 

Sleep is essential for the regulation of hormones. Chronic sleep deprivation disrupts the balance of hormones, leading to issues like weight gain, increased stress levels (due to elevated cortisol), and metabolic disturbances. Lack of sleep is associated with increased stress on the cardiovascular system, leading to a higher risk of conditions like high blood pressure, heart attacks, and stroke. It is not advisable for those who suffer from insomnia or severe sleep disturbances to drive or operate heavy machinery due to their reduced alertness and slower reaction times.^3,7 

As those suffering from clinophobia may avoid laying down completely it is reported that they sleep in a seated position which inhibits relaxation and limits the circulation from the lower limbs. This tendency has been reported to cause varicose veins and oedema, which can build up fluid in the legs and chronic wounds, superficial leg ulcers which may become infected and even lead to sepsis.³

How to help? 

No intervention has been researched to treat clinophobia specifically. However, cognitive behavioural therapy (CBT) is an effective tool used to treat different phobias and sleep disturbances, such as insomnia. Although no research has been done on the impact of CBT on Clinophobia, it may hold some potential to help individuals live a more content life.^5,8 As previously mentioned, antidepressants may also help alleviate some of the symptoms of anxiety, insomnia, and comorbid depression.⁵ 

However, there are no means to understand interventions and their potential benefits.

Summary 

The text discusses clinophobia, an irrational fear of lying down, and its physical and psychological impacts. Clinophobia can cause muscle pain, joint stiffness, and poor circulation due to prolonged sitting or standing. 

It's associated with anxiety disorders and sleep disturbances, such as insomnia, which can exacerbate mental health issues like depression and psychosis. The fear can originate from night terrors or traumatic experiences.

The physical consequences of avoiding lying down include hormonal imbalances, cardiovascular issues, and the risk of varicose veins and oedema.

Treatment options are limited due to the lack of research. Cognitive Behavioral Therapy (CBT) and antidepressants may help, though specific research on clinophobia is limited.