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What Causes Panic Attacks When Sleeping

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How To Deal With Panic Attacks While Sleeping

Dealing with a panic attack that has wakes you up from sleep is more difficult than that during the day. Normally, in sleep you have no time to be warned and to be prepared. Traditional coping techniques that help you deal with panic attacks during the day can help you deal with panic attacks during the night as well.

First of all, dont ignore the symptoms and try to get back to sleep. It will only make the situation worse and cause frustration and even an aggravation of the panic attack symptoms. Instead, get up from the bed, turn on the light and try focusing on the actual moment. Tell yourself that there is nothing for you to be scared and frightened, that there is nothing that will endanger your life, but that all are only symptoms of a panic attack. Talking to yourself might be helpful as well as it will stop your hyperventilation and manage your breathing. Keeping a panic journal might be helpful too. You can write about the symptoms that you experience, when the panic attack started, when it stopped, what triggered it, etc.

How Common Are Anxiety Disorders

Anxiety disorders are the most common type of mental illness, affecting the lives of around 20% of American adults and 25% of teenagers each year.

Adults Affected in U.S. Percentage of U.S. Adult Population
Generalized Anxiety Disorder
7.7 million 3.5%

Not all people with anxiety disorders have the same degree of symptoms or impact from anxiety on their everyday life. In one large survey, around 43% of adults described having mild impairment of their life from anxiety. Around 33% said it was moderate, and nearly 23% said it was severe.

The Panic Attack Began In A Dream That I Was Having While Asleep

It was my first panic attack, and it began while, in the dream, I was outside on a hill with my brother.

I dont recall if we were hiking or what, but I was on some rocks, and my heart began pounding a bit.

Maybe it was because I was climbing or trying to help out my brother, but my heart was beginning to speed up.

Still having the dream, my hearts pounding increased, distracting me from whatever I was doing in the dream while on the rocks.

The pounding eventually overrode the dream and awakened me, and I was lying there feeling my heart pound this had never happened before. How strange.

Nothing had occurred in the dream to validate the pounding.

In fact, the scariest nighttime dreams Ive ever had, had never caused my heart to pound either as part of the dream or upon awakening.

This was an odd thumping that forced me to sit upright and note the time: about 4 am.

I wasnt liking how this was feeling. I was 28, and the day prior, I had gone hiking climbing hard up a lengthy rocky trail without any problem, something that Id been doing for quite a while.

The hike lasted two hours not unusual for me at all.

Despite effortlessly taking on a two hour hike, I was really worried that something was wrong with my heart.

I began thinking, feeling, that the thumping meant that a heart attack was imminent and that death was near.

I couldnt shake the intimation that I was in danger of dying. So I called 9-1-1. I had never done this before.

Gerd Gastroesophageal Reflux Disease

Acid reflux disease, also known as GERD, has also been linked to sleeping panic attacks. GERD itself is an irritating but fairly benign disorder. But it can affect you in your sleep, especially if you ate too soon before going to bed. Lying down after eating increases GERD symptoms considerably, and each of these symptoms represents a potential trigger for panic attacks:

  • Chest pains
  • Night sweats
  • Hyperventilation

Some people also have trouble breathing, sore throats, and other issues that can become panic attack triggers. Many of those with nighttime GERD do not notice that they have any symptoms at night unless they wake up, and even if they wake up they simply deal with the discomfort and go back to sleep.

But others with tendencies toward anxiety are not so lucky, and it’s possible that their anxiety and GERD combine to increase the likelihood of nocturnal panic attacks.

Anxiety And Sleep Research

Nocturnal Panic Attacks: What Causes Them?

There is, however, plenty of research on how anxiety can affect sleep and vice versa.

According to the ADAA, shows that sleep disorders occur in almost all psychiatric disorders.

In a small 2015 study , researchers examined the relationship between cognitive behavioral therapy and sleep quality in people with anxiety. Researchers found that both sleep quality and sleep latency improved in participants who responded to CBT.

The researchers believe that targeting sleep problems during anxiety treatment might be beneficial for those who have trouble sleeping.

Its important to remember that it can take time to find the right treatment approach for your anxiety. Because of this, you and your doctor may choose to use a variety of different treatment options.

How To Stop Nocturnal Panic Attacks

You are sleeping soundly when all of a sudden you bolt awake, a cold fear gripping you. Breathing heavily, with your heart rate off the charts, you try to figure out what is happeningdid you hear a noise, have a heart attack or wake up from a bad dream? What is going on? Before you get the answer to that question, a sense of calm overtakes you, and you feel your stomach unclench from the anxiety of the past few minutes. Youre left to wonder: What just happened?


