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Why is my brother afraid of sleeping?

Q: My brother is 30 years old. For the last year he has been afraid of going to sleep. He thinks something will happen to him in sleep - like he will die. He becomes very fearful and anxious before going to sleep. He keeps thinking about this problem the whole day. All his medical tests are normal. Please guide us in dealing with this problem.

A:From your description it is not clear what might be making him afraid of sleep. There are some sleep disorders called as parasomnias which happen in sleep. Some of these, specifically sleep paralysis and nocturnal-sleep panic arousals can be frightening to the individual and one may be afraid to go to sleep if this is the case. In sleep paralysis the individual when he is coming out of sleep feels as if the whole body is paralyzed and that he/she can not speak and this may be very scary. In nocturnal-sleep panic arousal the individual wakes up with anxiety with heart racing, difficulty breathing, dizziness, tingling and numbness and is scared that something physically going to happen to him. He probably will need to see a physician with expertise in sleep medicine or a psychiatrist to evaluate him further in this regard and possibly treat the problem.

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