Nocturnal Panic Attacks: How to Cope with Panic Attacks in Your Sleep
Nocturnal panic attacks are when a person is woken up unexpectedly by symptoms of panic, which can be terrifying and disorienting. Learn more about nocturnal panic attacks and how to start overcoming them.
Experiencing repeated panic attacks (in any form) can have multiple negative impacts on a person’s life. Panic attacks at night can be particularly awful. Those who have experienced a panic attack during sleep know how distressing and disruptive this can be.
Nocturnal panic attacks are when a person is woken up unexpectedly by symptoms of panic—which can include shortness of breath, chest pain, racing heart, fears of dying, and other distressing sensations.
Understandably, waking up with these symptoms can be terrifying and disorienting, and it can be difficult to get back to sleep once it passes. It may even cause someone to become fearful of sleep and purposely reduce or change their sleeping habits, which can have flow-on effects to other aspects of mental health and wellbeing.
In this article, we aim to help you understand a little more about nocturnal panic attacks, in the hopes that this knowledge may be the beginning of overcoming this troubling condition.
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Panic attacks during sleep: How common are they?
Around half of people who experience panic attacks when they are awake will experience a panic attack in sleep at least once—nocturnal panic attacks rarely happen without the person also having daytime ones.
People who have both daytime and night time panic attacks usually have more frequent and severe panic attacks and experience higher distress and other mental health conditions.
That said, if a person only experiences panic attacks at night it might be difficult to identify it as such, because panic attacks in sleep can seem similar to other conditions, such as sleep terrors, sleep apnea, nightmares, PTSD flashbacks, or seizures. Careful monitoring of sleep—usually using sensors—may be needed to determine which of these conditions is occurring and give appropriate treatment.
To tell them apart from other conditions, nocturnal panic attacks will typically only occur once during a night of sleep, usually during the early or middle hours of the night (in non-REM sleep), are usually remembered the next day, don’t go along with bad dreams, and aren’t associated with brain abnormalities.
Most common causes of night panic attacks
Nocturnal panic attacks are somewhat of a mystery—they tend to happen pretty randomly and it’s not completely clear why. They can happen in all kinds of people, and there aren’t any clear trends as to who is more susceptible, other than those who are generally prone to panic attacks.
However, there are some theories about nocturnal panic attacks that may shed light on some possible biological or psychological causes.
Biological theories
Panic attacks generally have various symptoms and can be different between different people, with breathing difficulties being only one possible symptom. People who experience nocturnal panic attacks are more likely to have difficulties with breathing. This might mean that respiratory issues in general can make someone more susceptible to having nocturnal panic attacks. For instance, while sleep apnea is a different issue, the two conditions can be related.
There is a part of the brain that monitors levels of carbon dioxide in the blood, and when changes are detected, this area sends out a signal to increase breathing rate. This is a biological survival mechanism that is meant to help if a person is suffocating.
But it’s possible that some people might be hypersensitive to these changes, meaning that the signals are sent out when they don’t need to be—a “suffocation false alarm”—which leads to hyperventilation and a feeling of not being able to breathe.
Hypersensitivity to carbon dioxide levels may underlie panic attacks in general, but as breathing symptoms are more common in nocturnal panic attacks, this explanation might particularly apply to this form of the condition.
Psychological theories
Panic attacks in general are also linked to heightened fears about physical harm, and a belief that the symptoms of panic or anxiety might be dangerous. If you experience panic attacks, you might be extra careful to stay away from situations that can put you at risk of having a panic attack in order to protect yourself—which makes sense!
The thing is, we are basically completely helpless when we are asleep—we can’t actively protect ourselves from danger. So, sleep might be a scary situation for people who are extra concerned about their physical safety. This fear might trigger a panic attack during sleep.
What’s more, once a night time panic attack has occurred, it may set off a cycle in which a person links panic with sleep and then becomes even more fearful of sleep because of the chance of panic.
Fear of having a panic attack during sleep might cause a person to avoid or restrict their sleep, which often only serves to make the problem worse.
The fear of sleep makes a person more sensitive to possible signs of panic while sleeping, reinforces the belief that sleep is dangerous, and can lead to sleep deprivation which further aggravates mental health challenges.
Best ways to prevent panic attacks at night
Although we don’t fully understand nocturnal panic attacks, the good news is that it is treatable—research shows that treatments designed to address both the biological and psychological aspects of nocturnal panic attacks can be highly effective.
The treatments for dealing with panic attacks are likely to involve:
- Improving sleep quality in general by preparing the body and brain for sleep using good sleep hygiene practices.
- Deep breathing exercises before bed which can train the body to breathe differently during sleep and reduce the chances of hyperventilation.
- General panic attack coping skills, including reassuring yourself and calming the body.
- Cognitive behavioral therapy (CBT)—this is an effective therapy for panic attacks generally and works by changing thought processes and beliefs around what’s really happening in the body, helping a person to realize that they are not at risk of physical harm.
- CBT also involves exposure therapy—helping a person to experience a fearful situation (like falling asleep or feeling short of breath) and learn that they are safe, rather than trying to escape from these situations.
To try some of these techniques for yourself, the Mind Ease app includes more information about panic attacks, breathing and other calming exercises, and CBT techniques. Download the app today.
