Establish A Bedtime Routine
Establishing a bedtime routine lets you focus on taking proactive steps for yourself instead of ruminating in your anxiety. Your bedtime routine may include activities such as taking a shower, brushing your teeth, changing into pajamas, reading from an inspirational book, prayer, or listening to music.
Your bedtime routine should be established to help set you up for better rest. Dont include any activities that may be too overstimulating, such as scrolling through social media or watching TV.
Instead, make your routine calming and quiet, leading up to you falling asleep. This will signal to your brain that it is time to rest and will allow you to go to sleep without an upset and anxious mind.
Set An Intention Early
Many of us go from one activity to the next throughout our day without really considering how we are feeling, let alone how we would like to feel. For example, do you ever come home after a long day of work and think to yourself, I really want to relax and enjoy this evening?
Most likely you are far too busy or preoccupied to stop and ponder how you want your evening to be. However, by setting an intention early, you are more likely to get the results you want.
If you remind yourself each day that you are determined to have a peaceful evening, you are more likely to actually experience it that way.
Remembering to set an intention is easier when you mark a certain point in your day for it. For example, while driving home from work, you may be going over in your mind all the stress that you went through that day.
At a certain point during your drive home, such as when you drive over a certain bridge or pass a particular landmark, you can set the intention to let go of work stress from that point forward and enjoy the rest of your evening. Another option can be to set an alarm that reminds you to set your intention for a nice evening.
Regardless of what type of prompt works for you, get in the habit of setting your personal objective of how you want to feel each evening.
What Are Panic Attacks
Panic attacks are sudden, unexpected episodes of intense anxiety, which can cause a variety of frightening symptoms. These include:
- Feeling out of control and disconnected from your surroundings
- Feeling faint, dizzy or light-headed
- Chest pains and shortness of breath – a tightness of the chest and feeling as though its a struggle to breathe
- A racing or pounding heart
- Hyperventilating
- Numbness and tingling, for example, tingling lips and numbness in your fingers and toes
- Fluctuating body temperature feeling very hot or very cold
These symptoms can be so severe they sometimes make first time sufferers believe theyre experiencing a heart attack or a nervous breakdown. Over time, panic attacks can become more frequent, and the fear of having a panic attack becomes embedded, resulting in a vicious circle.
Night time panic attacks, also known as nocturnal panic attacks or night terrors, happen while youre asleep and wake you up, often with the same symptoms as day time panic attacks. However, while these nocturnal attacks usually only last for a few minutes, it can take a long time for you to calm down enough to go back to sleep after having one. This, coupled with worrying about whether youre going to have another panic attack, may lead to insomnia.
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Why Is This Blog About Panic Attacks At Night Before Bed Important
Panic attacks at night before bed can be quite frightening, overwhelming, scary, and exhausting, as we have discussed. Having a good night sleep is very important, when our quality of sleep gets reduced besides feeling tired or exhausted the next day, we could also experiment feeling confused, having trouble concentrating, etc.
Even though researchers havent actually agreed on a particular cause for panic attacks, there are some related causes we should be aware of. In addition, there are a few things we could do to treat anxiety some of them as simple as change¡ing of lifestyle or keeping a worrying journal or others such as going to therapy or getting medication to reduce the symptoms.
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Sleep Schedule And Hygiene
Improving sleep hygiene habits, which includes going to bed and waking up at a consistent time daily, can help improve your ability to stay asleep. Its important to set up a bedroom that facilitates sleep . This will help limit stimuli that could wake you up at night and make it easier to fall asleep.
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What Causes Panic Attacks At Night
Although its not known for certain what causes nocturnal panic attacks, some factors may increase the risk of experiencing them:ii
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Chronic stress
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Dwelling on anxious thoughts before bed
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Mental health conditions such as depression, anxiety, obsessive-compulsive disorder, or post-traumatic stress disorder
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Genetics sometimes having a close relative who experiences panic attacks can increase your risk of developing them
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Managing chronic illness such as cancer, for instance
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Alcohol or medication withdrawal
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Life changes e.g. bereavement, losing a job, or moving house
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Consuming stimulants such as caffeine or nicotine
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Worrying about the state of the world politically, socially, or environmentally
How Is Panic Disorder Treated
First, talk to your doctor about your symptoms. Your doctor should do an exam and ask you about your health history to make sure that an unrelated physical problem is not causing your symptoms. Your doctor may refer to you a mental health specialist, such as a psychiatrist or psychologist.
Panic disorder is generally treated with psychotherapy, medication, or both. Talk with your doctor about the best treatment for you.
