Nocturnal panic attacks (A brief guide)

In this guide, we will discuss what Nocturnal panic attacks are, symptoms related to panic attacks, potential causes, how is it diagnosed and some treatment options available. Educating yourself about anxiety and panic attacks will help you understand the condition better to develop strategies to cope with it.

Nocturnal panic attacks

Nocturnal panic attacks also known as nighttime panic attacks can “occur with no obvious trigger and awaken you from sleep. As with a daytime panic attack, you may experience sweating, rapid heart rate, trembling, shortness of breath, heavy breathing (hyperventilation), flushing or chills, and a sense of impending doom”, according to the Mayo Clinic.

Even though nocturnal panic attacks can be intense, scary, and overwhelming, they are not a life-threatening condition. However, experts consider the symptoms to be related to other conditions or problems so it is possible you may not always be experiencing a panic attack. For instance, you may have heart palpitations if you have low blood pressure or chest pain if you have a heart condition.

As indicated by the NHS “You may be diagnosed with panic disorder if you experience recurrent and unexpected panic attacks followed by at least a month of continuous worry or concern about having further attacks.”

If you have been diagnosed with panic disorder, it increases the chances to experience nocturnal panic attacks. According to a study from 2013, 18% to 45% of panic disorder patients experience both daytime and nocturnal panic attacks. However, there are a considerable number of patients who only experience panic attacks during the nocturnal sleep period.

What causes nocturnal panic attacks?

Experts and scientists don’t know the specific causes of panic attacks. However, they have suggested genetics, stress, personality traits, neurochemistry, among other factors may be responsible for causing panic attacks. Moreover, having underlying conditions such as sleeping disorders or thyroid problems can generate the symptoms related to panic attacks.

It is important to consult with your GP so they can assess your condition and determine whether you need additional tests in a search for possible underlying conditions.


Having a family member diagnosed with panic disorder or having experienced panic attacks increases the probability of experiencing panic attacks.

Stress and life events

Even though anxiety is not a synonym of panic attacks, they are closely related. We all experience some stress in our day to day activities but when it becomes too overwhelming it becomes a risk factor for panic attacks.

Moreover, when we haven’t developed enough coping strategies when we feel anxious or stress, life events such as losing your job, breaking up with your partner, having a child, or experiencing the death of a loved one can lead to panic attacks.

Brain chemistry

Changes in your brain chemistry due to hormonal changes or certain medications can put you at risk for developing future panic attacks.

Researchers have identified some regions of the brain become hyperactive during a panic attacks such as the amygdala, which is considered the ‘fear center’ of the brain, parts of the midbrain that control several functions, including how we experience pain.moreover, some studies have found a link between panic disorder and an imbalance in serotonin levels.

Medical conditions

Having a medical condition or mental illness can increase the chances of panic attacks. Here are some of them:

  • Cancer
  • Thyroid problems
  • Asthma 
  • Allergic reactions
  • Heart and lung diseases
  • Generalized anxiety disorder
  • Post-traumatic stress disorder 
  • Obsessive-compulsive disorder


As we have discussed, panic attacks can come suddenly and without a warning for no apparent reason. They are experienced with distress making them very frightening and scary. According to the NHS here are some of the symptoms:

  • a racing heartbeat
  • feeling faint
  • sweating
  • nausea
  • chest pain
  • shortness of breath
  • trembling
  • hot flushes
  • chills
  • shaky limbs
  • a choking sensation
  • dizziness
  • numbness or pins and needles
  • dry mouth
  • a need to go to the toilet
  • ringing in your ears
  • a feeling of dread or a fear of dying
  • a churning stomach
  • a tingling in your fingers
  • feeling like you’re not connected to your body

Moreover, most panic attacks are said to last between 5 and 20 minutes, however, some of them have been reported to last up to an hour. Some people report having panic attacks once or twice a month, while others can experience them several times during the week. 

How is it diagnosed?

There are no blood tests, imaging tests, or physical exams that can determine you have panic disorder or panic attacks. However, your doctor can rule out other medical conditions that could potentially explain the symptoms you are experiencing such as thyroid problems or heart disease.

If the results are not showing any underlying medical conditions, your doctor will still evaluate your symptoms and your family and medical history. In addition, they might ask you about your stress levels and when they are at their highest to determine any possible triggers related to the presentation of the panic attacks.

Moreover, as indicated by Kimberly Holland from, “If your doctor believes you’ve been having panic attacks or have panic disorder, they may refer you to a mental health specialist for additional evaluation. A therapist or psychologist can help you understand the causes of panic disorder and work to eliminate them.”

