Panic attacks when i try to sleep

How to Cope With Panic Attacks at Night

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How to cope with panic attacks at night

Getting a good night’s sleep is essential for our health and wellbeing. Sleep promotes rest and relaxation and gives us a chance to recuperate and let go of the stresses of the day. However, this isn’t the case for the many individuals who struggle with panic attacks at night.

Here, we provide advice on how to cope with panic attacks at night and give tips on how to reduce them.

What are panic attacks?

Panic attacks can happen day or night. They are sudden, unexpected episodes of intense anxiety, which can cause a variety of frightening symptoms. These include:

Feeling out of control and disconnected from your surroundings
Feeling faint, dizzy or light-headed
Chest pains and shortness of breath - tightness of the chest and feeling as though it’s a struggle to breathe
A racing or pounding heart
Hyperventilating
Feeling as though you’re choking
Nausea
Muscle spasms and palpitations
Excessive sweating
Trembling or shaking
Numbness and tingling, for example, tingling lips and numbness in your fingers and toes
Fluctuating body temperature – feeling very hot or very cold

These symptoms can be so severe they sometimes make first time sufferers believe they’re experiencing a heart attack or a nervous breakdown. Over time, panic attacks can become more frequent, and the fear of having a panic attack becomes embedded, resulting in a 'vicious circle'. You might also experience what's known as hypnic jerks. If you're particuarly stressed or anxious, you might also experience what's known as hypnic jerks. These involuntary muscle sensations, like jolts, occur when you are in your lightest stage of sleep.

Nighttime panic attacks, also known as ‘nocturnal panic attacks’ or ‘night terrors’, happen while you’re asleep and wake you up, often with the same symptoms as daytime panic attacks. However, while these nocturnal attacks usually only last for a few minutes, it can take a long time for you to calm down enough to go back to sleep after having one. This, coupled with worrying about whether you’re going to have another panic attack, may lead to insomnia.

What causes panic attacks at night?

If you wake up with a panic attack, it's not often clear why these nighttime panic attacks (or nocturnal panic attacks) have occurred - often there is no explanation. Similar to daytime panic attacks, symptoms can include feeling faint or dizzy, a pounding heart, shortness of breath, nausea, and sweating. However, we do know that the brain doesn’t ‘switch off’ during sleep, so it’s possible for any pent-up worries or anxieties to manifest in our unconscious brains, causing a nocturnal panic attack. Also, struggling with daytime panic attacks makes it more likely that you will experience panic attacks at night.

While nocturnal panic attacks can be sudden and frightening, they’re actually a common mental health condition. So what causes them?

Research suggests there are a number of other factors that could increase the risk of someone suffering from both day and night time panic attacks. These include:

Experiencing chronic stress in your day-to-day life
Struggling with other mental health conditions such as anxiety, depression, obsessive compulsive disorder (OCD) or post-traumatic stress disorder (PTSD)
A lack of assertiveness - some evidence supports the idea that people who suffer from panic attacks have a passive style of communication or interactions with others
Genetics – having a close relative such as a parent or sibling who suffers from panic attacks makes it more likely that you will also develop panic attacks
Alcohol, drugs or medication withdrawal
The side effects of some medications
Certain substances can also trigger panic attack symptoms, including caffeine and cannabis
Chronic physical illnesses such as cancer
Experiencing a significant personal loss, including bereavement, or the breakdown of a relationship
Significant life changes such as losing a job, becoming a parent, and moving house

How to overcome panic attacks at night

If you’re having a nocturnal panic attack, try the following:

Don’t fight it - If you wake up and you’re having a panic attack, it’s important not to fight it, as this could make things worse. Accept the panic attack for what it is and let the feelings wash over you. Remember, it is only temporary, and it will fade eventually. You just need to let it happen.
Try and relax - Try to get your body back into a relaxed state. Inhale deeply and exhale slowly to regulate your breathing. Relax your muscles, and try to focus your mind on positive thoughts and images.
Get up and do something - It’s unlikely you’ll be able to go straight back to sleep after a panic attack, that’s why it’s important to do something to take your mind off your panic. Get out of bed and physically remove yourself from the situation. Try doing something relaxing to shift your focus, such as yoga stretches, listening to calm and gentle music, reading an inspirational book, or even a menial chore such as doing the ironing.

