Psychology Online

Nighttime panic attack

What are nighttime panic attacks?

A panic attack at night is a panic attack that suddenly makes you startle at night for no obvious reason. D.

In many cases, those affected feel signs of breathlessness or palpitations; in severe cases, feelings such as fear of death and helplessness can also occur. This is often accompanied by sweats, dizziness or hot flashes.

It is typical of such a nocturnal panic attack that it occurs in complete calm.

The causes are very diverse and cannot always be clearly identified. The main problem with such a nightly panic attack is usually that a one-off panic attack quickly ends in a cycle. If a person has had such an attack more than once, it is very likely that they will have another nighttime panic attack in the future.

What is a panic attack anyway? You can find the answer to this on the main page under: Panic attacks

Causes of Nightly Panic Attacks

The causes of nocturnal panic attacks are very diverse and still not fully understood. However, there are various causes that are closely related to nighttime panic attacks.

For example, the connection between genetics and the triggering of panic attacks at night has been clearly proven.

Various malfunctions in brain activity can also have an impact on nighttime panic attacks.

In addition to molecular, physical causes, psychological causes can also increasingly be brought into a strong connection. Traumatic childhood experiences such as neglect, sexual abuse, alcohol abuse or violence in the family can be a cause of nighttime panic attacks. In addition, traumatic experiences at a later age can also be a cause. This includes events such as divorces or the death of one or more relatives.

People with a generally lowered fear threshold are also prone to panic attacks at night. If these people show mild symptoms, those affected often interpret the symptoms too intensely, which causes the fear to build up further and further until it ends in a possible panic attack.

Stress or general avoidance behavior can also trigger a nighttime panic attack. The general rule is that those affected unintentionally interpret the symptoms too strongly and thus become more and more afraid and the panic that goes with it.

Would you like to know more about the causes? So look also at the following articles:

What anxiety disorders are there? - Overview of anxiety disorders
Mental disorder
Consequences of stress

Alcohol as a cause of nighttime panic attacks

A link has also been established between substances such as alcohol and nighttime panic attacks.

While alcohol is often viewed as a sedative for stress or even anxiety, the factor that alcohol is just as good at inducing anxiety tends to be ignored.

As a general rule, occasional alcohol consumption cannot be clearly associated with panic attacks. However, those who try to drink for their anxiety very regularly, aggravate them more than reduce them.

While alcohol is not seen as a trigger or cause of a nighttime panic attack, it can make these panic attacks worse.

In addition to panic attacks, alcohol consumption can also be the cause of numerous other diseases. For more information, read at:

Consequences of alcohol
Effect of alcohol - influence on the various organs

Symptoms associated with nighttime panic attacks

The typical symptoms of a nighttime panic attack include palpitations, shortness of breath and fear of death. There are also many other symptoms that may occur with such a panic attack. However, every night panic attack of one person affected is different from that of another, so that it is difficult to determine a general course of such panic attack.

In general, with every panic attack, there is always a massive fear that can end in fear of death among those affected.

One symptom attributed to panic attacks is their duration. A typical nighttime panic attack begins very suddenly, but ends again after a few minutes.

A change in the heartbeat and its intensity are often named as triggering symptoms. In addition, symptoms such as sweating, tremors or dry mouth occur. In addition to the typical symptoms of the heart, breathing difficulties, chest pain as well as nausea and stomach pain are also often mentioned as reasons for waking up at night.
Also read: Hot flashes in men

Dizziness, insecurity and drowsiness are counted as frequent psychological symptoms of a nighttime panic attack. Those affected have an increased feeling of fear and perceive the symptoms as life-threatening.

In rare cases, the panic attack can result in those affected feeling strange in their familiar surroundings.

You can read about the individual symptoms and their causes in the respective main articles. Some of them are listed below:

Generalized anxiety disorder
Palpitations at night - is that dangerous?
Mentally induced shortness of breath

Palpitations during night panic attacks

In addition to shortness of breath, the rapid heartbeat is the most frequently mentioned symptom of a nighttime panic attack. Those affected often explain that after suddenly waking up at night they noticed an increased heart rate and increased palpitations.

The nighttime panic attacks can also occur in connection with physical illnesses. If, for example, a patient is aware of a cardiac arrhythmia or an increased risk of a heart attack, this can additionally reinforce the nocturnal panic attacks or even represent their cause.

Further important information on this topic can be found on the main page at: Palpitations at night - is that dangerous?

Difficulty breathing as a symptom of a nighttime panic attack

Shortness of breath is the most common symptom of a nighttime panic attack. According to their own descriptions, those affected wake up suddenly at night and find it very difficult to breathe. This subjective feeling of no longer being able to breathe leads those affected into a perceived fear of death.

As with a racing heart, lung and respiratory diseases can be one of many causes of a nighttime panic attack. Examples of diseases that are linked to the seizures are bronchial asthma, COPD or sleep apnea syndrome.