Treatment options

There are some options available to treat panic attacks such as psychotherapy or medication but the best approach to treat your anxiety will actually take a while, there are no immediate solutions.

However, as we have discussed panic attacks can result from having an untreated or undetected underlying condition such as:

  • Heart disease.
  • Hyperthyroidism.
  • Diabetes.
  • Chronic pain.
  • Irritable bowel syndrome.
  • Some brain tumors.


As indicated by Eleesha Lockett from, “There are many forms of psychotherapy that can treat anxiety. One of the most well-established methods is cognitive-behavioral therapy (CBT). CBT is a form of psychotherapy that encourages changing your thought patterns to improve your behavior and mood.”

Scientific research has shown significant results on the effectiveness of CBT in treating panic attacks without having to medicate. Also, your therapist will help you develop strategies or will teach you techniques on how to manage or cope with anxiety in a more effective way which has a long-term effect.  However, some professionals after performing an assessment may decide to combine psychotherapy and medication.


There are various types of medications your doctor may prescribe when treating anxiety. However, it is important you ask as many questions related to pros, side effects, etc. 

Some of the most commonly prescribed medications are:

Selective Serotonin reuptake inhibitors, which are antidepressants.

Serotonin and norepinephrine reuptake inhibitors, which are classed as antidepressants.

Benzodiazepines, which are known for their sedative effects and the risk of habit-forming.

One of the weak points of getting medicated are the side effects and how the medication will only reduce the symptoms and not really treat the reason why you are getting the panic attacks so as soon as you forget to take them or stop them (not without medical supervision), the symptoms will come back again.

Why is this blog about Nocturnal panic attacks important?

Nocturnal panic attacks can be experienced with high emotional and physical distress, becoming overwhelming and exhausting. There are many potential causes related to panic attacks such as genetics, stress, personality traits, neurochemistry, among others. However, consider visiting your GP for further assessment since there are some underlying medical conditions that mimic the symptoms of panic attacks. 

If your doctor considers there are no medical conditions associated with panic attacks, it is important to discuss with your doctor available treatment options. Moreover, there are many coping strategies only that can help you deal with day time and nocturnal panic attacks.

Please feel free to leave any comments or thoughts about the content of this article!

Frequently Asked Questions (FAQs) about Nocturnal panic attacks

How do you stop a nocturnal panic attack?

If you are having a nocturnal panic attack you can try the following:

– Acknowledge it and avoid fighting it, will only make things worse.

– Try to breathe and relax your muscles.

– Get up and do something such as reading a book or listening to calm or relaxing music.

– Make sure to get enough sleep time.

– Establish sleep hygiene habits.

– Prepare yourself for the following day.

– Keep a journal close by.

– Limit your caffeine, nicotine, sugar, and alcohol intake before going to bed.

Can you wake up and have a panic attack?

You could wake up and have a panic attack. It could be due to having a nightmare or a nocturnal panic attack. Just like daytime panic attacks, symptoms such as sweating, rapid heart rate, increased breathing rate, among others, may be present. Panic attacks usually come unexpectedly so they are terrifying and scary making it difficult to go back to sleep.

What is sleep anxiety?

Sleep anxiety is considered a form of performance anxiety. Many people tend to stress about not being able to get enough sleep or how their sleep quality has been considerably reduced, but the stress of trying to get a good night’s sleep can cause people to think about it for hours still not being able to sleep.

Can anxiety wake you up at night?

Anxiety can wake you up at night in the form of a nocturnal panic attack. It tends to have the same symptoms as a daytime panic attack and will wake up for no apparent or obvious reason. The reasons why people may experience these types of episodes are still not clear enough but there are some factors associated. 

How long do nocturnal panic attacks last?

According to the Mayo Clinic, Nocturnal Panic attacks usually only last a few minutes but when trying to go back to a baseline or relaxed state, it may take longer causing difficulties going back to sleep. As scary or frightening it might be, nocturnal panic attacks are not life-threatening or harmful.

References “Panic disorder”

Sawchuk, C.N. (n.d.) Nocturnal panic attacks: what causes them? Retrieved from

Lockett, E. (2018, Dec.) How to Ease Anxiety at Night. Retrieved from

Gans, S. (2018, Nov.) How Nocturnal Panic Attacks Interfere With Sleep. Retrieved from

Holland, K. (2019, Jun.) Why You Might Be Waking Up with a Panic Attack. Retrieved from