Written by Dr. Paul Kelly, C.Psych. March 24, 2024
Does This Sound Like You?
- Panic: “I wake up terrified.”
- Insomnia: “I am afraid to go to sleep.”
- Fear: “I don’t feel safe when the lights are out.”
- Trauma: “I have a trauma history.”
If this sounds like you, check out this article.
I wrote it for you.
How Will This Article Help You?
- Learn about the connection between trauma and nocturnal panic.
- Learn how to cope with trauma-based panic attacks.
- Sarah’s story shows that nocturnal panic attacks can be managed.
Table of Contents
- What are Nocturnal Panic Attacks?
- Trauma History and Nocturnal Panic: Causes and Connections
- Sarah’s Story: Panic Attacks, Trauma, and Coping
- What Kind of Self-Help and Psychotherapy Helps for Nocturnal Panic Attacks?
- A Personal Note
What are Nocturnal Panic Attacks?
Nocturnal panic attacks cause sudden awakening. People often feel intense fear or a sense of doom. Physical symptoms include rapid heartbeat, sweating, shaking, and shortness of breath.
Nocturnal panic attacks are short. They usually last about 2 to 8 minutes. They often occur one to three hours after falling asleep and can cause chronic insomnia. People are afraid to go to sleep. People with a trauma history have more nocturnal panic attacks.
Trauma History and Nocturnal Panic: Causes and Connections
All of us have some awareness while we are asleep. That is why you can turn over without falling out of bed. That’s how a sleeping mother can hear her baby in the next room.
Trauma victims are more vigilant. They have hyperarousal because they have faced threats and danger. Their nervous systems are extra-sensitive – even when they are asleep.
They can have panic reactions to lots of things in the night. Even small things like tight sheets, an outside sound, or a change in body temperature can remind them of danger.
Nightmares, or worrying when half-asleep, can also remind them of a trauma threat. Any of these things can trigger a panic attack during sleep. That is why trauma survivors wake up with nocturnal panic attacks.
Sarah’s Story: Panic Attacks, Trauma, and Coping
Sarah came to Canada with her family when she was a child. There was civil strife in her native country. Her parents fled after people close to them were killed. She remembers being afraid at night.
Now that she is an adult, Sarah lives in a safe neighbourhood with her sister. They share a two-bedroom apartment. Her parents live in a small town where they run a family business.
Growing up, Sarah was a nervous person. She startled easily. It was hard for her to stop worrying. Her sister was very supportive, and Sarah felt safe when her sister was around.
That’s why they lived together. Then, her sister got a new job that required her to travel. She was away from the apartment several times every month. Sarah started to have panic attacks at night when her sister was away.
Sarah’s Panic Attacks
Sarah said this about a panic attack.
- “I woke up suddenly. My heart was racing. I was sweaty.”
- “I couldn’t get enough air. My breathing was fast and shallow.”
- “I felt horrible dread. At first, I did not know where I was. I was shaking.”
- “It only lasted about 5 or 10 minutes, but it felt like an eternity.”
Sarah Faced Her Problem and Learned to Cope with Nocturnal Panic
Sarah’s sister offered to quit her new job so Sarah would not be alone at night. Sarah refused. She told her sister: “I have to learn to deal with this so both of us can have a better life.”
She talked to her family physician, who wanted to make sure there was no medical cause for her panic. Her doctor referred her for a sleep study. The sleep specialist measured her brain waves, heart rate, and many other things.
Sarah did not have sleep apnea, sleep paralysis, or seizures, so she knew that her problem was psychological, not medical.
Sarah’s doctor offered to prescribe anti-anxiety medication. But Sarah said that she wanted to try self-help and psychotherapy first.
She worked at it diligently for about three months. She had coaching from a therapist, and she did lots of home practice. The panic attacks were 80% better. Sarah said: “I’m not afraid of them anymore.
I still get a panic attack when I have a lot of stress, but I know what to do, and I am able to go back to sleep. Panic attacks don’t rule my life. I am in control, and my sister doesn’t have to worry when she is on a business trip.”
What Kind of Self-Help and Psychotherapy Helps for Nocturnal Panic Attacks?
This is a very important question. I want you to have a detailed, practical answer – so I wrote a special blog article for you. Here it is.
Use the Table of Contents to find the answers you need.
You can learn:
- What to do after you wake up from a panic attack.
- How to prepare for restful sleep.
- How to calm down after a panic attack.
- What types of psychotherapy can help with nocturnal panic attack.
- And, how to pick a therapist who is right for you.
A Personal Note
I have not had nocturnal panic attacks, but someone close to me had a terrible time with them. She had a sleep study, and it showed that she had sleep apnea. She needed a CPAP machine, not psychotherapy.
After she started using the machine, her breathing improved, and she stopped having panic attacks. Her story shows that it is important to get a proper diagnosis.
If a sleep study confirms that you have nocturnal panic attacks, don’t despair. Find a good therapist and learn how to overcome panic symptoms. You can make progress even if you have had a lot of traumas in your life.
I care a lot about helping people with anxiety problems because I had phobic anxiety when I was a kid. When I was 9 years old, a car hit me while I was riding my bicycle. I was almost killed.
After I got out of the hospital, I could not cross the road if I saw any cars. My brain was hypersensitive to danger. It predicted that any moving car would hurt me.
My parents were not therapists, but they gave me some practical advice. They told me to try crossing when a car was far away. I was anxious, but I still started to try something new. Little by little, my fear decreased.
My brain learned how to recognize a safe car distance. I was doing exposure therapy, and I didn’t even know it. Eventually, the phobic anxiety went away, and I could buy ice cream without having it melt before I got home.
You have my sympathy if you have nocturnal panic attacks. Remember, this problem can be tamed, so it doesn’t control your life. Improvement is possible. You can learn to have fewer attacks and to be less distressed by them. You have a right to enjoy your life. I wish you well.
Sources
It is important to me that you find practical and trustworthy information. That is why I personally selected and reviewed all the sources for this article. My advice is also based on my own experience with anxiety and my decades of experience.
I have treated thousands of clients and trained and mentored hundreds of therapists and psychologists. The therapy approaches I recommend are used at my Clinic. We track progress, so I know that the techniques can help.
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- Craske, M.G. & Tsao, J. Assessment and treatment of nocturnal panic attacks. Sleep Medicine Reviews. 2005. Retrieved from: https://www.sciencedirect.com/science/article/abs/pii/S1087079204001078
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- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (fifth edition.). Arlington, VA.
- Sankari, S. et al. Relationship between posttraumatic stress disorder and sleep disturbances in Syrian refugees in the United States. Avicenna Journal of Medicine, 2023; 13:82-88. Retrieved from: https://doi.org/10.1055/s-0043-1768646
- Barlow, D.H. et al. Unified Protocol for Transdiagnostic Treatment of Emotional Disorders, Workbook. Oxford University Press, 2018.
- Barlow, D.H. (Editor). Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual, (sixth edition). The Guilford Press, 2021.
- National Institute of Mental Health. Anxiety Disorders (April, 2023). Retrieved from: https://www.nimh.nih.gov/health/topics/anxiety-disorders.
