Panic attacks are brief periods of intense fear or discomfort that can come without warning and frequently lead to physical and emotional distress. Panic attacks are most easily associated with activity during the day, but panic attacks at night, or nocturnal panic attacks, are an under-studied but equally debilitating phenomenon. These nighttime attacks are as debilitating as daytime panic attacks, leaving one exhausted, terrified, and uncertain about their own health.
What Are Nocturnal Panic Attacks?
Nocturnal panic attacks are essentially panic attacks that occur at night, usually while one is sleeping. They can occur at any stage of sleep, but most often in rapid eye movement (REM) sleep, the stage where vivid dreams occur.
People who experience nocturnal panic attacks wake up suddenly, overwhelmed by fear and tension, experiencing physical symptoms similar to daytime panic attacks such as:
- Racing heart
- Shortness of breath
- Sweating
- Chest pain
- Lightheadedness
- Nausea
- Hot flashes or chills
Because these attacks can occur while a person is asleep, most of the afflicted won’t have any idea what’s happening. Instead, they’ll wake up in a panic state, confused, disoriented, or anxious, and individuals often mistakenly believe that they are experiencing a medical crisis, such as a heart attack.
Causes Of Nocturnal Panic Attacks
Even though the reasons why nocturnal panic attacks take place are not yet clearly determined, there are several factors that may contribute to these nighttime attacks. Some of the main causes are:
- Underlying anxiety disorders
Anxiety disorders, such as generalized anxiety disorder (GAD), social anxiety disorder, or panic disorder, are primarily related to nocturnal panic attacks. People with anxiety disorders will experience heightened stress and fear during both day and night. The body’s inherent fight-or-flight mechanism may even be activated while asleep, resulting in such nocturnal occurrences.
- Sleep disorders
Certain sleep disorders, for example, sleep apnea or insomnia, can predispose an individual to nocturnal panic attacks. For example, people with sleep apnea will wake numerous times during the night due to interrupted breathing, which may trigger feelings of panic or fear upon waking. Similarly, chronic loss of sleep can create added stress and anxiety, making one vulnerable to panic attacks.
- Stress and trauma
Severe stress or unresolved prolonged trauma can put the body into a state of hyperarousal and increase susceptibility to nighttime panic attacks. Night is typically the time when the mind is least engaged, and unresolved emotions and fear can surface, even resulting in a panic attack. Nightmares and night terrors in individuals with a past history of trauma also lead to nocturnal panic attacks.
- Medications and substances
Some medications, particularly those that influence the central nervous system (e.g., antidepressants, stimulants, or beta-blockers), can induce panic-like symptoms or result in sleep disturbances. The consumption of illegal drugs or alcohol, or withdrawal from them, may also lead to nocturnal panic attacks.
- Genetics and family history
Family history of anxiety disorders or panic attacks may increase the risk for nocturnal panic attacks. There is some evidence to suggest that there could be a genetic component to fear response and stress, and this may make some individuals more susceptible to panic attacks when asleep.
Symptoms Of Nocturnal Panic Attacks
Night-time panic attack symptoms are largely the same as daytime symptoms. However, since they occur at night, their intensity usually causes greater confusion and distress. The following are some key signs:
- Waking abruptly from sleeping: Individuals wake up during the middle of the night with an intense feeling of fear or terror.
- Palpitations of the heart: Pounding or racing heartbeat is a common bodily symptom.
- Shortness of breath: Difficulty breathing or having the sensation that one cannot breathe in is common.
- Choking sensation: Some individuals have the sensation of choking or not being able to breathe, which exacerbates the feeling of panic.
- Feeling disconnected from reality: This can lead to a feeling of unreality or separation from the body, which further exacerbates the disturbance.
- Fear of dying or losing control: Fear of a forthcoming health crisis, such as experiencing a heart attack, is common during nocturnal panic attacks.
Coping Strategies For Nocturnal Panic Attacks
Treating nocturnal panic attacks can be challenging, but there are several methods that can reduce the occurrence and intensity of the attacks. Some helpful tips are mentioned below:
- Sleep hygiene
Good sleep hygiene plays a key role in treating nocturnal panic attacks. This includes:
- Adhering to consistent sleeping times
- Ensuring a relaxing bedtime routine
- Preventing night use of substances that act as stimulants, such as nicotine or caffeine
- Ensuring a quiet, cool, and comfortable bedroom for sleep
- Limiting screen use during bedtime to reduce the impact of blue light on melatonin production
- Stress and anxiety management
Since anxiety and stress are significant causes of panic attacks, their management can stop them from happening. Methods such as meditation, slow breathing, progressive muscle relaxation, and yoga can be employed to calm the mind and body at night. Cognitive-behavioral therapy (CBT) is an effective treatment for anxiety and panic disorders and can help cure the root cause of night panic attacks.
- Think of therapy
Therapy, especially cognitive-behavioral therapy (CBT), may also be helpful in treating panic attacks. CBT can assist a person in learning to identify and dispute the negative cognitions that contribute to their anxiety. Exposure therapy, which systematically exposes a person to the causes of their panic attacks in a safe setting, can also decrease both nocturnal and daytime attacks.
- Medication
Medication is at times prescribed to ease panic attacks, especially for those with an anxiety disorder diagnosis. Antidepressants (SSRIs or SNRIs) or benzodiazepines will keep panic and anxiety at bay, but these should only be taken under a doctor’s supervision.
- Seek support
It might feel that living with night panic attacks is lonely, but being involved with a support group of friends, family, or groups can alleviate feelings of comfort and reassurance. Listening to others who understand the experience can minimize feelings of anxiety and fear, knowing that they are not alone.
Conclusion
Night panic attacks are frightening moments that can affect a person’s sleep, mental health, and overall well-being. Understanding the potential causes and symptoms of these attacks is the first step toward managing them.
By improving sleep habits, managing stress, seeking therapy, and, if necessary, using medication, individuals can manage nighttime panic attacks. If you are suffering from nocturnal panic attacks, you ought to see a health practitioner to identify what would be the optimal treatment in your situation.