Nocturnal panic attacks!

Have you ever woken feeling lost and confused, short of breath, and have a feeling of dying? If so you may have experienced what is known as a nocturnal panic attack, usually occurring when you are comfortable and asleep. They are random and unexpected and may take place when you are experiencing higher stress levels than usual.

When a nocturnal panic attack occurs, you will be awakened violently in a complete state of panic, and may feel as if you have had the worst nightmare you can ever recall, although there was in fact no nightmare at all. You will experience shortness of breath, a racing heartbeat, sweating, tingling sensations throughout your body, dizziness and an overall feeling of dread. Research suggests that these panic attacks usually occur between stages 2 and 3 of sleep whereas nightmares occur during the REM sleep (stage 4) and most likely take place 90 minutes after the onset of sleep. So if nightmares aren’t responsible for panic attacks, what is happening?

The actual reason for nocturnal panic attacks is not known. However, there are many theories including sleep apnea, GORD (gastro-oesophageal reflux), and laryngospasm which is a blocking of the airways usually found in middle aged men. When a person is in a deep relaxed state such as sleep or meditation this relaxation may be what is causing the individual to incur the symptoms of panic. It is noted that people who suffer from nocturnal panic attacks will begin to show symptoms of panic or may feel more anxious when they are participating in meditation techniques.

In a survey conducted with nocturnal panic attack sufferers, the majority responded affirmatively to statements like “I find it hard to just let go,” “I feel uneasy when I try to relax,” and “I’m apprehensive when I’m sitting around doing nothing”. This lead to the results displaying the inability for nocturnal panic sufferers to relax or they have a fear of loss of vigilance. That is, people with nocturnal panic attacks may fear that when they are relaxed, they will be unable to respond appropriately and therefore are unable to protect themselves from threatening stimuli. Therefore, as sleep represents the ultimate relaxation and vulnerability, this fear of loss of vigilance would make a person more likely to incur nocturnal panic attacks.

A common trigger for a panic attack is the feeling of loss of control. For the nocturnal panic attack sufferer it is being in this state of unconscious sleep that represents this ultimate lack of control. There are many rationalisations of why nocturnal attacks may be occurring, including the fear of death as sufferers believe they will die in their sleep and although these fears are irrational, attacks may still be triggered to these suffers.

So, what can a nocturnal panic attack sufferer do? Before you go ahead and try to void yourself of these attacks it is best to see your GP, as they will need to rule out things that may mimic panic attacks such as hyperthyroidism (overactive thyroid), post-traumatic stress disorder (PTSD), and hypoglycaemia (low blood sugar). There are many techniques in assisting you with your nocturnal panic attacks, including Cognitive Behavioural Therapy (CBT) consisting of frequent sessions with a CBT therapist. This form of therapy will assist those suffering to decrease irrational thoughts and behaviours that reinforce the attacks. These techniques may include relaxation methods and also introducing exposure to situations that aggravate the anxiety. This therapy will also support the sufferer in understanding the emotional forces that may have contributed in developing symptoms.

There are many techniques proving to be valuable to sufferers of nocturnal panic attacks. In the view that caffeine, alcohol and illicit drugs may worsen the attacks these things should be avoided. In managing your nocturnal panic attacks you may like to consider exercise (a simple stroll with your dog around the park), or joining a yoga group as these activities will assist in relaxation and in decreasing the severity of attacks. Try listening to some soothing music before bed.

Without treatment these attacks may continue for many years contributing to further irrational fears and phobias, suicidal thoughts or actions, a substance abuse or larger medical conditions. Your anxiety may worsen where you are left seriously affected by your attacks, with lack of sleep, numerous accidents and health issues may possibly arise. There are medications that your GP can assist you with however, this may only be a temporary relief. If you do suffer GORD, sleep apnea or laryngospasm, you will need to consult your GP for medications for these conditions.

As nocturnal panic attacks are still not largely recognised, it would be interesting to hear stories from sufferers regarding their experiences with this condition. Jump on ADAVIC’s forum and tells us what it is like for you with nocturnal panic attack disorder.

By Georgette (ACAP Placement Student)