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Panic attack in sleep, symptoms, treatment

Hi. I’m sorry that you have experienced something quite similar to what most people call a panic attack. With that, perhaps the panic attack happened at night in sleep. I know it must have a horror experience. I know because I used to be in the same shoes. I’ll explain all about it in this post.

So I’m experiencing that many people are with that the same as I was that the panic attack strikes at night in sleep. It is so scary. I do know it from my very own panicky experiences. In this article, I’m happy to share with you what I have learned from the PANIC because I do know it will help you a lot.

Panic attack symptoms

Mentioning my own experiences in 15 years of panic disorder that I have already overcome, thank God, I experienced a tremendous amount of symptoms. In other words, I’d say it was surely hell itself. My panic attack signs were mostly the same, basically all the time. They varied from time to time but certainly not too much.

There was, by the way, one thing that, however, never changed. I always felt anxious before the next panic attack occurred. And it was not just being anxious but also, under those circumstances, it looked like inevitable despite my best effort, right before the panic attack strikes. 

It was almost 100% scary and 100% unknown to me at that time. I often call that pre-anxiety prior panic attack as a phantom menace.

Now, this particular chapter relates to panic attack symptoms in sleep or daytime, I know. So I thought instead of copy & paste the DSM-5 literature here, I’m going to detail my panic attack symptoms instead. And I do so the way I have experienced them.

A few words about how it started with me

Not just that because of the night occurrence. But at first, it was my first panic attack in my life that happened to me almost in sleep, by the way. It is unforgettable. Later on, from time to time, I experienced many more nocturnal panic attacks too.

The symptoms of a panic attack are an intense fear response to be where you were not to be, roughly speaking. Or, in other words, to be in a situation where you’d rather not be at all. The last thing you would want to be in that particular fearful situation. And that causes tension inside you. 

It follows all the symptoms that certainly everybody would feel in such a situation in the same way, which is often called a fight-or-flight response. 

Fear of death, for example, and rapid and pounding heart rate alongside an intense sense of danger to start with the symptoms of a panic attack. And also, most people feel a few more of them: sweating, shaking, chest pain, headache, dizziness, and indeed that lightheadedness. Probably one of the scariest ones is even more that sense of unreality or that horrible detachment feeling.

The first panic attack is not like other panic attacks

Now that for sure. I can tell. The first panic attack was a once in a while thing. The scariest one of all the rest panic attacks occurred to me. 

On the other hand, and that is to say, the first panic attack worth gold for the rest of panic attacks in your life. Why is that? It is because the other panic that occurred in your life is fuelled by the first one. Perhaps I’d risk saying this: if your first panic attack were not that scary, probably you would never felt more panic attacks in your life. That’s why I’m saying that the first one is fuel for the rest of the ones.

On the negative side, your first panic attack leaves you with a massive memory about that. Just thinking of my panic attack in sleep. Even if it comes up to your mind (and it does so very often, and it’s like a dragon-agent, or a regular mind-visitor), it scares you a lot. Or even so, you know what is all about? It keeps you alert. It holds you under not to forget for a damn second that something is not right. That’s why the memory of your first panic attack hails you all the time.

I never forget that night.

It was already bed time. Instead of sleeping, the dragon visited me. I experienced my first panic attack even though I wasn’t quite yet in sleep. Then I produced all the panic attack symptoms that are all listed in the psychological literature. They were staying with me for an hour or so at the least, that unforgettable night (or nightmare).

Then my mission started. To avoid everything that could lead me to experience one more time that particular hell ever again in my life. I was not very successful in my post first panic attack experience afterward. Even though my mission, that is to say was to avoid everything that could be panicky ever again. That mission was, of course, a failure because I couldn’t possibly prevent everything. As a result, however, it leads us and my panic story to be continued.

Second panic, the third one, etc

Well, the second panic attack – always comes (I did not say that) – generally speaking, so it doesn’t wait too long to revisit you. In particular, we don’t know when it comes, but it, without doubt, does.

On the contrary to the first one, the second panic attack is also a dragon (I like to call it dragon to illustrate a panic attack as an entity, especially one of those who comes when you’re already in sleep) that can bite this time.

Perhaps there’s one significant difference between the first panic attack and the second one. And this is that you are expecting it, that is to say, pre-worrying it by keeping the danger alive. So the second panic attack is going to come then as expected, and once has happened, bites you as a dragon.

On this occasion, it’s hard to say, don’t you worry, the third panic attack will not come. And so after all, in the hope that you’re ok. Unfortunately, this is not the case. My experience says that the more intense fear is in your head against a third panic attack (fear of panic), the more sure it will come. 

Summing up, my second panic attack happened not in sleep at night time, but it did attack me in the daytime.

Panic attack at night

If let’s say, a prospective panic attack preconditions you to scare the dragon, then yes, the panic attack strikes surprisingly at night in sleep or, in fact, daytime too. 