Psychotherapy. A type of psychotherapy called cognitive behavioral therapy is especially useful as a first-line treatment for panic disorder. CBT teaches you different ways of thinking, behaving, and reacting to the feelings that come on with a panic attack. The attacks can begin to disappear once you learn to react differently to the physical sensations of anxiety and fear that occur during panic attacks.
For more information on psychotherapy, see .
Medication. Doctors also may prescribe different types of medications to help treat panic disorder:
- Selective serotonin reuptake inhibitors
- Serotonin-norepinephrine reuptake inhibitors
- Beta-blockers
- Benzodiazepines
Another type of medication called beta-blockers can help control some of the physical symptoms of panic disorder, such as rapid heart rate. Although doctors do not commonly prescribe beta-blockers for panic disorder, they may be helpful in certain situations that precede a panic attack.
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What To Do When You Wake Up Anxious At Night
Get out of bed. This is a strategy for dealing with insomnia and sleep-maintenance insomnia that experts like Runko teach their patients, and it comes from CBT for insomnia .
If youre anxious, youre physiologically more awake, which can lead to conditioned arousal, she says.
Move away from your bed and try a calm, sedentary activity that you consider to be a pleasant distraction. That can include TV , meditation, or reading a book.
Once you are again drowsy, go back to bed.
What Are The Signs And Symptoms Of Panic Disorder
People with panic disorder may have:
- Sudden and repeated panic attacks of overwhelming anxiety and fear
- A feeling of being out of control, or a fear of death or impending doom during a panic attack
- Physical symptoms during a panic attack, such as a pounding or racing heart, sweating, chills, trembling, breathing problems, weakness or dizziness, tingly or numb hands, chest pain, stomach pain, and nausea
- An intense worry about when the next panic attack will happen
- A fear or avoidance of places where panic attacks have occurred in the past
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Always Seek Professional Advice
Always seek medical advice if you are not sure whether your symptoms, or another persons symptoms, indicate a panic attack. In an emergency, dial triple zero for an ambulance. Its important to see your doctor for a check-up to make sure that any recurring physical panic-like symptoms are not due to illnesses, including:
- Diabetes
Symptoms Of Panic Attacks At Night
The symptoms of panic attacks at night will match other symptoms of panic attacks. Though the duration of the panic attack, symptoms, and experience will be the same, the most important difference is the timing. Typical panic attacks occur during the day, but nocturnal panic attacks happen while sleeping.
Like during the day, panic attacks at night occur when a person experiences at least four of the following symptoms at once:1
- Heart changes, like palpitations, pounding heartbeat, or quick heart rate
- Excessive sweating
- Feeling detached from self or feeling like life is not real
- Fear of going crazy or losing control of self
- Fear of dying
These symptoms must be part of an abrupt surge that peaks quickly. With nocturnal panic attacks, the surge must have already begun while asleep. It cannot begin some time after waking to be considered nocturnal.
Panic attacks are different from other anxiety because they:1
- Peak quickly
- End in a clear and discrete way
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Tips To Prevent Panic Attacks At Night
Experiencing a panic attack at night may make you worry about having another, causing a vicious circle, and leading to insomnia. There are a number of things you can do to try and avoid this becoming a frequent problem, and ensure that youre getting a good nights sleep:
Give yourself enough time to get the sleep you need
On average, adults need eight to nine hours sleep each night to feel rested and refreshed. Therefore, its important to make sure you go to bed at least eight hours before you need to get up so youre giving yourself enough time to have a good nights sleep. Going to bed too late and not leaving enough time for sleep may result in you constantly checking the clock and worrying that youre not going to feel rested the next day. These negative thought processes can fuel anxiety, and potentially spiral into a panic attack.
Prepare yourself for the following day
Many people struggle to get to sleep because they are anxious about the following day. You can try to reduce this anxiety by making sure that you have everything prepared. For example, you could have a to-do list, or even have your clothes laid out.
Establish a consistent sleep routine
Limit caffeine, sugar and alcohol before bed
Avoid electronic devices late at night
The Next Day And Beyond
Someone who just had a first nocturnal panic attack is likely to find himself worrying about having another one. The thought “what if I have one tonight?” is likely to occur to you the next day. That’s a natural, ordinary response. It’s just you experiencing a little nervousness, and it will be best to allow yourself to notice that thought without getting into a struggle with it.
People often respond to this worry by focusing more on their prospects for sleep. They think a lot about what time to go to bed try to tire themselves out during the day think about taking sleeping medication, or alcoholic beverages, to ensure sleep review all the important activities they have scheduled at work, home, or school, and worry that they’ll be unable to function if they don’t sleep, and so on.
