Nocturnal Panic Attacks: A Guide to Understanding and Overcoming

Nocturnal panic attacks are similar to typical panic attacks, except they specifically happen at night while trying to go to bed. They often come with a sense of doom that strikes just as you are falling asleep, waking you up in fear. In this article, we will discuss what a nocturnal panic attack is, how to overcome it, and when to seek help.

Key takeaways:

What are nocturnal panic attacks?

A panic attack that happens specifically when you are going to sleep is called a nocturnal panic attack. Nocturnal means occurring at night, and panic attack means an episode of intense distress. So, a nocturnal panic attack is an episode of intense distress that occurs at nighttime and happens right before sleep or in the first stages of sleep.

This feeling may prevent you from falling asleep or even develop a fear of sleeping called somniphobia. People who experience panic attacks may also feel like they are scared or fearful of something when nothing is happening.

The feelings of fear, with no cause, while trying to sleep may keep you from sleeping at night. It may even happen right after falling asleep and wake you up. Almost three-quarters of people who experience panic attacks also experience nocturnal panic attacks.

Nocturnal panic attack symptoms

Nocturnal panic attacks start when going to bed and can last around 10 minutes before starting to dissipate. Having a nocturnal panic attack may only happen once, say before a stressful event the next day. Or, it may be a recurring issue that happens most nights, preventing you from falling asleep.

It may feel like you are having a hard time breathing or going to have a heart attack until you are more awake. Sometimes, people mistake their panic attacks for a heart attack or a pulmonary embolism and go to the emergency room.

To be considered a panic attack, you must be experiencing at least 4 of these 13 symptoms:

  • Chest discomfort
  • The feeling of impending doom
  • A feeling of being smothered
  • Heart palpitations
  • Dizziness or fainting
  • Feeling like you are choking
  • Tingling in your arms or legs
  • Fear of losing control
  • Shortness of breath
  • Detachment from self
  • Trembling
  • Nausea
  • Sweating

It may be difficult to discern if you are having a nocturnal panic attack or another health issue. If you are unsure, you should seek professional help as a caution.

Causes of nocturnal panic attacks

There isn’t a lot of current research on nocturnal panic attacks. There are some speculations about why they occur, but the true cause is unknown. It may be due to stress during the day or an anxiety disorder. Sometimes, there may even have no cause at all.

Certain predispositions can be a reason for a nocturnal panic attack. Some of these may include:

  • Family history
  • Genetics
  • Brain chemistry
  • Trauma
  • High-stress life events
  • Substance abuse
  • Post-traumatic stress disorder
  • Anxiety or panic disorders

Managing nocturnal panic attacks

Management of nocturnal panic attacks is done through therapy and medications. Cognitive behavioral therapy (CBT) is a specific type of therapy that may be used to help treat panic attacks at night. Additionally, medications such as antidepressants and benzodiazepines may also be prescribed to assist in combating nocturnal panic attacks.

If having nocturnal panic attacks is a recurring problem that is preventing you from getting sleep, there are a few things you can do to try and prevent them.

Meditate before bed. Meditating before sleep may help you to relax and stay calm, preventing you from having a panic attack.

Use ice as a method to calm down. Using ice packs or holding on to something icy can help trigger your nervous system, stopping or preventing a panic attack.

Count to 100. Counting to 100, sometimes 3–4 times, helps focus your brain and distract you from feeling panicked.

Get up and walk around. If you feel you are having a panic attack while lying down, stand up and walk around the room or the house for a short while to expend energy and start to relax.

Use your 5 senses. Think of something that you notice with each of your 5 senses: what do you see, what do you hear, what do you feel, what do you smell, and what do you taste? Tuning into each of your senses can help distract you from your panic attack.

Take slow, deep breaths. Count the seconds of your inhales and exhales and try to make them the same. For example, if you inhale for 5 seconds, then exhale for 5 seconds.

When to seek treatment for nocturnal panic attacks

Other symptoms may mimic the signs of a panic attack, such as a heart attack, pulmonary embolism, or thyroid disease. If you are experiencing any symptoms such as shortness of breath, chest pain, or abnormal heartbeats, you should speak with your doctor to rule anything else out.

Your doctor may want to perform a routine exam, run some blood work, and maybe even an electrocardiogram (EKG) on the heart.

If nothing is wrong with your physical health, your doctor may refer you to a mental health provider for more assistance.

Recurring nocturnal panic attacks can prevent you from getting the appropriate amount of sleep needed, leading to health issues. Chronic stress and panic attacks can also lead to health issues as well, such as heart disease, high blood pressure, weight gain, and more.

Nighttime panic attacks are treatable, and your doctor may be able to help create a treatment plan that is right for you.

Nocturnal panic attacks can be scary to experience and keep you from sleeping at night. It is important to rule out that what you are feeling is, in fact, a panic attack and not something more serious. Experiencing panic attacks at night is something that can be treated both professionally and at home. Taking time for yourself and looking at why you are having panic attacks can help.


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