Panic Attacks in Sleep: How to Cope

Think of the term “panic attack” and you’ll usually visualize a situation that involves sudden and intense fear, a pounding, racing heartbeat and a sense of impending doom, usually in a specific situation or environment. 

While many people experience panic attacks while awake, it’s also possible to experience panic attacks in your sleep. These attacks can occur suddenly and jolt you out of your sleep, making it difficult to calm yourself and feel relaxed again.

Dealing with a nighttime panic attack can be overwhelming, but the good news is that like panic attacks that occur during the daytime, nocturnal panic attacks are treatable.

Below, we’ve explained what nighttime panic attacks are, as well as why they occur. We’ve also shared proven techniques and treatments that you can use to deal with sleep panic attacks and prevent anxiety from interfering with your night’s rest.

Yes, you can. In fact, panic attacks that occur while you’re sleeping are a common symptom of panic disorder.

What is panic disorder? Panic disorder is a type of anxiety disorder. It involves panic attacks — sudden, severe feelings of terror and loss of control — that can occur in any place, at any time. 

Panic attacks can involve psychological and physical symptoms. You might suddenly feel as if you’re losing control of your emotions, or as if your doom is imminent. Many panic attacks can involve severe anxiety symptoms and feelings of fear, even if the situation isn’t dangerous.

From a physical perspective, you may develop a rapid heartbeat, chills, trembling, tingling that affects your extremities, chest or stomach pain, shortness of breath and feelings of weakness and dizziness.

Panic attacks can vary in severity. Although they’re most common in people affected by panic disorder, panic attacks can also affect people with other mood disorders, anxiety disorders or substance use disorders.

When a panic attack occurs at night, it’s referred to as a nocturnal panic attack. Like daytime panic attacks, nocturnal panic attacks are very common — in fact, research suggests that they occur in 44 to 71 percent of people diagnosed with panic disorder.

Researchers aren’t yet aware of precisely what causes panic attacks to happen at night. In fact, like with many other common mental health issues, experts still aren’t completely sure of why or how panic disorder develops in the first place.

Currently, research suggests that panic disorder is caused at least partly by genetic factors, as it sometimes runs in families.

Other research, including findings from brain imaging studies, suggests that panic disorder may be caused by increased activity in certain parts of the brain, such as the amygdala (the area of your brain responsible for controlling emotions).

Your brain remains active while you’re sleeping, meaning the issues that can trigger panic in the daytime may also have the potential to affect you at night.

Panic attacks affect men and women, but they’re most common in women. Your risk of panic attacks — whether during the daytime or at night — is typically highest during adolescence and early adulthood.

Nocturnal panic attacks can take a significant toll on your well-being. Not only can the physical and psychological symptoms of a nighttime panic attack affect your health, but the feelings of anxiety triggered by a panic attack can make maintaining normal sleep habits difficult. 

Luckily, nocturnal panic attacks are treatable. Treatments such as talk therapy and medication can help to lower your risk of developing panic attacks, while certain techniques and strategies can help you to better cope with them when they occur.

If you’re prone to nighttime panic attacks, it’s important to talk to a mental health provider about your panic attack symptoms and their effects on your sleep.

You can do this by asking your primary care provider for a mental health referral, scheduling an appointment with a psychiatrist or psychologist in your area, or from your home with our anxiety treatment online service. 

Medication for Panic Attacks

If you have panic disorder, your mental health provider may suggest using medication to control your symptoms and reduce your risk of experiencing panic attacks.

Several different types of medication can be effective at treating panic attacks, including anxiety medications, antidepressants and beta-blockers.

Anxiety medications, such as benzodiazepines, work by attaching to receptors in your brain that inhibit activity and promote relaxation. They work quickly and are very effective at stopping the symptoms of panic disorder, but they can be habit-forming and cause dependence.

If you’re prescribed a benzodiazepine to treat panic attacks or night terrors, your mental health provider may only recommend using it for a short period of time.

Antidepressants work by changing the way your brain uses natural chemicals that control your moods and feelings of anxiety. Common types of antidepressants include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).

