A sleep panic attack is a frightening situation in which a person experiences a rapid heartbeat, a feeling of confusion, anxiety, or intense fear, and sometimes nausea while asleep or shortly after waking. Though it's not entirely clear what causes people to feel like this, it's likely connected to anxiety disorder. Several other medical conditions may be associated with night panics as well, including sleep apnea. Generally speaking, this disorder is treatable with a combination of self-care and medication.
Types
Sleep panic attacks typically take one of two forms, both of which can be very frightening. In the first type, a person wakes up feeling like he or she is about to have a panic attack, or is already in the middle of one. The person's heart will be beating very fast, and he or she may feel confused, disoriented, anxious, and disconnected from reality.
The other type happens when a person begins to consciously experience a panic attack while he or she is still asleep. This may have similar symptoms to a waking panic attack, or it may be accompanied by other symptoms like tooth grinding, head pain, and a feeling of pressure in the ears. In most cases, the person may not be aware of being asleep during the event, or may feel that he or she is struggling to wake up.
Possible Causes
The exact cause of sleep panic attacks isn’t well understood. Since they're much more common in people with anxiety disorder than others, however, they're thought to be connected to that condition. Another theory is that a fear response is triggered as a result of increased levels of carbon dioxide. This is most common in people who have a tendency to hyperventilate. The increase in carbon dioxide can cause a sensation of suffocating, which can lead to anxiety.
Other possible medical causes are sleep apnea, heartburn, and myoclonic twitches. Those with sleep apnea have trouble breathing while asleep, which can lead to a feeling of suffocation and fear. Likewise, a person with severe heartburn might get the feeling that he or she is having a heart attack, which can be very frightening. Additionally, some people get scared when they have myoclonic twitches, which are sudden muscle jerks that happen when someone falls asleep. These can sometimes feel like electric shocks or a sensation of falling, which can trigger a panic attack.
Another possibility is that a fight or flight response happens during changes in the sleep cycle. Nocturnal panic attacks typically occur during the second stage of the cycle, right before deep sleep. This leads researchers to believe that this disorder is not connected to dreams, since they appear in the last stage, Rapid Eye Movement (REM) sleep. A frightening dream might cause a person to have an attack after he or she wakes up though.
Treatment
Treatment for this condition varies depending on other symptoms present. For many people, a combination of medication and self-care can help reduce the frequency of the attacks, and make them easier to cope with when they do occur. Common self-care techniques include understanding what a panic attack is and recognizing the symptoms so that the event won't be quite as traumatic; doing calming activities like tai chi or meditation; breath control; and getting into a regular sleep schedule, since people without one tend to have more panic attacks. Anti-anxiety medication, antidepressants, or tranquilizers may be prescribed depending on the situation, as well as the severity and frequency of the episodes. Psychotherapy is sometimes beneficial as well.
Prevalence
Between 50% and 70% of people who have anxiety disorder will also experience one or more sleep panic attacks. People who regularly experience this problem are also more likely to experience other sleep disturbances, including insomnia and restless sleep.
