A panic attack is a sudden, intense onset of distress or fear. These feelings heighten for around 10 minutes until starting to fade. Panic attacks can occur at any time of the day or night. People may experience a panic attack without warning. Others may have frequent, unexpected attacks.
Those who have frequent panic attacks may begin to identify certain triggers, such as stress at work or fear of flying. However, nocturnal panic attacks may happen without a trigger and even wake a person from sleep.
Some people with a panic attack may feel as though they are having a heart attack and seek medical treatment.
Read on to learn more about nighttime panic attacks, including their causes, ways to cope, and possible treatments.
Since there are several potential risk factors and causes of having a panic attack, it is possible that a person may experience panic attacks at night.
There is very little research on nocturnal panic attacks, however, so doctors are unsure what causes them to occur while a person is asleep.
People who have nighttime panic attacks typically also have panic attacks during the day.
When a panic attack occurs at night or while a person is sleeping, it may be difficult for them to calm down again.
Fear of the panic attack reoccurring can prevent the person from falling asleep again, which may lead to sleep loss and increased stress.
Scientists do not yet fully understand the exact causes of panic attacks, both in the day and at night.
However, some factors can make it more likely that a person will experience a panic attack. These include:
- genetics, or having family members with a history of panic attacks
- personality type
- life events, such as job loss, a public speaking engagement, or a fear of flying
- brain chemistry
- underlying conditions, such as social anxiety disorder
A panic attack, during the day or at night, occurs when a person experiences four or more of the following symptoms:
- feeling faint
- palpitations, a pounding heart, or an accelerated heart rate
- feeling dizzy or lightheaded
- feeling unsteady
- trembling or shaking
- feeling smothered
- feeling a fear of dying
- depersonalization, or the feeling of being detached from oneself
- sensations of shortness of breath
- feelings of choking
- fear of losing control
- pain or discomfort in the chest
- paresthesia, or sensations of tingling or numbness
- derealization, or feelings of unreality
Some people may experience fewer than four of the symptoms listed during an attack. In these cases, a person may have had a limited-symptom panic attack.
Panic attacks are related to anxiety. Anxiety can also cause a person to experience physical symptoms. What makes a panic attack different from general anxiety is the speed of onset (reaching a peak within 10 minutes) and the intensity of the symptoms.
How to cope
Before, during, and following a panic attack, a person can try several different methods to calm down. These include:
- concentrating on breathing using slow, deep breaths
- thinking about positive things
- focusing on relaxing the muscles in the jaw and shoulders
- getting away from the situation causing anxiety
- talking to a loved one
- slowly sipping a glass of water
- focusing the eyes on something nearby
- trying to meditate
- doing light exercise, such as going for a walk or doing light stretches at home
A doctor can assess a person to determine if they have had a panic attack, have panic disorder, or have another condition such as thyroid or heart disease that could present similar symptoms.
To diagnose a panic disorder, a doctor will typically:
- perform a complete physical examination
- run blood tests to check for issues with the thyroid
- run tests, such as an electrocardiogram, to check heart health
- discuss the person’s family history, current stress levels, any situations they may be avoiding, and their fears and concerns
A doctor may also refer a person for a mental health assessment. A person may receive a diagnosis of panic disorder if:
- they experience repeated unexpected panic attacks
- the attacks cannot be associated with other psychological or physical health conditions
- the attacks are accompanied by 1 or more months of worry about having another attack
Even without a panic disorder diagnosis, there are treatments available.
Formal treatment of panic attacks will typically involve medications, psychotherapy, or a combination of both.
Cognitive behavioral therapy (CBT) is often the first line of therapy for people who experience panic attacks.
In CBT, a therapist helps a person confront and understand their symptoms of panic attack in a controlled, safe environment. Once the fear is resolved, it can help a person avoid future attacks.
In addition to or instead of therapy, a doctor may prescribe one or more medications to help treat anxiety. Some examples include:
- selective serotonin reuptake inhibitors, which are antidepressants
- serotonin and norepinephrine reuptake inhibitors, which are also antidepressants