What happened was a nocturnal panic attack. The Anxiety and Depression Association of America defines these episodes as the abrupt onset of intense fear or discomfort that reaches a peak within minutes. In addition to the psychological effects, panic attacks can also trigger a tide of physiological symptoms that mimic life-threatening conditions. While panic attacks subside in mere minutes after onset, they are scary because they can occur out of the blue or stem from a particular anxiety, and while you are in the midst of one the fear can seem overwhelming and uncontrollable. Panic attacks can also signal that you may be suffering from a panic disorder. This is a type of anxiety disorder that afflicts 6 million adults in the United States, according to the Anxiety and Depression Association of America. 


Who Might Experience Nocturnal Panic Attacks

While they can happen to anyone , some people are more predisposed to experiencing nocturnal panic attacks, including:

  • Those who suffer from PTSD-related . “Individuals with PTSD may have nightmares about their trauma; these nightmares essentially replay what they endured,” which may cause them to wake up “in a frightened state as they feel like they are reliving this trauma,” explains Dr. Magavi. The nightmares could “lead to panic attacks while they are sleeping.”
  • People who have general anxiety and panic disorder. “About 18 percent of panic attacks will occur during the night,” adds Dr. Dimitriu, who says that nocturnal panic attacks are “common in people who also experience daytime panic attacks.”
  • Those with sleep disorders. “Sleep apnea can result in sudden awakening due to inability to breathe, which could cause sweating, palpitations, and panic attacks,” says Dr. Magavi. “Sleep-initiation and sleep-maintenance can cause panic attacks as individuals begin to experience significant anxiety when they are unable to sleep.”

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.

Panic Attacks During Sleep: Causes And Dealing Ways

Panic attacks can be a real problem leading to an intense sensation of fear. They usually occur during the day, affecting a persons life. However, panic attacks can occur even at night while sleeping. If they occur at night, they are known as nocturnal panic attacks. Nocturnal panic attacks affect many people, leading to extreme fear and causing extreme distress, waking a person from sleep. Often, these panic attacks when sleeping lead to sleep deprivation problems the following day. If a person doesnt sleep well, or if a person is afraid to continue sleeping due to panic attacks, its normal not to be able to function properly the next day.


How To Stop Anxiety And Panic

Of course, even if you reduce the frequency of your nighttime panic attacks, you are still going to find yourself suffering if you continue to deal with panic disorder. That’s why you need to make sure that you find the appropriate long term treatment for reducing the frequency and severity of your panic attacks and doing whatever it takes to prevent them from coming back.

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How Common Are Nighttime Panic Attacks

Theyre pretty common and the majority of people who have been diagnosed with panic disorder have probably experienced nocturnal panic attacks, says Dr. Bea. While anxiety is thought to be a component of sleep panic attacks, other stressors can trigger them.

The absolute cause of panic attacks is pretty unknown at this point, but people who experience them may have histories of panic disorder, other anxiety disorders or behavioral health concerns that might be causing stress in general.

Dr. Bea adds that when people feel panicked, its very common that they might be experiencing situations in their life where they feel relatively trapped.

It could be occupationally, it could be in a relationship or in some other role that theyre playing. Its not uncommon to see correlates of that sort of tension in people who are having nighttime panic attacks. However, these types of panic attacks arent limited to people with a history of anxiety. They also arent rare. About 18% of panic attacks that people experience seem to occur at night.

The Causes Of Nocturnal Panic Attacks

Nocturnal panic attacks are a bit of a mystery, as there is no known reason why one should occur while you are asleep. However, if a panic attack occurs during the night, there is a chance you could also have one during the day. If you have multiple panic attacks, that can be a clue you have a panic disorder. 


There are certain triggers that can make you more likely to have a panic attack. There may be a genetic component to this condition, such as having a family history of panic attacks. Gender can also be a factor; women are twice as likely to have panic attacks than men. Panic attacks can also be brought on by an extremely stressful life event or traumatic incident. If you dont handle stress well, especially during times of life change, that may also increase your risk for panic attacks. Other factors include childhood abuse , changes in neurological function or smoking or drinking caffeine too much. 


Finally, panic attacks can co-occur with other types of disorders, and in fact be triggered by them. For instance, someone with deep social anxiety may experience a panic attack if they are alone at a large party or must give a speech in front of a lot of people. Instead of panic attacks occurring spontaneously without warning, in these cases a person may begin to anticipate that a panic attack can occur if faced with a situation that feels threatening. 

Can You Wake Up In A Panic Attack

Causes of Panic Attacks While Sleeping

The concept of having a panic attack while sleeping is somewhatmisleading in the sense that its very difficult to sleep during the course ofa panic attack. Its the panic attack that usually wakes you up, causing fearand disorientation.

