How to Deal with Constant Panic Attacks at Night – A Primer

If there is something worse than regular panic attacks, it is panic attacks at night. One moment you are fast asleep and the next moment you are awake with adrenaline rushing through your veins and a feeling of impending doom overshadows your whole being. You don’t know what is going on and it feels as if your entire existence is made up of an inexplicable primal fear.

It sounds like something the hero of a high fantasy novel might experience but in reality, nocturnal panic attacks are remarkably similar. The few minutes it takes your mind to catch up with them are nothing short of horror. So much so that some people who experience them are even terrified of going to sleep every night.

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What causes panic attacks at night?

The question “what causes night time anxiety?” is difficult to answer. In spite of all the advancements made in the field of psychoanalysis, we still have not been able to pin point the exact reason why panic attacks in general occur. Night time panic attacks are thought to be a combination of various psychological and in some cases, physical factors.

Many people who go through panic attacks at night are often perplexed at their occurrence, mostly coz of the age old belief that their brains are asleep at night. This is a myth. Our brain is not just ‘awake’ but is also rather active at night. In reality a night time panic attack is not much different than a regular panic attack, except the fact that since we are not fully conscious during sleep, it seems much for the worse.

There are however a few causes of panic attacks in men and women that might have played a part in the last attack that you’ve endured.

Physical causes of nocturnal panic attacks

Not many people who suffer from panic attacks are aware that even physical conditions can affect the onset of one. Obstructive sleep apnea or shallow breathing doesn’t by itself cause anxiety during sleep but it surely can bring upon favorable circumstances for a panic attack to occur.

In such a case, a person’s upper airways get blocked as a result of the relaxation of throat muscles leading to difficulty in breathing. In extreme cases, breathing has been known to stop for as long as 30 seconds, causing hypoventilation, namely inadequate ventilation that causes increased concentration of carbon dioxide in our systems.

While a majority of people suffering from obstructive sleep apnea tend to go back to sleep, in many cases a person can wake up in panic and start hyperventilating in order to regain their breath. What follows unfortunately, is a panic attack.

Hyperventilation is another possible cause of nightly panic attacks, especially when it is brought about by incorrect breathing habits and stress that carries over from our daily lives.  In majority of cases however, poor breathing habits are the main cause. You combine hyperventilation with a bad dream or a frightful nightmare and you got yourself a middle of the night panic attack.

It must also be noted that people who are overweight or obese are highly prone to suffering from obstructive sleep apnea as well hyperventilation and are therefore more susceptible to nightly panic attacks.

Panic attacks can also be brought about as a result of acid reflux disease or gastro esophageal reflux disease (GERD). This happens because the symptoms for GERD greatly resemble those for more serious problems like a heart attack. These symptoms can include difficulty in breathing, chest pains and excessive sweating. Needless to say, these symptoms can force a person to wake up in terror and trigger an imminent panic attack.

On the other hand, anxiety and recurring depression increase a person’s chance of developing GERD. It is a vicious cycle where in anxiety causes GERD, the symptoms of which (that mimic another serious disease) cause further anxiety.  It should also be noted that people who regularly smoke and drink or habitually eat more than their body requires are also common victims of the acid reflux disease.

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Psychological causes of nocturnal panic attacks

There is an obvious connection between panic attacks and our minds. For instance, one of the reasons panic attacks occur is coz of a pattern of catastrophic thinking in a person. Namely, taking the symptoms of a lesser problem for what it is not- a serious disease. In simple words it can be referred to as panicking about something trivial to the extent that it balloons itself into a full fledged panic attack.

Traumatic experiences like losing a loved one or ending up in a dangerous situation (like an armed robbery) can very well lead to panic attacks at night, especially when a person finds themselves reliving a similar situation in their nightmares. In many cases such negative associations do not come to the surface immediately and can often take years before negative effects are felt.

In a similar vain people suffering from phobias like agoraphobia run a higher risk of experiencing a nocturnal panic attack.

From the above, it is fairly obvious that such panic attacks can be caused by any number of physical and/or psychological reasons and every person’s situation is likely to be different than another.  With that being said, knowing the scientific reason behind night time panic attacks won’t be of much practical help unless you know how to deal with them.

How to prevent anxiety attacks at night

Getting anxiety attacks while sleeping can be a serious condition. When a panic attack occurs in the middle of the night, you are likely to be jolted out of deep sleep feeling a shortage of breath and more than a few beads of sweat on your forehead. It is very important that rather than take short, quick breaths (that will only cause hyperventilation and make you feel worse) you exhale completely and then take slow deep breaths instead.

Shifting to this style of breathing simulates your body’s parasympathetic response and brings about a relaxation response. It slows down the heart rate, lowers the blood pressure, reduces any muscle tension and brings a sense of calmness in the mind. In other words, it brings about conditions that are directly contradictory to the symptoms of a panic attack.

It is very likely that after a night time panic attack, you will not be able to go back to sleep right away. You can try it for a minute or so, but do not fret and feel helpless if sleep does not come. It is very natural. The right thing to do in such a case is to get off the bed and walk around a little and by walking around, we don’t mean pace in circles worrying about what is happening.

Go get yourself a drink of water or splash your face with some. Go pet your dog (or cat) or maybe just take a walk around the house. This will distract you from the unwelcome feeling of panic and allow you to feel normal. You might be tempted to switch on the TV or log on to the Internet to distract yourself but it is better to avoid that. Such a thing will only keep you from going back to sleep and further disrupt your daily sleep cycle.

At this point you must ask yourself if you are ready for sleep. If you are, then head to bed right away. If not, then busy yourself with some chore, or some menial task that you have been meaning to do (there are always tons of those around always, aren’t there?). Again, avoid the urge to entertain yourself or get into a long textual conversation on the cellphone. The idea is to bore or tire yourself to sleep not midnight entertainment.

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Long term approach to nocturnal panic attacks

While the tips mentioned in the previous paragraph will greatly sooth your night, there are bound to be recurring thoughts in your head to the tune of ‘what if it happens again?’. Worry clearly won’t solve these issues therefore it is imperative that you take a planned approach to it.

While there is no quick fire solution to this problem, there are precautionary steps that you can take that will ease it by a long mile.

First and foremost, if exercising isn’t a big part of your daily life then you must make it so, especially if you are overweight. Exercising and being at your ideal weight will instantly help you avoid the biggest trigger by cutting down the chances of sleep apnea and improve the overall functioning of the body.

If your realize that the main reason for your attacks is acid reflux or a feeling of heartburn then it is advised to take some over the counter medicine to counter that. Yet it is important to consult a physician about this as well so that you can weed out the problem right from its root. In either case (whether sleep apnea or GERD) the key is to eliminate the trigger completely so as to drastically reduce your chances of suffering an attack.

More than anything else, you must learn the right way to breath. Instead of taking short, hurried breaths, practice taking deep breaths right into your belly (or diaphragm). To calm your mind before sleeping, it is a good idea to indulge in mild meditation, even if it is only for a couple of minutes. If you do nothing else then do this. Correct breathing will solve half the problem by itself.

In conclusion

Though science may not have been able to pinpoint what causes panic attacks at night, the solutions mentioned above will go a long way in making the experience a lot more tolerable. Gradual practice of the tips mentioned above will teach you ways on how to go to sleep with anxiety and panic attacks. Also combined with an additional focus on improving your mental and physical health will certainly deliver dividends in due course of time. So stop fighting the panic attacks. It will serve you much better to accept them while learning to deal with them.