Shortness of breath is a condition that should not be underestimated. For this reason, we recommend that you deal with the topic. You can find detailed information at:

Shortness of breath - what's behind it?
Mentally induced shortness of breath

Fear of death during a nighttime panic attack

The fear of death is a frequently described side effect of a nighttime panic attack. It is caused by the increasing discomfort that the person concerned feels. A patient who has suffered a panic attack at night experiences the racing heart or the shortness of breath so intensely that he feels he can die from it.

What is dangerous about this fear of death, however, is that it only intensifies the symptoms perceived. The panic that occurs makes the heart pound even faster.In addition, the person concerned breathes faster and faster in the excitement, which quickly leads to hyperventilation. This in turn increases the shortness of breath. As a conclusion, the fear of death of those affected increases - a vicious circle develops that is difficult to avoid.

Diagnosing nightly panic attacks

In order to be able to make a diagnosis, various examinations must first be carried out. These are usually done by a family doctor. Eventually, those affected are referred to a therapist or psychosomatic clinic for further examinations related to nighttime panic attacks. These can differentiate an anxiety disorder from panic attacks on the basis of specific external assessment questions.

A panic attack, even at night, can usually be clearly distinguished from an anxiety disorder. In comparison to anxiety disorders, panic attacks occur without any connection to exertion or dangerous situations.

Disease progression in nighttime panic attacks

Without treatment for nighttime panic attacks, they can last for many years. The panic attacks occur more or less frequently at different intervals. They can have an enormous impact on the person concerned in their everyday life and especially in their nightly sleep. It is not uncommon for such disorders to cause further clinical pictures in those affected - for example, depression.

With the help of a psychotherapist or targeted medication, the nocturnal panic disorders can be reduced or even avoided.

It is generally accepted that panic attacks do not go away on their own, so consulting a doctor is always recommended. Taking medication on your own without consulting a doctor or trying to reduce anxiety through alcohol can cause significant addictions and are in no way recommended.

Treatment of nighttime panic attacks

For the treatment of panic attacks at night, the usual therapy is a combination of cognitive behavioral therapy and medication. Alternatively, panic attacks can also be counteracted with the help of psychodynamic psychotherapy. There are also some self-help groups that can support those affected if necessary. Exercise is also considered helpful.

In cognitive behavioral therapy, the person concerned is first informed about their mental disorder so that they can better understand how the nighttime panic attacks come about. Just knowing about typical characteristics or knowing that many people suffer from such symptoms can usually alleviate the anxiety somewhat.

In the following step, the person concerned consciously tries to trigger a panic attack in himself. This step is intended to give the person concerned a sense of control, since he initiated the panic attack himself for the first time. In addition, the therapist present can now try to make the harmlessness of his panic attack clear to the affected person. The patient should face his panic attacks again and again in the following sessions and thus get the feeling of control and security. The fear of a future panic attack can thus be consciously reduced.

If such cognitive behavioral therapy is ineffective, psychodynamic psychotherapy is considered. The therapist in charge finds out the background to the nightly panic attacks so that possible triggers and causes can be identified and treated. This gives the person concerned access to suppressed feelings, so that they recognize that unresolved conflicts and not physical complaints are the trigger for their panic attacks.

But also specific breathing exercises or avoiding stress can reduce the nightly panic attacks in a targeted manner. In general, however, you should always seek advice from a doctor or therapist about treatment options.

You can read about the individual treatment methods at:

Behavior therapy
Therapy and help for children and adolescents with behavioral problems

Nighttime panic attack medication

Nocturnal panic attacks can be treated with medication in addition to behavioral and psychotherapy. Drugs from the class of antidepressants are particularly recommended. Serotonin reuptake inhibitors (SSRIs) or benzodiazepines are examples of typical drugs for nighttime panic attacks. Serotonin is one of the main triggers of a panic attack. The SSRI prevents the serotonin from getting back into the cells - it is therefore no longer able to trigger a panic attack.

The benzodiazepines, on the other hand, work in a different way. They are widely considered to be a sedative drug that helps reduce anxiety and panic. However, it should always be ensured with the benzodiazepines that they can be quickly addictive.

Antidepressants, like any other medication, can cause side effects. Make sure of these before taking:

Side effects of antidepressants
Serotonin Syndrome

Duration and prognosis of nocturnal panic attacks

A common nighttime panic attack occurs very suddenly and with complete calm. It has a maximum during the course, in which the symptoms and the resulting fear have rocked to the maximum. However, after a few minutes, the nocturnal panic attack often ends again.

In psychotherapy, the diagnosed triggers of such a panic attack can be analyzed and understood. Behavioral therapy and typical psychotherapy can then be used to try to control the nocturnal panic attacks as best as possible, so that the duration of the panic attacks is shortened.

Psychotherapy is essential for panic attacks. So it is advisable that you deal with the topic under: What do you do in psychotherapy?