Waking up scared in the middle of the night (Why?)


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Page last updated: 10/10/2022

Waking up scared in the middle of the night (Why?)

In this guide, we will discuss “Waking up scared in the middle of the night”. Factors or potential causes related to developing panic attacks, medical conditions that could contribute, how are panic attacks diagnosed, and what you could do to stop the panic attacks in the middle of the night (treatment options).

Waking up scared in the middle of the night

If you have been waking up scared in the middle of the night you are not alone. Many people make up in the middle of a panic attack after experiencing a nightmare or nocturnal panic attack. The symptoms experienced would be the same as any other panic attack such as sweating, heart palpitations, fast breathing, shaking, or trembling, among others. 

Waking up in such a frightening state can make you feel confused, overwhelmed, and disoriented. Even though it is less than ideal if you have started to have these regularly there are some treatments that can help stop panic attacks. But the real question you may be asking yourself is, what triggers these panic attacks at night?

Just as Kimberly Holland from Healthline indicates, “It’s unclear what causes panic attacks, or why 1 in 75 people develop the more chronic condition known as panic disorder.

Moreover, “Researchers have identified underlying factors that might increase your risk for a nighttime panic attack. Even still, not everyone with these risk factors will wake up with a panic attack.”

Moreover, Vivian Okirie, M.D from calmclinic.com says, “When you experience panic attacks at night, known as nocturnal panic attacks, you can wake up in the middle of the night in a deep sweat, barely comprehensible, frightened that something terrible will occur” and they are believed to be more terrifying than the daytime panic attacks. You may not even feel safe in your sleep which can cause problems going to sleep before and after an episode, which can lead to insomnia.

Let’s talk about some of the factors that may contribute to developing panic attacks or potentially a panic disorder.

Factors or potential causes for panic attacks

First of all, if you have family members with a history of panic attacks or panic disorders then you become more prone or at risk of developing this condition. 

In addition, if you have been under a lot of stress or highly anxious, it can be considered as a risk factor for developing future panic attacks. Moreover, some experts consider that changes to your brain chemistry such as hormonal changes or changes produced from medications that can potentially alter the chemistry in your brain can potentially cause panic attacks.

If you have suffered from a traumatic life event such as the death of a loved one, the birth of a child, moving to a new place, losing your job, being abused, a serious accident, etc., may lead to developing panic attacks.

Moreover, underlying conditions such as generalized anxiety disorder, acute stress disorder, Post-traumatic stress disorder, or obsessive-compulsive disorder can also contribute to waking up scared in the middle of the night.

Finally, according to Kimberly Holland from healthline.com, “Fear of having another panic attack may increase anxiety. This could lead to sleep loss, increased stress, and higher risk for more panic attacks”. This means just the thought of having another panic attack can be enough to trigger a new one.

Waking up scared in the middle of the night (Why?)

Causes of Nocturnal Anxiety Attacks (medical conditions)

As we have discussed, it is difficult to determine the specific trigger for a panic attack especially when sometimes there may not be an evident or obvious trigger. Even though there may be many potential causes, there are some specific factors that may contribute to developing nocturnal panic attacks such as:

  • Obstructive sleep apnea. This is a sleeping condition considered one of the most common causes of nocturnal panic attacks. In obstructive sleep apnea, the individual has short spurts of not breathing while sleeping, which forces the lungs to try to take a deep breath to resume breathing. When the upper airway is blocked, you can stop breathing for a few seconds causing hypoventilation which can induce stress on your heart and several of the symptoms related to panic attacks.
  • Gastroesophageal Reflux Disease (GERD). You could have heard of it as ‘acid reflux disease’, which is believed to be associated with nocturnal attacks. Some people with GERD can have certain symptoms such as chest pain and pressure, difficulty breathing, and sometimes even night sweats. This can cause you to wake up scared in the middle of the night when a panic attack gets triggered.
  • Hyperventilation disorder. This is a chronic problem that affects many people that suffer from panic disorder. As indicated by Vivian Okirie from calmclinic.com, “In many cases, the hyperventilation symptoms are induced by anxiety and/or stress; so when a person is sleeping they become less likely to hyperventilate.”
  • Recurrent nightmares. If you suffer from recurrent nightmares, you may be at a higher risk of developing nocturnal panic attacks. When you have a nightmare your brain is not aware of what it is real and what isn’t meaning it will trigger the fight-or-flight response if it senses danger.