While panic attacks at night usually only last for a fewminutes, it may take a while for you to calm down and go back to sleep, sincethe fear of another panic attack can lead to insomnia.

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How To Cope With A Panic Attack At Night

Waking up and discovering youre having a panic attack can be an overwhelming and scary experience, and the fact that youre probably still groggy and trying to come round from sleep, can make you feel out of control and cause you to panic even more.

If youre having a nocturnal panic attack, try the following:

Dont fight it

If you wake up and youre having a panic attack, its important not to fight it, as this could make things worse. Accept the panic attack for what it is and let the feelings wash over you. Remember, it is only temporary, and it will fade eventually. You just need to let it happen.

Try and relax

Try to get your body back into a relaxed state. Inhale deeply and exhale slowly to regulate your breathing. Relax your muscles, and try to focus your mind on positive thoughts and images.

Get up and do something

Go back to bed when youre ready

Only go back to bed when youre beginning to feel tired again and ready for sleep. When youre in bed, keep yourself calm by breathing deeply in through your nose and out through your mouth, to the extent that your whole abdomen, not just your chest, is rising and falling.

Sleep Anxiety Caused By Panic Attacks

The fear of having another panic attack can often lead tosleep anxiety. This could lead to sleep loss, increased stress and higher riskfor more panic attacks. How could sleep anxiety develop? Well, insomnia from apanic attack can fuel a cycle of anxious that makes you dread going back tobed.

For example, Sarah may have a panic attack where she wakes up withfear of losing her job. She might try to go to bed but end up being restless for anhour. She might get up again in the early hours of the morning – her mindracing with nervous thoughts about work.

Anxiety could spread to other areas such as thinking about nextdays events, an appointment she has in a few hours, and even how her day willbe terrible if she doesnt get some sleep. Such an inner dialogue could repeat formultiple nights in a row, causing sleep anxiety and the dread of going to bedin the first place.

If youre struggling to fall asleep due to anxiety, it couldbe that treating the anxiety will help you solve your insomnia. Anxietydisorders should only be diagnosed by a licensed therapist or medicalprofessional, so seek out required assistance as needed.

You can also reduce sleep anxiety by shifting yourperspective. Try to acknowledge that its completely normal to have bad nightsof sleep and sometimes its unavoidable. When you can tell yourself that youexpect it to happen, your body may be more likely to relax and naturally fallinto sleep.

What Are The Causes Of Nocturnal Panic Attacks

Having a panic attack during sleep is probably more common than you think.

With that being said, I find it somewhat alarming that even though thousands of hours of research has gone into this subject, there still appears to be no clear-cut reason why people suffer from panic attacks at night.

From my own research into sleep and sleep disorders, I am aware that the brain is still functioning pretty much as normal even while were asleep.

I would hazard a guess that some people may believe that the brain somehow switches off while were sleeping, but nothing could be further from the truth.

This leads me to believe, that in some cases, nocturnal panic attacks may be due to pent-up stress, worries, or anxiety.

You may even be stressed and worried about daytime panic attacks when you go to bed.

The research that there is into panic attacks suggests that I may be correct in this assumption, plus the following are also factors:

  • There are even a wide variety of substances which can cause panic attacks. These include caffeine and marijuana.

What Does Anxiety Feel Like

The symptoms of anxiety disorders can affect people both emotionally and physically.

People with anxiety may feel extremely nervous and on-edge. This can affect their concentration and mood, leading to irritability and restlessness. Their fear or sense of impending doom can feel overwhelming and out-of-control.

Physically, anxiety disorders can provoke tense muscles, rapid breathing and heartbeat, sweating, trembling, gastrointestinal distress, and fatigue.

Many people with anxiety disorders attempt to avoid situations that could trigger heightened worry; however, this does not resolve their underlying fear and can interrupt both professional and personal activities. Over time, a person with anxiety disorder may get used to being worried such that a state of distress or fear seems normal.

Anxiety disorders can occur alongside other mental health problems like depression. According to the Anxiety and Depression Association of America , nearly 50% of people with depression are also diagnosed with an anxiety disorder.

How To Recognize A Panic Attack

Because they come on suddenly and manifest with physical and emotional signs, panic attacks can be confusing and difficult to identify in the moment, especially if they are nocturnal, waking you from your sound sleep. Generally, a panic attack is of a fairly short duration, peaking after roughly 10 minutes, although it can take much longer than that to wind down from a nocturnal panic attack. You may feel too disturbed to be able to fall back asleep right away.