It’s these very efforts which lead to more trouble with sleep anxiety.
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What Are The Symptoms
Some symptoms are the same ones you may experience with a daytime panic attack, such as rapid heart rate, trembling, sweating, shortness of breath, hyperventilation, feeling too hot or too cold, and a sense of impending doom. But panic attacks that occur at night often involve more problems with breathing, such as shallow, rapid, or uneven breathing.
Many people also suffer from muscle tension. They may have muscle cramps or spasms, numbness, or a tingling sensation. Others may experience sudden changes in body temperature and some even feel temporarily paralyzed.
A typical attack lasts for 15 minutes or less, although it certainly may seem longer.
How Are Panic Attacks At Night Diagnosed
Although diagnostic tests like blood tests and physical exams are unable to indicate whether someone is experiencing a panic attack, they can make sure that nothing else is taking place involving symptoms related to thyroid conditions, heart disease, or something else.
This can help to develop the right approach for treating the condition, and put the patient in touch with the proper specialists who can help them deal with the problem. It will also help make the patient aware of any symptoms accompanying their panic attacks, so that they can be prepared to deal with the full range of possible consequences.
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Keep Your Mind In The Present
Notice five things you can see around you. Then, four things you can touch. Three things you can hear. Two things you smell. One thing you taste. When you stay grounded in whatâs going on around you, it gives your mind something better to do than focus on fear or bounce from one worry to the next.
What Are The Causes Of Panic Attacks At Night
Up to date, what causes nighttime panic attacks is still unidentified. However, researchers have pointed out a few factors that could heighten the risk of suffering both day and night time panic attacks. These include:
- Underlying conditions, such as social anxiety disorder
- Genetics and medical background of the family
- Traumatic events and major life changes, such as job loss, a break-up, moving house, or fear of flying
- Day-to-day stress
- Communication skills
For the most part, psychotherapy may need to go side-by-side with medication to produce the best result in treating anxiety. Benzodiazepines and antidepressants are the most commonly recommended medications for anxiety.
Lifestyle Tips
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When To Seek Professional Help
If nighttime wake ups are frequent, bothersome, or impact your quality of life, dont hesitate to seek help from a therapist or a sleep medicine specialist. If you have anxiety, treatment may also include medication, like SSRIs or SNRIs, as previously discussed.
You should also focus on healthy lifestyle measures, like diet and nutrition, physical activity, mindfulness, and relaxation exercises. Your doctor, therapist, psychiatrist, or sleep medicine specialist can help you come up with a plan that will work for you.
How To Handle A Panic Attack
Professor Paul Salkovskis, Professor of Clinical Psychology and Applied Science at the University of Bath, says it’s important not to let your fear of panic attacks control you.
“Panic attacks always pass and the symptoms are not a sign of anything harmful happening,” he says. “Tell yourself that the symptoms you’re experiencing are caused by anxiety.”
He says don’t look for distractions. “Ride out the attack. Try to keep doing things. If possible, it’s important to try to remain in the situation until the anxiety has subsided.”
“Confront your fear. If you don’t run away from it, you’re giving yourself a chance to discover that nothing’s going to happen.”
As the anxiety begins to pass, start to focus on your surroundings and continue to do what you were doing before.
“If youre having a short, sudden panic attack, it can be helpful to have someone with you, reassuring you that it will pass and the symptoms are nothing to worry about,” says Professor Salkovskis.
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When To Get Help
See a GP if you’ve been experiencing symptoms of panic disorder.
They’ll ask you to describe your symptoms, how often you get them, and how long you have had them.
They may also carry out a physical examination to rule out other conditions that could be causing your symptoms.
It can sometimes be difficult to talk about your feelings, emotions and personal life, but try not to feel anxious or embarrassed.
You may be diagnosed with panic disorder if you have regular and unexpected panic attacks followed by at least a month of continuous worry or concern about having further attacks.
Helping Someone Whos Having A Panic Attack
It can be scary when someone you know is having a panic attack. But there are some simple things you can do to help them:
- Stay calm Keep your voice calm and dont talk about or focus on whats happening to them during the panic attack. Remind the person that theyre safe and that itll be over soon.
- Ask if they need anything Someone having a panic attack might not always be able to tell you what they need, but asking can help remind them theyre not alone.
- Help them to breathe Try counting out loud as you breathe in for 5 seconds and out for 5 seconds.
- Support them afterwards Take them somewhere quiet to calm down and get them some water if they need it. Try to stay with them for a few minutes afterwards or for as long as they need to feel better.
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