Go back to bed when you’re ready - Only go back to bed when you’re beginning to feel tired again and ready for sleep. When you’re in bed, keep yourself calm by breathing deeply in through your nose and out through your mouth, to the extent that your whole abdomen, not just your chest, is rising and falling.
Give yourself enough time to get the sleep you need - It’s important to make sure you go to bed at least eight hours before you need to get up so you’re giving yourself enough time to have a good night’s sleep. Going to bed too late and not leaving enough time for sleep may result in you constantly checking the clock and worrying that you’re not going to feel rested the next day. These negative thought processes can fuel anxiety, and potentially spiral into a panic attack.
Prepare yourself for the following day - Many people struggle to get to sleep because they are anxious about the following day. You can try to reduce this anxiety by making sure that you have everything prepared. For example, you could have a to-do list, or even have your clothes laid out.
Establish a consistent sleep routine - Try and go to bed and wake up at the same time every day. Even at the weekend, try and get up at a time that isn’t too different from when you get up during the week.
Limit caffeine, sugar and alcohol before bed - These substances can make you feel anxious and jittery at night, and can prevent you from getting to sleep and staying asleep.
Avoid electronic devices late at night - Avoid using electronic devices such as computers, mobiles and tablets within 30-60 minutes of your target bedtime. These devices give off light which can be overly stimulating and keep you awake.

Get help today

“Panic attacks can be very distressing to experience but can be effectively managed with suitable treatment. It is always better to seek help as soon as you identify the symptoms.” Dr Natasha Bijlani (CCST, FRCPsych, MBBS), Consultant Psychiatrist and panic attack specialist at Priory Hospital Roehampton, London.

Even though these steps can help, it’s important that you seek professional support if your panic attacks are becoming more frequent and are impacting on your ability to function. You could speak to your GP about your concerns or get in touch with Priory. We can provide you with access to expert psychiatrists, therapists and other mental health professionals, who will be able to support you with your challenges.

Page medically reviewed by Dr Natasha Bijlani (FRCPsych, MBBS), Consultant Psychiatrist based at Priory Hospital Roehampton London

Get in touch today

For details of how Priory can provide you with assistance regarding mental health and wellbeing, please call 0800 840 3219 or click here to submit an enquiry form. For professionals looking to make a referral, please click here

Mini Panic Attacks When Falling Asleep? Here's Why

Hypnic jerks or nocturnal panic attacks could jolt you awake in a state of panic. Whatever the cause, there are ways to manage anxiety at night.

If you wake up at 2 a.m. in a panic (and it’s not because you had too much caffeine before bed), you may be experiencing a nighttime or nocturnal panic attack.

Nighttime panic attacks can feel incredibly similar to daytime panic attacks — with rapid, short breaths and a racing heart rate.

When you wake up from sleep in a state of panic, it could also be caused by other things like hypnic jerks. No matter the cause, you can take steps to relieve distress and symptoms.

Hypnic jerks are involuntary muscle contractions that some people experience as they’re falling asleep. They usually occur during the transitions between your sleep-wake cycle.

These twitches or “hypnic jerks” are pretty common, often mild, and even unnoticeable. However, sometimes these spasms may be strong enough to startle you or jolt you awake.

A 2016 study found that hypnic jerks are “highly sporadic and affect all ages and both sexes with prevalence between 60% and 70% in the general population. ”

There’s a good chance these “jerks” or “twitches” have happened to you, and you may not have known it!

More than hypnic jerks

If your nighttime jerking or jolting is accompanied by feelings of distress, there may be more at play.

Panic disorder is an anxiety disorder that’s characterized by repeated panic attacks and a fear of having them. Authors from a 2013 study noted that 18% to 45% of people with panic disorder had nocturnal panic attacks.

Though panic attacks during your waking hours can develop quickly, they usually don’t jolt you awake in a second like the ones during sleep.

Experts are still unsure what exactly causes someone to have panic attacks. However, there are a few things that may contribute to someone having nocturnal panic attacks.

This includes:

having a family or personal history of panic attacks
living with certain conditions, such as anxiety or depression
experiencing traumatic life events
changes to your brain chemistry (hormonal or from certain medications)
feeling stressed

As with the more well-known daytime panic attacks, nighttime attacks can occur without any reason or warning. But there’s one different symptom.

Unlike waking panic attacks, sleep terrors, or nightmare disorder, in a nocturnal panic attack, you’re awoken from sleep every time.

Other common symptoms may occur during waking or nighttime panic attacks, including:

a fast or racing heart rate
shaking or trembling
sweating
difficulty breathing
tingling
dizziness
chills or hot flashes
fear of losing control
fear of dying
chest pain or discomfort
feeling like you’re choking

Panic attacks and anxiety — whether during the day or at night — can feel frightening, but they’re not dangerous.

One of the most stressful things about nighttime panic is that you just don’t know when it’s going to happen, so you feel like you can’t prepare. There are actually several things you can do to help manage your anxiety before and in the moment, so you can get back to sleep.

