Night-time panic attacks: what are they? And why do they happen?

Night-time panic attacks, or ‘night terrors’ as they are sometimes called, are surprisingly common, but they can feel overwhelming if you’ve never experienced one before. Characterised by symptoms including a racing heart, sweaty palms or a shortness of breath, night-time panic attacks are intense, unexpected bouts of anxiety that wake you up in the middle of the night, rather than stopping you getting to sleep in the first place. However, just because they don’t occur when you’re trying to get to sleep, doesn’t mean night-time panic attacks can’t contribute to conditions such as insomnia. 

Indeed, while night-time panic attacks typically only last for short periods, trying to calm yourself down enough to get back to sleep after having one can take a long time. You may also worry about falling back to sleep for fear of another panic attack happening, or put off going to sleep in the first place. In short, night-time panic attacks can have a big impact on your overall mental health and well being, making finding ways to cope with them (and in the long term, stop them from happening) super important.

What are night-time panic attacks?

“Nocturnal panic attacks are when we wake from a sleep state with a sense of panic,” Dr Arroll explains. “These are common in people who also have panic attacks in their waking hours. night-time panic attacks are distinct from other “waking triggers” such as “night terrors, sleep apnoea or dream-induced arousal because these periods of intense anxiety are not associated with “obvious triggers” – a fact that can make them feel unpredictable and difficult to control. “Night-time panic attacks usually occur within non-REM sleep phases, from 2-3 hours after going to sleep, last for 2-8 minutes and most often only happen once per night. “However, it can prove very difficult for people to get back to sleep after a panic attack and these events often stick vividly in the mind.”

What are the symptoms of a night-time panic attack?

Symptomatically, night-time panic attacks typically only differ from regular panic attacks in the sense that they wake you up. Apart from that, Dr Arroll explains, they tend to trigger the same kinds of symptoms. Nocturnal panic attacks can be incredibly distressing,” Dr Arroll explains. “Individuals experience the classic physical symptoms of panic attacks such as a racing heart and palpitations, shortness of breath, sweating, chest pressure, dizziness or light-headedness and for some, fear of dying or worries around sanity.

What causes night-time panic attacks?

One of the most frustrating things about night-time panic attacks is that research hasn’t been able to identify exactly why they happen, although it’s thought to be down to a number of factors – for example, people with panic disorder are more likely to deal with night-time panic attacks. Conditions such as post-traumatic stress disorder (PTSD) and OCD are also thought to increase the chance of a night-time panic attack, as well as strenuous life events and experiencing chronic stress. Although you can’t stop night-time panic attacks in the moment, there are things you can do to help yourself cope, both in the moment after the attack and in the long-term. 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 (non-caffeinated) tea.

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