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Nocturnal Panic Attacks

Approximately two of every five panic disorder sufferers experience nocturnal panic attacks, which normally occur as they transition between sleep stages 2 and 3. While no definitive cause of nocturnal panic attacks has been established, there are many theories about why they happen.

One of the most debilitating characteristics of panic attacks is that they can strike at any time. Nocturnal panic attacks, if there is anything good to be said for them, are at least predictable. A nocturnal panic attack is one awakens a sleeping person to a state of complete panic porno perceivable reason. A person experiencing a nocturnal panic attack may be convinced that he or she is suffering from cardiac arrest, because the two states share such similar symptoms.

Those symptoms include shortness of breath (to the point of feeling suffocated); a racing heartbeat; dizziness; tingling in the extremities; sweating; and an incapacitating sense of dread. Perhaps you can recall a night when you went to bed counting on getting plenty of rest because you had a big day coming up. You might've fallen asleep normally, but something happened as your brain was transitioning from deep to light sleep, as it does several times during the course of the night.

During one of those transitions, you awakened violently, gasping for breath and alarmed at the pounding of your heart. It might have felt as if you had just awakened from the worst nightmare of your life, except that there was absolutely no dream involved! Dr. Michelle Craske, a researcher of nocturnal panic attacks, says that they occur most often in adults who are transitioning between sleep stages 2 and 3, usually about 90 minutes after the onset of sleep.

Nightmares, on the other hand, occur during the REM (Stage 4) stage of sleep. If nightmares aren't responsible for nocturnal panic attacks, what are some other possible causes?

nocturnal panic attacks

Sleep Apnea

One theory is that underlying sleep disorders, like sleep apnea, can create the physiological conditions which lead to a nocturnal panic attack. During sleep apnea, breathing is interrupted. The sleeper’s heart rate and blood pressure become elevated as the blood oxygen levels drop, producing sensations of anxiety which can surface as a nocturnal panic attack. As frightening as the attack may be, it serves its purpose awakening you so that you will begin breathing again!


Another possible cause of nocturnal panic attacks is Gastroesophogeal Reflux Disease (GERD). People suffering from GERD, experience a backflow or reflux of their digestive juices into the esophagus, with an accompanying burning sensation. Reflux occurring while they are a sleep may cause them to awaken with a feeling of discomfort in their chests which escalates into elevated respiration or even hyperventilation. These symptoms can create anxiety which leads to a nocturnal panic attack.


Some middle-aged men have a condition called sleep-related laryngospasm which causes their vocal cords to contract while they sleep, blocking their airways. This leaves them unable to breathe for a few seconds, until the airway begins to open again. The partially opened airway creates a high-pitched whistling sound when these men inhale, and usually lasts less than a minute while the airway opens fully. But during the time when the person is trying to get air, nocturnal panic may occur. The cause of the spasms is not known.

One final theory proposed by Dr. Craske is that people prone to daytime and nocturnal panic attacks seem to be less able to completely relax, and react to lower vigilance by panicking. These people, when they are relaxing into deep sleep, may subconsciously begin to panic simply because they are letting their guards down!

If you are suffering from nocturnal panic attacks, you may find helpful advice from National Sleep Foundation about changing your diet. They suggest that you limit your consumption of caffeine and alcohol during the afternoon and evening hours, and stop taking catnaps during the day. Go to bed tired and relaxed, so that your body will be ready to sink all the way into stage 4 sleep without any interruptions from nocturnal panic attacks!

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