There are several signs that you should know about that indicate you are having a panic attack. For a full-blown panic attack, at least four of these symptoms will be present; less than four means you are experiencing what is called a limited-symptom panic attack. The signs:


  • A sensation that you are outside of your body or detached from the panic attack
  • Fear of losing your mind or dying


These symptoms can be very intense in the heat of a panic attack, but you can try to remember that it will pass when the panic attack does. 

What Is Anxiety What Are Anxiety Disorders

Anxiety is a feeling of worry and unease. Its normal to experience anxiety occasionally in response to fearful or stressful situations.

In anxiety disorders, this distress becomes excessive. Fears are not proportional to the situation, and worrying interferes with everyday life. These feelings become persistent, occurring most days for a period of six months or more.

Other Ways Panic Disorders Can Prevent Sleep

Not all panic-related sleep issues involve waking up in the middle of the night with a panic attack. Episodes of panic characterize panic disorders, but its not the only time symptoms manifest. Panic disorders can cause anxiety between panic attacks. Episodes are so unpleasant that people with panic disorders often fear the return of another episode. This anxiety can make it  hard to get to sleep and lead to insomnia.

Panic disorders can also cause physical symptoms that make you worry about your health. Symptoms can include heart palpitations, chest pains, and even numbness in your hands. Panic shares some symptoms with other issues that are more immediately dangerous, like heart attacks or strokes. People who have experienced these symptoms during a panic attack may worry there is something physically wrong with them. Seeking treatment can alleviate some of these fears, but ultimately, panic disorder needs to be addressed to effectively deal with anxiety. 

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Believing You Have No Control Over Your Feelings

Panic Attacks During Sleep

One of the objectives of Cognitive Behavioral Therapy is giving you more power over your thoughts. And because your thoughts are directly linked to your body and your feelings, when you heal your mind your physical symptoms will decrease.

It may seem like panic happens to you, but in reality it doesnt. Once you understand this, you will have more control.

What Causes Panic Attacks To Occur In The Middle Of A Dream

A study of people with panic attacks during sleep using electroencephalograms during sleep found the panic was preceded by Non-REM sleep during which dreams are rare, begins David D. Clarke, MD, President, Psychophysiologic Disorders Association , Clinical Assistant Professor of Gastroenterology Emeritus, Oregon Health & Science University, and author of They Cant Find Anything Wrong.

Dr. Clarke specializes in physical symptoms that result from stress.

But it was a study of a small number of subjects , so I would not rule out the possibility of panic during other stages of sleep during which dreams are more common, continues Dr. Clarke.

But I suspect the panic event is triggered independently of the content of the dream.

It seems odd that anyone should panic during such a peaceful time of the daily cycle, but panic during sleep is nevertheless a well-known phenomenon , awaiting better understanding.

Since 1983 Dr. Clarke has successfully cared for over 7,000 patients with stress illness.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.  


Controlled Breathing: The Mental And Physical Health Benefits Of Daily Breathwork

Other ways to calm yourself down in the moment include focusing on positive, peaceful and relaxing images, practicing mindfulness meditation or doing something to distract yourself from your anxiety, such as walking around the room or pouring yourself a cup of tea.

How to prevent night-time panic attacks

Although theres no guarantee that you can avoid night-time panic attacks completely, there are some things you can do to help reduce the risk of them developing.

Cognitive behavioural therapy has been shown to be an effective treatment for nocturnal panic attacks, with significant reductions in both daytime and night-time events, and other gains such as lowered heart rate, less leg movement and increased cardiac variability while sleeping, Dr Arrol explains.  

Other preventative measures recommended by the NHS include trying complementary therapies such as massage and , doing regular physical exercise to reduce stress and tension and avoiding caffeine and alcohol.

If you visit a GP to seek help for night-time panic attacks, they may also recommend medication such as . 

How to cope with fear of night-time panic attacks

One of the less-talked about side effects of night-time panic attacks is the anxiety and worry it can trigger surrounding sleep. Because night-time panic attacks can be so frightening and distressing, some people may develop a fear of the attacks themselves, and worry about going to sleep for fear of waking up in a state of panic.

What Causes Night Time Panic Attacks

While nocturnal panic attacks can be sudden and frightening, theyre actually a common mental health condition. So what causes them?

So far, research hasnt found a single, clear-cut reason for why people experience panic attacks at night. However, we do know that the brain doesnt switch off during sleep, so its possible for any pent-up worries or anxieties to manifest in our unconscious brains, causing a nocturnal panic attack. Also, struggling with day time panic attacks makes it more likely that you will experience panic attacks at night.

Research suggests there are a number of other factors that could increase the risk of someone suffering from both day and night time panic attacks. These include:

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