Sleep Panic Disorder: When Panic Attacks Wake You Up

Reviewed by Melinda (Santa) Gladden, LCSW

Published 07/26/2022

We have all seen it happen in the movies: someone waking up in a sheer panic. However, repeat panic attacks can do more harm than good in the form of a full-blown Sleep Panic Disorder. Sleep panic disorder can be described as waking up for no particular trigger without completing a healthy sleep cycle. Essentially, you can understand these happenings as simple or ordinary panic attacks, with the exception that they take place while you are fast asleep. They are problematic given that there is no way to predict them, and when they do occur, most of the time, you cannot identify the trigger. However, when it does happen, you wake up in a panic attack all the same with abnormal sweating, a high heart rate, and palpitations, abnormal breathing patterns, hyperventilation, and chills with flushing. Another commonly associated symptom of sleep panic disorder is waking up with a sense of impending doom.

While the nocturnal panic attack by itself may not last for a long period, you will find yourself entirely worked up, and it may take you a while to get back to normal before you can eventually fall back asleep. Most of the time, if you have nocturnal panic attacks, you experience panic attacks in the daytime.

Causes of Nocturnal Panic Attacks

Like daytime panic attacks, the triggers of nocturnal panic attacks are often unknown and beyond any reasoning. There is currently an understanding that these attacks result from various factors, including genetics, stress, personality, etc. Research indicates that underlying conditions such as a thyroid issue, a second sleep disorder, or a malfunction in a bodily system that impairs the balance in hormones may be behind nighttime panic attacks.

If you experience daytime panic attacks, you must watch out for chronic stress. This is because chronic stress wreaks havoc on your mental and physical health, allowing such panic to be triggered in your system more easily. Another theory is that a lack of assertiveness could also be behind such panic attacks. It is important to make sure you are actively treating any other mental health conditions to help keep the panic at bay. Far too many of us experience depression, anxiety, or trauma of some kind that goes untreated, making us more susceptible to panic attacks.

Medication can be another cause of nocturnal panic attacks. If you are taking any medications, make sure you go over the side effects they may cause. Some of them may cause depression, other conditions that may directly lead to panic attacks or panic attacks. Nothing is indispensable when it comes to good health. In any case, it is worth a discussion with your medical health practitioner.

For example, experiencing a heavy personal loss, such as a death in your close circle, intimidating chronic conditions such as cancer, or a major life change, such as a job loss, may also trigger such attacks.

Treating Sleep Panic Disorder

Even if treatment cannot eliminate the problem, it can reduce the intensity. Treatment for panic disorders in general, including sleep panic disorder, can be twofold:

  1. Cognitive-behavioral therapy sessions
  2. Medications

After working with their doctors, most people choose a combination of the two options above, depending on their symptoms.

How to Cope With Sleep Panic Disorder

Even with effective and excellent treatment, you may not begin to see results right away. So, what do you do if you find yourself coping with sleep panic disorder? After all, being woken up in the middle of your sleep can be intimidating, even if there was no panic involved.

Go With the Flow and Do Not Resist

The more you come to expect the attack, the better you will be able to deal with it when it comes. You will eventually learn to accept what is broken in your system for the time being, even as you work to heal it. Learning to accept the situation rather than aggressively react to it can help immensely. Continuing to resist will make dealing with the attacks difficult, and recovery will be longer. Keep in mind, most of these attacks barely last a few minutes. Once you learn to let them simply happen without reacting, you will return to your normal quicker, and you can move on from the attack with a little bit of effort.

Focus On Relaxing

If you can, try to remember how soundly you were asleep before you had the attack. Most people can easily do that and will tell you first thing how good their sleep was. By remembering that state of relaxation, you can work yourself back into the most inviting posture, focusing only on your breath and your muscles relaxing. This exercise and relaxation are easier to achieve if you have bedtime rituals built around your sleep. Artifacts, imagery, and other tools that help direct your thoughts towards positivity can also help achieve a state of relaxation as you fall asleep.