How are panic attacks diagnosed?

There are no specific brain scans, blood test samples, or physical exams that can determine whether you have panic attacks or a panic disorder. However, your physician may want to rule out other conditions according to the symptoms reported, for instance, thyroid or heart diseases.

After doing some tests, if your doctor doesn’t find an underlying condition, they will go deeper into asking questions related to your stress levels and if there have been any recent life events that could have been responsible for triggering the panic attacks. However, most likely your doctor may refer you to a mental health professional for additional evaluation. 

How can I stop waking up in the middle of the night?

Panic attacks are extremely unpleasant but are not considered as dangerous meaning you won’t die from a panic attack unless there were special circumstances, underlying conditions, or complications, so you could die from something else but not from a panic attack. However, there are treatment options to reduce the symptoms and occurrence of panic attacks.

Some of them include relaxation techniques before going to bed, focusing on your breathing and relaxing each set of muscles from your toes to your head. Some of the techniques consist of tensing for a few seconds and relaxing the muscles consciously which helps you feel very relaxed. Moreover, you can try to distract yourself from the panic attack such as counting backward or focusing on a funny story you could start telling out loud. This will shift the focus and will tell your brain you are not in real danger.

 Some other techniques involve doing regular exercise, mindful meditation, having a healthy diet, etc. However, long term treatments may involve medication, psychotherapy, or a combination of both:

  • Psychotherapy: research indicates the most effective is Cognitive Behavioral Therapy (CBT), where the therapist helps the individual understand the possible causes of the panic attacks. Moreover, the therapist will help you develop strategies and mechanisms to cope with the attacks.
  • Medication: the most prescribed type of drugs for panic attacks are SSRIs which include fluoxetine (Prozac), paroxetine (Paxil, Pexeva), and sertraline (Zoloft). However, always consider asking your doctor about any side effects and risks.

Why is this blog about Waking up scared in the middle of the night important?

Waking up scared in the middle of the night while having a nocturnal panic attack or just a nightmare can be considered very distressing and frightening. It can even interrupt your sleeping pattern to the point you don’t go back to sleep fearing you may have another attack. However, there are many treatment options available for you, just find the one that you see fit by consulting with your doctor so they can assess your condition and rule out any physical health issues such as the obstructive sleep apnea or GERD we talked about earlier.

Finally, consider going to a therapist if you feel too overwhelmed with the nocturnal panic attacks or if you feel your quality of life has been reduced considerably.

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

Frequently Asked Questions (FAQs) about Waking up scared in the middle of the night

Why do I wake up scared in the middle of the night?

You could wake up scared in the middle of the night after experiencing a nightmare or a nocturnal panic attack. If you have experienced this before, you may be familiar with sweating, having heart palpitations, rapid breathing or shortness of breath, etc., but since they started when you were asleep, it is the reason why you wake up scared, frightened and disoriented.

Why do I keep waking up at 3 am?

You could be waking up at 3 am because it is the time you shift from deep sleep into a lighter sleep. Also, if during the day you have been under a lot of stress and anxiety, it could contribute to waking up at the same time. In addition, if you drink a glass of water before going to bed, it could also be contributing to waking up at 3 am to go to the bathroom.

What causes panic attacks at night?

There are several reasons why you may be experiencing panic attacks at night but we can say the most common would be experiencing chronic stress in your day to day activities and struggling with mental health conditions such as anxiety, depression, obsessive-compulsive disorder or OCD, or post-traumatic stress disorder (PTSD).

Why do I keep waking up in a fright?

You could be waking up in fright due to several factors such as recurrent thoughts or overthinking about something that makes you really anxious, excessive caffeine consumption before going to sleep, chronic stress, having nightmares, or nocturnal panic attacks.

What is Sexsomnia?

Sexsomnia is also known as sleep sex, a distinct form of parasomnia or abnormal activity that happens when an individual is asleep. It is characterized by an individual engaging in sexual acts while in nonrapid eye movement (NREM) sleep.


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

Okirie, V. (2018, Oct.) Nocturnal Panic Attacks: When Night & Fear Combine. Retrieved from calmclinic.com.