Nocturnal panic attacks happen at night, causing you to wake up in fear. You may struggle to breathe, have a racing heart and sweat profusely. People who have panic attacks, or panic disorder, are more likely to have nocturnal panic attacks. Cognitive behavior therapy (CBT) and antidepressants can ease panic attacks.
A nocturnal (night) panic attack is a sudden feeling of fear that wakes you from sleep. You wake up in a state of panic, experiencing physical reactions like a racing heart, sweating and difficulty breathing (gasping for air).
About 11% of Americans experience a panic attack every year. As many as 7 in 10 people with panic disorder (recurrent panic attacks) also have nocturnal panic attacks.
Night terrors are a disruptive sleep disorder (parasomnia). A person experiencing a night terror has symptoms like those of a nocturnal panic attack. One key difference is awareness.
People experiencing night terrors are often unaware they’re having them. They may look like they’re awake — and they may scream, jump out of bed and run around. They’re actually asleep, and it’s difficult (and often not recommended) to wake them. When a night terror ends, a person falls back to sleep. They may not remember the event in the morning. Children are more likely to have night terrors, although adults have them, too.
A panic attack wakes you from sleep. You’re aware of the feelings of fear and other panic attack symptoms. It may take a long time to fall asleep again. Nocturnal panic attacks primarily affect teens and adults.
Experts don’t know why some people experience panic attacks. Something affects how your brain and nervous system perceive and process fear and anxiety. Most panic attacks happen during the day, usually when a nonthreatening situation triggers a panic response. Similarly, nocturnal panic attacks don’t have a basis in the situation.
You’re more likely to have panic attacks at night if you have them during the day. Other risk factors include:
Nocturnal panic attacks cause the same symptoms as attacks that occur during the day. However, research suggests that people who have panic attacks at night may have more severe breathing symptoms. They may struggle to catch their breath (shortness of breath) or feel like they’re choking or having a heart attack.
Signs of a nocturnal panic attack include:
Nocturnal panic attack symptoms usually peak in less than 10 minutes and then subside. It may take a while to fall back to sleep.
Your healthcare provider may order tests to rule out health problems like heart disease and thyroid disease that cause symptoms similar to panic attacks. If they don’t find a physical cause, your healthcare provider may diagnose nocturnal panic attacks based on symptoms and risk factors.
Once a panic attack starts, the only option is to let the symptoms run their course. Some people find they can reduce an attack’s severity with deep, controlled breathing or muscle relaxation exercises. Your healthcare provider may prescribe medication to lessen your symptoms.
Your healthcare provider may recommend a combination of medications and therapy to stop nocturnal panic attacks. These are the same treatments for daytime panic attacks.
Nocturnal panic attack treatments include:
Waking up in a panic is very disruptive to a good night’s sleep. Concerns about having a panic attack at night may cause you to delay going to bed or lead to insomnia.
Lack of sleep affects health in many ways. It can lead to:
These steps may lower your risk of having panic attacks:
Talk to your healthcare provider before taking herbal supplements or over-the-counter medications. Certain ones can heighten anxiety.
Panic attacks are treatable. Most people get symptom relief through therapy and medications. Once you have a handle on daytime panic attacks, the frequency and severity of nighttime panic attacks should also improve.
You should call your healthcare provider if you experience:
You may want to ask your healthcare provider:
A note from Cleveland Clinic
If you’re not sure if you’re having nocturnal panic attacks, don’t be embarrassed to talk to your healthcare provider. They can help you find the cause and offer treatments that can help. Therapy can teach you strategies to manage triggering events and prevent attacks during the day. Preventing panic attacks during the day should help get rid of panic attacks at night.
Last reviewed by a Cleveland Clinic medical professional on 04/16/2022.
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