Nocturnal Panic Attacks - Symptoms, Causes, Treatment

What are Nocturnal Panic Attacks?

A nocturnal panic attack is a panic attack that occurs while a person is asleep. Nocturnal panic attacks is scary and upsetting for the person to experience because they are not well known, nor are they typically discussed by professionals unless brought up by a patient. Even though they are not often spoken about, nocturnal panic attacks are fairly common, especially among those who have severe or chronic anxiety conditions, panic disorder, or posttraumatic stress disorder.

A panic attack can be very upsetting for a person because they are scary and sometimes painful. People who experience panic attacks often do not understand what triggered their panic attacks and feel anxious about not knowing when their next one will occur. It can be quite stressful to not know when or how to expect the next panic attack, and having one while asleep increases the intensity of the reaction because you wake up in a panicked state and delirious from having your sleep cycle disturbed. It is scary to experience a nocturnal panic attack since there is no conscious stream of thought that could trigger the attack. However, it is professionals believe the process of a nocturnal panic attack is the same as a conscious panic attack. Since the brain remains active during sleep the activity leading up to a panic attack remains unchanged.

Symptoms of a Nocturnal Panic Attack

A nocturnal panic attack will cause the same symptoms of a conscious panic attack. Sometimes the symptoms will feel more intense than with a conscious panic attack. This is because the person having the nocturnal panic attack is exiting a deep sleep quickly and without warning, which can leave him or her confused, disoriented, and with a feeling of threat or danger. Besides the intensity, there is little difference between a conscious panic attack and a nocturnal panic attack. Symptoms of a nocturnal panic attack include:

  • Ringing in ears, sweating, or trembling
  • Chest pain or pressure
  • Believing you are dying or having a heart attack
  • Hyperventilation or shortness of breath
  • Disorientation, fear and confusion
  • Tingling or numbing sensation throughout body
  • Racing heartbeat or a flood of adrenaline
  • Stomach pain and nausea
  • Feeling faint, dizzy or lightheaded

What Causes Nocturnal Panic Attacks?

The causes of nocturnal panic attacks are the same as conscious panic attacks. Panic attacks, whether experienced during waking hours or while asleep, have the same triggers, causes and risk factors. Common risk factors for nocturnal panic attacks are:


Having too much stress in your life could result in panic attacks. Stress can come from several sources, including:

  • Work or school
  • Relationships or family issues
  • Chronic pain or ongoing medical issues
  • Adjustment to new surroundings

Nocturnal panic attacks will be especially prevalent in your life if you do not allow your body and mind to decompress. Self-care and stress relief is important in the reduction and prevention of nocturnal panic attacks. Some ways to reduce the effects of stress include:

  • Cardio exercises
  • Meditation
  • Socializing
  • Maintaining a daily or weekly schedule
  • Limiting work hours
  • Leaving work-related matters at the office, not taking it home with you
  • Maintaining medical care

Mental Health Issues

Having certain pre-existing mental health related issues also attribute to experiencing nocturnal panic attacks. A person may experience nocturnal panic attacks if he or she is actively avoiding confronting a difficult issue or situation. Examples of such issues include:

  • A history of sexual, physical, mental or emotional abuse
  • Unresolved feelings regarding a traumatic experience
  • Grief or fear of losing a loved one

Often people who experience nocturnal panic attacks have a diagnosis of a mental health or psychiatric disorder. The following disorders commonly cause both conscious and nocturnal panic attacks:

  • Bipolar disorder
  • Phobias
  • Obsessive compulsive disorder
  • Generalized anxiety disorder
  • Panic disorder
  • Depression
  • Posttraumatic stress disorder
  • Postpartum depression

How to Reduce Nocturnal Panic Attacks

The key difference between nocturnal panic attacks and conscious panic attacks is nocturnal panic attacks happen when the affected person is asleep. This means that the quality of the sleep cycle is related to the overall occurrence of nocturnal panic attacks. If the quality of sleep is improved then there will be less nocturnal panic attacks. Here are some ways to improve your sleep:

  • Reduce stress during the day. Any stress during the day will affect your sleep at night. It is difficult to reduce overall stress levels, but there are measures you can take to reduce stress, like taking on fewer responsibilities, and managing your workload to prevent procrastination or stressful deadlines.
  • If something is bothering you, face it. Nocturnal panic attacks often have to do with something that you are actively avoiding. Whether it is a conflict, bad memory, or coming to terms with something unpleasant, the more you push it away the worse your nocturnal panic attacks will get. That is why it is important to face the challenges (it helps to seek counseling if the issue is particularly difficult to cope with).
  • Allow your brain to transition to sleep time. Remember, your brain is a muscle. You need to allow it to wind down before turning it off. Like any other activity, you must allow your brain to de-stress itself before falling asleep. Taking measures like deep breathing, cardio exercising, and meditating one to two hours before bed will help your brain wind down for sleep.
  • Stick to a schedule. Sticking to a sleep schedule will help a great deal in reducing nocturnal panic attacks. When your brain and body are on a sleep-wake schedule it is easier for them to understand and prepare for when and how to shut down for sleep. Picking a set bedtime and wakeup time will help keep you on a schedule that your brain and body can keep up with.
  • Reduce sugar and caffeine intake. Sugar affects your ability to sleep soundly. Cut out any sugary snacks four hours before bedtime. This will help you sleep more soundly at night. Caffeine will also prevent a good night’s sleep. Caffeine not only actively keeps you awake and prevents a restful sleep, but it also affects the overall anxiety that triggers the panic attacks. The less caffeine you consume in a day the lower the risk of having a nocturnal panic attack.