Having Panic Attacks at Night? Here's How to Stop Them

Nighttime panic attacks typically only last for a few minutes. But that doesn't make them any less frightening and uncomfortable, thanks to their intense physical symptoms and impending sense of doom.

"Nocturnal panic attacks can be distressing and debilitating," says Seattle-based licensed psychologist Jennifer Chain, PhD.

Sleep deprivation caused by the attack itself can leave you tired in the morning. And if you're anxious about future attacks, you might start to have trouble falling or staying asleep for nights to come.

There's some reassuring news, though. While a nighttime panic attack can't be stopped once it's started, there are steps you can take to make getting through the attack easier — and even reduce the risk for future ones.

Panic attacks are sudden episodes of intense fear that occur when a person isn't actually in danger. They can happen during the day or at night. About 70 percent of people who have frequent panic attacks will experience panic attacks at night, according to the Cleveland Clinic.

When a panic attack wakes you up at night, you might experience symptoms that are intense enough to make you worry that you're having a heart attack or even dying.

Phoenix-based licensed professional counselor and psychotherapist Elizabeth Fedrick, PhD, says a panic attack can cause:

• Shallow breathing
• Increased heart rate
  Chest pain
• Dizziness
• Shaking
• Nausea
• Excessive sweating
• Numbness or tingling
• An experience of intense fear
• An overwhelming feeling of distress

Part of what makes daytime or nighttime panic attacks so disturbing is the fact that they often occur out of the blue. Experts don't fully understand why these episodes happen, but it's thought that factors like genetics, stress and changes in brain function could all play a role, per the Mayo Clinic.

What's more, certain people may be more prone to nighttime panic attacks than others.

"I often find that people who experience them have a hard time relaxing even while awake," says Chain. "When their body is sleeping, their mind may interpret the relaxed state as dangerous and wake them up with a rush of stress hormones."

Those challenges with relaxing might stem from traumatic experiences that caused you to feel threatened or out of control.

"They could be one-time experiences such as a car accident, natural disaster, sexual assault, war or physical violence," Chain says. "But they can also be more chronic and subtle, such as growing up in a family that could not meet your emotional needs, being in a toxic work environment or living as a person of color in our racist society."

In other cases, the panic attack could be the result of going through a particularly stressful period, Fedrick says. That could be navigating a job loss, for instance, or dealing with a serious illness, the end of a relationship or the loss of a loved one.

Panic attacks that wake you up (or happen during the day) can't be stopped in their tracks. "Try not to fight against it or control it, but rather simply acknowledge that it is taking place," Fedrick says.

As the attack runs its course, try to remember you're not actually in danger — you're just distressed and uncomfortable. In a few minutes, the panic attack will end and you'll start to feel better.

"Tell yourself that you're safe and your body is safe. Tell yourself that this is not your fault," Chain says.

Practicing deep breathing exercises during a panic attack can help you feel more grounded and potentially make your symptoms less severe. Fedrick often recommends square breathing:

1. Gently exhale all of the air in your lungs.
   
2. Slowly inhale while counting to four. Focus on the feeling of the breath entering your nose, mouth and lungs as you inhale.
   
3. Hold the inhale for four counts.
   
4. Slowly exhale while counting to four. Focus on the feeling of the breath leaving your nose, mouth and lungs as you exhale.
   
5. Hold the exhale for four counts.
   
6. Repeat four to five times.
   

You probably won't be ready to go right back to sleep after the attack ends, so don't force it. Instead, give yourself some time to get back to baseline with a relaxing activity.

"Give yourself a hug or a foot massage, wrap yourself in a comfy blanket, stretch, make a cup of tea, light a candle or turn on some soothing music," Chain recommends.

Just because you had a nighttime panic attack doesn't mean you'll have another. But if you're worried about a repeat attack, consider talking with a therapist.

Having just one panic attack doesn't mean you have a panic disorder, but it could be a sign you're dealing with excessive stress or anxiety, Fedrick says. "Engaging in therapy would be a great option to determine if there's something more going on and how best to manage it," she says.

If you've experienced repeat panic attacks or have been diagnosed with depression or anxiety, medication may be helpful. Antidepressants like SSRIs or SNRIs, beta blockers or anti-anxiety medications like benzodiazepines can be utilized to manage recurrent panic attacks, per the National Institute of Mental Health.

You should talk with a mental health professional if your nighttime panic attacks are becoming debilitating or are affecting your quality of life.

"If you are waking up exhausted, unable to focus on your day, anxious about going to bed or are experiencing other mental health concerns such as anxiety, depression, PTSD, OCD, stress, burnout or substance dependence, you should seek help," Chain says.