Antidepressants are effective for many people prone to panic attacks, but they may take a few weeks to start working. It’s important not to suddenly stop taking your antidepressant, as this may cause withdrawal symptoms.

Beta-blockers are medications for hypertension (high blood pressure). Although they have no psychological effects, they can help to lower the severity of some physical symptoms of panic attacks, such as a rapid heart rate, heart palpitations and shaking.

Your mental health provider will choose the most effective type of medication for you based on your symptoms, personal needs and health history.

If you’re prescribed medication to treat nocturnal panic attacks, make sure to use it exactly as directed. Inform your mental health provider if you experience any side effects, or if you think your medication isn’t working effectively.

Psychotherapy (Talk Therapy)

Panic disorder often improves with psychotherapy, or talk therapy. A common form of therapy for dealing with panic attacks is cognitive behavioral therapy (CBT), which involves identifying and changing your ways of thinking and behavior that occur when you panic.

If your panic attacks mostly occur during the night, your therapy provider may work with you to develop specific coping skills to help you relax and return to your normal stages of sleep.

Therapy is effective, but it can require time and effort to produce results. You may need to take part in therapy for several months, either on its own or in combination with medication, in order to experience noticeable improvements.

Healthy Habits and Coping Techniques

In addition to using medication and taking part in therapy, simple habits and coping techniques can often make it easier to deal with nighttime anxiety and panic attacks. 

Try the following techniques to reduce your risk of panic attacks and cope with them when they occur:

• Practice mindfulness meditation. Mindfulness meditation is a form of medication that involves focusing your attention completely on the present, then accepting your feelings without any judgment.Research shows that it helps to reduce stress and anxiety.
  If you wake up after a panic attack or night terror, try practicing mindfulness meditation to calm your mind and make returning to sleep easier.
  

• Keep yourself physically active. Exercise may help to make managing your feelings of panic and anxiety easier.Research also shows a clear link between exercise and sleep quality and duration (your total hours of sleep per night).
  Try to keep yourself active. Even a short walk around your neighborhood, bike ride in the local park or workout at home can have a noticeable positive impact on your mental and physical well-being.
  

• Limit your consumption of alcohol. Although many people think of alcohol as relaxing, research shows a clear link between problematic alcohol use and anxiety disorders such as panic disorder.
  If you’re affected by nocturnal panic attacks, try to limit your alcohol consumption. This is especially important if you’re prescribed medication to treat your anxiety, as alcohol may increase your risk of side effects from many anxiety medications.
  

• After a panic attack, try a relaxing activity. After you go through a panic attack, going straight back to deep sleep isn’t always possible. Instead of trying to sleep straight away, try spending a few minutes on a relaxing activity to calm your mind first.
  This could mean reading a book, listening to calming music, practicing mindfulness for a few minutes or simply doing some deep breathing to calm your mind and body.
  

• If you have a sleep disorder, talk to your healthcare provider. Some sleep disorders, such as obstructive sleep apnea, appear to play a role in the subsequent development of panic disorder.
  If you have a sleep disorder and think it could be related to nocturnal panic attacks, don’t hesitate to talk to your healthcare provider.
  

• Take steps to limit stress. Sometimes, panic attacks can occur when you’re under a lot of stress. Try practicing our self-care tips to improve your emotional health and reduce the effects that stress can have on your mental and physical well-being. 

Panic attacks in your sleep are very common. When they occur, they can cause everything from rapid breathing and a racing heartbeat to ongoing anxiety that makes it hard for you to maintain normal sleep habits.

The good news is that with the right treatment plan, it’s possible to gain more control over panic attacks that occur and improve your mental well-being. 

If you’re prone to panic attacks and want to seek help, you can connect with a licensed provider using our online mental health services. You’ll receive a personalized treatment plan and, when appropriate, medication to control your symptoms and help you feel better.

Need more information about dealing with panic symptoms? Our guide to medications for panic attacks goes into more detail about your treatment options, while our free mental health content shares techniques that you can use to deal with stress, anxiety and other common issues.