Practice mantras

A mantra is a helpful saying you use to affirm yourself when needed. When nighttime panic arises, you could try saying mantras to help calm down so you can go back to sleep.

Dr. Kathy HoganBruen, clinical psychologist and founder of District Anxiety Center, suggests the following mantras:

“Panic is uncomfortable but not dangerous.”
“This is my body’s hardwired reaction to stress, but just like a faulty or very sensitive smoke detector, the alarm going off doesn’t necessarily signal any true danger or emergency.”
“Now is the time to sleep, and tomorrow is the time to address any pressing issues.”

Try mindfulness

Mindfulness is a technique where you’re aware of what is presently happening in your body and mind without any judgment.

“Do a body scan from head to toe to notice and feel sensations and thoughts, but without deeming them troubling. Like a fly on the wall, just observe,” says HoganBruen.

Instead of letting your mind spin out of control, you can mindfully focus on the present moment without worrying about things that just happened or haven’t happened yet.

You may want to try a meditation app that has sleep meditations, which can mindfully guide you back to sleep.

Focus on your breath

If you’ve ever had a panic or anxiety attack before, then you know that regulating your breathing isn’t easy when you’re panicking.

But by leveraging deep breathing exercises for anxiety, you can get your nervous system back to a state of calm which can help with that fight-or-flight response you’re going through and thus help you sleep, explains HoganBruen.

Try CBT

Dr. Bryan Bruno, medical director for Mid City TMS in New York, suggests cognitive behavioral therapy (CBT), a type of talk therapy. He says, “This form of psychotherapy helps patients confront their fears and anxieties in a controlled environment.”

“Therapists may also offer tips for better sleep hygiene and coping mechanisms to control or de-stress after a nocturnal anxiety attack,” he explains.

Experiencing nocturnal panic attacks can be just as intense and scary as daytime panic attacks, but with the added suddenness of waking you up.

But whether awake or asleep, panic attacks are not dangerous. You can use several coping tools to get through the panic and get back to what you were doing — like sleeping.

You could:

practice mantras
try mindfulness
focus on your breath

If nighttime panic attacks are affecting your quality of life, you may want to consider speaking with a mental health professional or sleep specialist. Their knowledge and experience can help you find tools and treatments that will work best for you.

"You can't sleep, and when you fall asleep you have nightmares." Two seasons of work with covid

"I saw how a dead person became alive"

"In the spring I had a panic attack for the first time. I wear a respirator with a valve at work, and with every exhalation there is a click. And here I drive - without mask, because there is no one around. And suddenly I find myself not feeling this click. With my head I understand that this is how it should be, but my panic grows, I begin to breathe often, often, my fingers get cold, tremble, accelerates heart. Thank God, I didn’t get into an accident.”

Ilya Marey seems very calm. He is a resuscitator, it is customary for him to see people in critical conditions. Seeing dead people is also part of the job. Almost every physician knows what it means to not sleep regularly at night and be on a 12-hour shift. But the months of work in the red zone turned out to be very difficult - both for Ilya and for his familiar colleagues.

Ilya wanted to become a doctor since childhood. In medicine, at first he leaned towards surgery: "I think everyone who studied to be a doctor had such a period." Then - to neurology: "There is something from the work of a detective. Sometimes we think that a person is just strange, but in fact this is how the disease manifests itself." And then he ended up in the intensive care unit. By that time, Ilya managed to work as an orderly and, among other things, took out the bodies of deceased patients to the morgue. “I knew very well what a dead person looks like,” he says. “But then for the first time I saw how a living person became dead. And then we carried out resuscitation and he became alive again. And I realized that I want to do this all the time.” life".

Since 2018, Marey has been working at the Federal Research and Clinical Center of the Federal Medical and Biological Agency of Russia (FSCC FMBA). In March, the clinic was redesigned for covid. Ilya's asthma is a risk group. But he had no question whether to stay in the red zone.

How many resuscitators we have determines how much work each one will have to do. And how many patients can we help. Fewer resuscitators means a higher mortality rate. And behind every percentage is someone's life. Leaving my colleagues and patients at such a moment seems to me savagery

The wife, of course, asked not to go to the red zone, but "at the beginning of this conversation, we already knew how it would end." Ilya's wife is also a doctor, now she is on maternity leave: their son will soon be three years old. Ilya laughs that he himself is "in a slightly more advantageous position": "It is always easier to go for self-sacrifice than to see how a loved one does it. And if it were not for the decree, the wife would not sit at home either."