Listen To Your Body and Mind

Struggling to fall asleep after you climb into bed? If your body and your mind are keeping you awake, then just do what they want. This may mean forgetting about sleep in the interim and starting on something that would absolutely engage your entire mind. This does not necessarily mean jumping back into work mode or focusing on being productive. Perhaps all you really need at that time is a good yoga session, listening to calm and relaxing music, digging into positive literature, or just something that will help you grind an edge. For example, some people may take to cleaning or putting clothes away, etc. What is not advised is something that would stimulate you too much. This means stay away from things like caffeine, vigorous exercise, or consuming toxic content. These things will only make your sleep situation worse.

Keep Sleep in Mind

Even though you may get up and do something to calm your mind, you have to be ready to hit the bed as soon as you can work yourself back into sleep. Take advantage of every instance when you start to feel tired again or are no longer opposed to lying down and getting some rest. When in bed, keep the meditative state going. If you have any practice with meditation, you can control your breath and thereby control your mood. To relax while breathing, you also want to make sure you engage your abdomen and not merely your upper respiratory system.

Preventing Symptoms from Occurring and Reoccurring

Many individuals who experience nocturnal panic attacks worry about another panic attack that lands them in a vicious cycle that validates itself repeatedly. All of a sudden, they go from having panic attacks to also being insomniacs. This leads to the common question of whether you can take steps to prevent the symptoms from materializing. Here are some practices that can help reduce the chance of you having nighttime panic attacks.

Focus On Building Good Sleeping Habits

The habits you have when you go to sleep make a huge difference in your stress levels and relaxation while sleeping. To build good sleep habits, you need to give yourself plenty of time to get ready for bed and budget for the time you will take to fall asleep. When you give yourself just enough time in the bed to get 7 hours, any difficulty in falling asleep will elevate your stress levels, which could potentially trigger another attack. This is especially true if you keep looking at the clock looking at all the more time left to sleep before you have to get up with your alarm. To avoid this, give yourself enough time so you can stay relaxed in bed.

Reduce Your Overall Stress and Anxiety

When it comes to preventing nighttime panic attacks, you want to reduce stress and anxiety in every aspect of life.  Not only will that positively affect your sleeping habit, but you would also have aggressively taken out a few different reasons to worry. For example, do not wait until the last day to accomplish something that needs to be done anyway. Likewise, make sure to negotiate for enough time to get your work done. You are actively trying to thwart what could generate more anxiety in your life, eventually leading to an anxiety attack in sleep.

Improve the Quality of Your Sleep

Making an extra effort to get good quality sleep is important in keeping your body relaxed while sleeping. Essentially this means riding over your anxiety. A strong sleep routine and your commitment to it may mean the difference between waking up and barely remembering the nightmare you had the night before. One option could be a fixed sleep routine with set times for getting to bed, finishing up with stimulating activity, or negotiating certain cravings. You could also have a bedtime habit that will allow you to tell your system it is time to start winding down from the inside. You absolutely do not want to engage in caffeine, alcohol, or sugar for hours before its bedtime. They will interact with your central nervous system, activating it and depressing it at will when you want it to be dictated as per your conscious decision-making.

Turn Off the Screens

Unbelievably, we are more isolated than ever in this age of information. Given the amount of time we spend interacting with these gadgets, we may develop vices like screen addiction that may again affect your sleep quality. Far too many of us want to take our gadgets to bed to check on our notifications one last time. Professionals recommend putting these devices away between a half-hour and an hour before you hit bedtime to protect against panic attacks while sleeping. Otherwise, you may find yourself over-stimulated. On the other hand, a book or a magazine may have a reverse impact, and they are generally recommended across the board as a good activity before bed.

You are Not Alone

Dealing with sleep panic disorder can be scary, but you do not have to go through it alone. Working with a licensed counselor can help you get the root cause of your anxiety. Likewise, talking to your medical doctor can determine if the situation is serious enough to warrant medication of any kind. If you believe you exhibit a few of the symptoms discussed above, you can take this free sleep test to evaluate the nature of your sleep disturbances (or nightly panic attacks).