Before the first panic attack with most people, there are other mental health issues. Depression, social anxiety mention to few.

Anxiety at night

As I mentioned, of course, earlier, my first panic attack happened to me at night, or more accurately, just right at the moment before I fell asleep. Later on, during the time of panic disorder, I experienced anxiety and anxiety attacks too, and no matter whether it was day or night time.

Given that, there are many people out there with anxiety, as today, many of us already know that. And what I mean by that is where the regular panic attack happens there’s a good chance that a few of the panic attack occurred at night. Or as it often called nocturne panic attack.

I know I’m not alone with hard falling asleep. And it is because of thoughts, seeking solutions, different thought patterns that are all, in essence, good to make it difficult to fall asleep.

Often it starts with a solution-seeking thought pattern, then it brings emotions of uncertainty, plus fear has arisen with appearing anxiety. Now that is more than enough to feel it’s almost impossible to fall asleep. Then what is left? The anxiety. And sleeplessness. That raises more stress. And this is a fear cycle. Or the panic cycle, in other words.

Did I just have a panic attack?

Well, it’s hard to say. But perhaps if you think so, it was it. It doesn’t matter what we call it as long as every panic attack is an intense fear response. If you experienced just like that, and now you’re doing your best to try desperately avoid by guessing how to avoid or prevent to get another panic attack, then yes. I’d say it might be a panic attack. 

If you’re feeling right now, you don’t know how to avoid a feared next panic attack, then perhaps it means you’re in an anxious and fearful state right now. It’s ok to start seeking help, but if this was your first occasion, maybe it is not necessary. 

For example, being a panic coach myself, I’d adopt my support and help to make a slight correction to rectify the needs to address at the current state in your life.

Frequently fear of death plus nocturnal panic attacks

As an illustration of my own experience regarding my panicky state, so it was time to time a bloody fear of death. So the first thing to remember here is for fear that I was desperately seeking for a solution for my current situation. 

There’s a thought pattern in you that is with you to imply solution-seeking and even so taking off your (bed) time. And your mental capacity is becoming so busy that which only rarely, if so, leaves you sleeping.

Sooner or later, I usually come up with Eckhart Tolle’s teaching. And one of his most known stories that are, of course, part of his book, the well known The Power Of Now, and his spiritual awakening. Eckhart tells us the whole story about his beautiful spiritual transformation in which points to the terrible anxiety. Then in just a few minutes, he shifts decidedly, mentally, psychologically away from anxiety-fear, just like that. 

Before Eckhart’s spiritual awakening, it often happened to him that in the middle of the night, he usually wakes up because of an anxiety attack. 

Sleep disorder

In essence, insomnia or any kind of sleeping disorder for even just a period of a short time, it doesn’t mean that you have in reality anxiety or you’re stressed. On the other hand, the opposite, on the contrary, often seems right. Most of the time, the stress and the fear and anxiety are good to go to disrupt your life, but at least your sleeping.

On the other hand, the experience of a panic attack in sleep at nighttime, only a jump away from this point. Unfortunately. But it’s true. I have experienced that.

Child sleep, night terror, pavor nocturnus

Night terror, or in other words, pavor nocturnus, is the name that children experience in age, usually between 3 to 12 years. On the other hand, it’s essential to know that this is not the same when a child starts crying in the middle of the night, perhaps because of a bad dream. And then all the child wants is a mother’s hug that quickly calms the child down. Pavor nocturnus or night terror is, however, different.

It’s typical for the child to wake with a start and wide-eyed and to look rigidly forward. It’s almost impossible to understand what the child speaks. Another time the child became so fearful and screaming.

Following intense vegetative signs of excitement accompany, such as tremors, sweating, rapid heartbeat, and breathing. In this state, the parent cannot comfort the child with anything, because the little thing is not completely alert. The child does not respond to a call. Even this often further increases his fear. It lasts for around 5-10 minutes.

Then the horror suddenly ends. The child’s consciousness clears and doesn’t remember anything. After this, the best parents can do to put the child back in bed as soon as possible so the sleep can continue. Also, best practice for parents to refrain, after that, from asking questions because it is confusing to the little one as the child was surprisingly not awake. Only quasi-awake from the deep sleep phase.

If someone suspects epilepsy, an EEG test can always provide specific evidence. Pavor nocturnus is a relatively well-defined disease and is characterized by it and still occurring in the first 3-4 hours of sleep after bedtime, but never later.

Anxiety in children

Several anxiety phenomena usually accompany healthy child development. In infants, xenophobia at the age of 6-8 months, specific phobias in infancy, performance anxiety in school-age children, and guilt-related fears in adolescence are common phenomena.

One such disease is a separation anxiety disorder, which is an excessive fear of separation from a parent.