"I shaved my head for the first time in my life"

"The first day in the red zone we just lay. Everyone - from the bosses to the nurses - found some horizontal surfaces for themselves and lay down," recalls Ilya. "We got used to shortness of breath and constant pressure on the face". Few patients were admitted that day, only two or three people were admitted to the intensive care unit, and this gave doctors time to get used to personal protective equipment (PPE).

"It's hard, hopeless and difficult"

In June, the clinic returned to its usual, "non-covid" work. Ilya even managed to go on vacation for a week - mainly to "show that I'm alive." “We, like everyone else, hoped that there would not be a new strong wave, that in the fall there would be enough clinics that had been working all this time,” says Marey. But in early October, I had to "return to what we tried to forget these months."

"What was it like coming back? Disgusting!" Ilya laughs. According to him, the difference between spring and autumn was only in the rate of admission of patients. In March, an intensive care unit for 40–50 people was filled in three days: after the first calm shift, patients began to be brought in by a "huge tsunami wave." Now the intensive care unit is also full, but it took a week and a half.

And the disease proceeds the same way - in this sense, Ilya sees no difference. True, it is stipulated that he still works only with the most difficult ones - others do not enter the intensive care unit. A typical set of their symptoms is a high temperature that nothing can bring down, incessant shortness of breath and low saturation (the amount of oxygen in the blood).

Intensive Care Unit at the Federal Research and Clinical Center of the Federal Medical and Biological Agency of Russia

Ilya says that everything in the intensive care unit is "hard, hopeless and difficult." This is a room for six or seven beds, without division into men's and women's. Patients lie naked: "Seconds count, and taking time to take off their clothes is a luxury." Instead of a toilet - ducks. Surveillance around the clock - and the light too. The constant noise of technology: "The ventilator is rustling, the heart monitors are beeping." According to Ilya, if a healthy person is placed in intensive care, he will become sick very quickly. And this is not an exaggeration: in an environment where it is always light and noisy, the rhythm of the body's work goes astray and an "internal raskardash" occurs - up to mental disorders.

"We fight for everyone. And it exhausts with time"

One day, Ilya saw how right during the duty of a nurse "on the floor" (as he calls the general, not intensive care unit) a fever began. Opened the PPE, measured the temperature - 38.9. The girl immediately did a computed tomography - and a serious degree of lung damage was discovered. She returned to the ward as a patient.

During this time, many doctors have been ill in the clinic. Some have died. Ilya himself was ill with close friends - "thank God, without a catastrophe." Several familiar colleagues from other hospitals died - someone with whom Ilya crossed paths, whose lectures he listened to, with whom he once had a chance to work.

Marey himself did not have covid. But back in the spring, he started having panic attacks, problems with pressure and sleep. And it continues to this day.

During the six or seven hours you sleep, you wake up eight or nine times. Or you can’t fall asleep, and when you fall asleep, you have nightmares. In general, you become unstable, in just a few seconds you can slide from joy into absolutely black despondency and apathy. Such that it is impossible to get out of bed

Ilya says that all this, especially insomnia, is now happening to all of his acquaintances in resuscitation. And in the spring, he gained five extra pounds - the shift could end at two in the morning, after it I wanted to eat, and "the night zhor just didn’t go away. "

At first, Ilya tried to support himself with sports, but his strength quickly ran out. Now only communication with loved ones helps. The doctor lives alone - his wife and child moved out to their parents so as not to risk it. Every week he takes a test, and if the weekend falls on the first couple of days after the result, he allows himself to meet with his family. But basically life now consists of work and sleep. He laughs that even the salary has nowhere to spend: only for food and gasoline.

But the hardest thing about working with covid is not respirators, which cause a "lousy taste in the mouth" and shortness of breath, not PPE, which is impossible to get used to - "I have not heard from anyone that he became comfortable working in this suit ". Long shifts are common. And not even the risk of getting infected and dying.

“The main thing is that it is not clear what to do to make a person feel better,” says Ilya. “It is incomprehensible everywhere, all over the world. There is still no cure. while his body fights itself. According to Marey, this is the main cause of depression among doctors - now too often little depends on them.

“Often the whole team spends a lot of physical and mental strength to save someone, but the person still dies,” says Ilya. “For various reasons: bleeding, septic shock, some kind of complication with which nothing can be done "The patient just takes it and dies right away, that's all. And we hope for a miracle - what if there is a chance with this particular person? We fight for everyone. And it drains over time."

One day, Ilya's team fought so hard for an 18-year-old patient. He died.

Bella Volkova

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Covid-19

Panic attacks before falling asleep (evening)

Panic attacks in the evening arise when the body is overexcited or some departments of the nervous system are addicted to work. They can also appear if you neglect your health during the day. Drinking too much coffee, especially early in the morning and late at night before you go to bed, can make you feel panic symptoms while you sleep.

The first signs of the onset of an altered mental state will be a feeling of complete inaction and a need to take some action. You can get out of bed and start walking around the room or shaking your leg under the covers. Increased breathing, the appearance of a headache and feelings of nausea will become additional symptoms of a panic attack when falling asleep.

If during the day you are often in a state of strong emotional stress, then the experienced fear can accumulate and develop into a panic attack in the evening. Such phenomena are often affected by young people under 35 years old, who are in the stage of active life. After 5 minutes, the attack may recede, but in some situations it may be longer. At the end of this unpleasant state, you will feel overwhelmed and devastated. Apathy and depression will arise on their own.

These attacks may be one-time or regular. If you experience them as you fall asleep, it's important to know what to do in these situations so that your pre-sleep panic attacks don't escalate into an anxiety disorder.

The more stressed your psychological state is, the more often panic attacks will appear. It will become harder to recover mentally and physically over time. Fear of death can be exacerbated, driving into depression. Evening and night experiences will eventually affect your health.

What should be done to get rid of a nighttime panic attack?

Panic attacks are often the result of the sufferer's introspection. Delving into your own thoughts and feelings, thinking about the future, presenting it in unflattering shades, you can provoke a panic attack yourself. If you do this every night, you will, without outside help, drive yourself into a difficult mental state from which it will be difficult to get out.

How to stop the first symptoms of a panic attack?

Take a break from bad thoughts. Visualize something positive, dream big and set yourself up for a great day.
If you have difficulty falling asleep in a new place and this provokes fear, try to stay at home for the night or take some favorite thing with you. Let a soft toy or favorite pillowcase create the feeling of your own bed.
Learn how to sleep properly. No matter how strange it may sound, not many people know how to go to sleep correctly. You need to relax, imagine yourself in a safe place and get rid of oppressive thoughts.
A person who once experienced a panic attack is in constant expectation of a second event. To avoid it, before going to bed, you should do pleasant things. Devote this time to your favorite hobby, communication with loved ones and dear people.
Self-examination helps a lot. Lie down in a comfortable position and mentally and tactilely probe your body, trying to feel possible unpleasant symptoms.

Panic attack therapy

Experts recommend seeing a doctor if a panic attack is not the only precedent with an understandable root cause. Seizures at bedtime can provoke the development of somatic diseases of the cardiovascular system, gastrointestinal diseases and other pathologies.

To restore well-being, doctors recommend meditation, breathing exercises, herbal teas, muscle relaxation techniques. Sedative drugs will help get rid of the symptoms of an unpleasant condition, but will not exhaust it as a phenomenon. In addition, some of them are addictive. Therefore, if you are able to try to take control of your mind and body, it is better not to abuse sedatives and sleeping pills.

People for whom evening panic attacks are not nonsense have developed several options for spending time that allow you to fall asleep quickly and with pleasure. They advise reading fiction books, watching positive TV shows, drinking delicious warm tea, and going to bed an hour or two earlier than you are used to. Such actions will help to destroy the habitual algorithm that leads to a panic attack and force the body to work according to a different scheme. So you deceive the psyche and fall asleep peacefully.

If you feel the first urges of a panic attack, call a good friend, pay attention to a pet or change location. Try to take the fetal position - in it our body feels as safe as possible.

In some cases, it is recommended to visit an osteopath and a neurologist, as any damage to the spine can cause pinched nerves, problems with breathing, pressure, circulation and, as a result, motivate a panic attack.

What is important to know about panic attacks that occur at night?

An uncontrollable panic attack at night usually occurs when you are in deep sleep. The first is a feeling of intense fear, as if in anticipation of some tragedy. You will wake up in a very agitated state, perhaps screaming. At the physical level, breathing problems, tachycardia, eye pupils will be dilated.

If you are near a loved one at this time, seek support from them, because uncontrolled actions during a panic attack can lead to injury. Try to catch your breath and take your mind off what happened.

It is important to know that panic attacks occur in both childhood and adolescence. They are often associated with the period of growing up and the transition to a new stage in the development of the body. At a very young age, such attacks usually do not appear. Most often, a panic attack is provoked by events that occurred during the day, and experiences from them. Children's consciousness perceives reality differently than an adult's, and any little thing can seem more tragic to a child than it is in reality.

In such a situation, parents need to reassure their son or daughter, stay close, offer tea or wash.

Learn more