The child can be full of unreal fears about the parent or himself. Does not dare to go to school, falls asleep at half night, as this can also mean a kind of separation from the parents. Any stranger, the unknown situation, seems unbearable to the child only feels good about within the family or in a familiar environment.

Refusal to attend school (formerly called school phobia) is a common phenomenon that is due to separation anxiety. As mentioned earlier, it is an anxiety disorder. It also happens that life outside of school may seem attractive to the child, possibly avoiding school because of negative experiences.

There may also be various coercive actions, e.g., 

  • going to school on the sidewalk 
  • you have to step on a specific stone to have a successful day at school, 
  • in class, you have to step on your textbook in a case to avoid answer that day

And so on.

Treatment of nocturnal panic attacks

If we would know all of those thoughts that are directly causing nocturnal panic attacks, so it would be advantageous. But most of the time we just don’t know that at all.

I’m wondering though it is so strange that we don’t know our very own thoughts, so what’s going on here? Why on earth, we are often not aware of our thoughts, images in our head. That is quite strange to me. But the truth to be told, I’m just as much don’t remember my thoughts as anybody else.

In my case, 15 years of panic disorder, agoraphobia, that I had to go through, made my empty-headed. I couldn’t quite catch my thoughts that kept my fearful and danger awareness alive. Therefore my danger awareness non-stop fuelled the panic inside me. It was until I realized that I should catch my thoughts that were directly causing and keeping the anxiety alive in me.

I want to thank the fact I’m now panic-free to Michael Norman’s PanicFree program that helped me overcome panic disorder myself.

How to cope with panic disorder?

There are tons of advice online. I know because I already checked them out. Quite the same all. 

Are they useful? Well, in theory, yes, they are. The only problem is the intense fear of feeling deep inside one’s panicky state. And you know what fear is? A giant STOP sign. And this is very counterproductive not to address this fact. So I do it here.

Let me give you an example. 

Let’s say you have a friend with arachnophobia, you know, the fear of spider. Your friend, one day, desperately asks your help to overcome the fear of spiders. How would you phrase your help?

Wouldn’t you say something like that? Hey! Do it step by step! First, just watch a painted spider or a real one. Second, just get closer to the spider, and when you and your spider feeling ok, each other then finally touch the spider for a second. Trust me in this case. To feel a spider to a person who originally had arachnophobia, it is quite impossible. So well done for you because you were just an incredible brilliant therapist, indeed.

After the theory of treating arachnophobia as painted above, there’s the same theory to treat panic attacks, whether it happens in sleep at night or daytime.

Practical tips that help right now

Metanoia in psychological meaning. And I’m using Jung’s term as William James used as well. I think this is a brilliant term to describe one’s fundamental change of psyche to start healing itself. Somewhat this theory is wording accordingly in the 3. point of the Twelve-step Program by the Alcoholics Anonymous (AA). And my point here too to say: there’s no way to start healing without the fundamental decision or Metanoia.

Accurate diagnosis or, in other words, I would say, it’s like a mental map needle in light of you do need to know exactly where you are right now. You need this needle to start your journey out of your panic.

Helpful activities in which you could ask yourself: Am I going through on the highway of my dreams, or I’m like nowhere? The reply here is immediately lifechanging! I can not stress enough: the answer for this mantra-question is lifechanging if action follows.

Acceptance is one of the critical points of Eckhart Tolle’s teaching that appears first in his beautifully written pure gold worth book, in The Power of Now. The secret here is in the acceptance. Starting your journey out of the panic, it is not enough to know where you are right now (diagnosis), but also, you need to accept where you are as well.

And a few more…

Affirmations: that are, as you may already know, works well that slowly but firmly make you stronger. Practice those that work best for you and take good advantage of using your best affirmations.

Training and exercise are, of course, essential. You know that so I’m not going to make you bored to repeat it. However, I’d rather say that the body is quite good at mirroring the soul. Arguably not always the case that a slightly higher body mass index indicates that there’s perhaps something to do with the soul too. With me, there’s no exception. My body, by all means, mirrors my soul.

Meditation and relaxation helped me tremendously. It’s one of the best ways to feel better after a panic attack in sleep at night. Perhaps a session of meditation would be the best. There’re a lot of sources available online to learn mindfulness meditation.

Cognitive Behavioral Therapy. I wrote a modified version of CBT that helped me understand my child-self in my adulthood. It was a fantastic journey. It shaped my empathy ability tremendously. I wrote it every day and named it Thought Record. I can’t be more grateful for that. Without it, I wouldn’t be able to overcome 15 years of panic disorder with agoraphobia; that’s for sure.

Asking for help is unbelievable bravery. If you’re asking for help, then you should know it is courage. Well done. May I suggest a multiple-level approach? You should talk first to your physician than continue to speak someone else who has an experience of panic already and also know how to get out of the panic disorder. In case you have found that person, you can contact me here.

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