9 Ways to Cope with Nocturnal Panic Attacks

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9 Ways to Cope with Nocturnal Panic Attacks | Waking up in the middle of the night experiencing a panic attack is extremely frightening, leaving you anxious, stressed, and sleep deprived. And since sleep (particularly deep sleep) is so important for anxiety management, it can feel like a vicious cycle. From identifying triggers, to controlled breathing, to visualization and more, we're sharing our best tips and coping strategies so you feel in control of your nighttime panic attacks.

There’s no argument that panic attacks are terrifying. They happen out of nowhere, and you feel like you’re having a heart attack. But nocturnal panic attacks are a different ballgame. As the name suggests, they happen at night, startle you from a deep sleep, and can cause severe anxiety and disruption to your entire day from sleep deprivation. And if you or a loved one suffer from them, you’ll learn how to cope with nocturnal panic attacks to ensure they don’t interfere with your sleep or day-to-day life.

What Are Nocturnal Panic Attacks?

Yes, panic attacks can happen at night. They are real and very frightening to those that experience them. Like their daytime counterpart, they involve intense periods of fear and anxiety coupled with uncomfortable physical sensations but occur when you are asleep and suddenly jolt you awake. But unlike night terrors, which also cause similar symptoms, those with nocturnal panic attacks vividly remember their experience.

12 Signs and Symptoms of Nocturnal Panic Attacks

Like daytime panic attacks, nocturnal ones share the same signs and symptoms:

  • Shortness of breath
  • Rapid heart rate
  • Nausea 
  • Sweaty palms
  • Chills
  • Feeling of choking 
  • Trembling
  • Chest pain
  • Feeling detached from self/reality
  • Dizziness or lightheadedness 
  • Intense fear and anxiety
  • Tingling or numbness in fingers or toes

5 Causes of Nocturnal Panic Attacks

Unfortunately, it’s not entirely known what causes nocturnal panic attacks. But thankfully researchers have identified a few underlying factors that may increase your vulnerability:

  • Genetics and family history of panic attacks, panic disorder, or anxiety 
  • Consistent stress from work, relationships, or other situations
  • Traumatic life events such as divorce, loss, losing a stable job, etc. 
  • Underlying conditions such as anxiety disorder, depression, sleep disorder, thyroid disorder or substance abuse disorders
  • A chemical imbalance in the brain that tells the body it’s awake when it’s asleep 

9 Ways to Cope with Nocturnal Panic Attacks

1. Practice controlling your breathing

Panic attacks cause rapid and shallow breathing. And one of the best ways to calm your nerves is by practicing breathing techniques for anxiety. For example, prolonged and deepened exhales can actually reverse the fight-flight-or-freeze response you feel and activate your parasympathetic nervous system. Here’s how to practice:

  • Begin by inhaling for 3 seconds 
  • And exhaling for 5 seconds 
  • As you feel calmer, keep progressing 
  • Inhale for 4 seconds and exhale for 6 seconds, and so forth 

2. Reconnect to reality

Nocturnal panic attacks shockingly jolt you from your sleep. As such, you might wake up afraid and disoriented from your surroundings. One way to reconnect with reality is to remind yourself that you’re safe. For example, ask yourself, “Where am I? Am I somewhere safe?” Then work through the fear by saying, “I am safe in my bedroom, and I am having a panic attack, but it will end soon”. After, breathe and cope with the subsequent anxiety with the following tips.

3. Remind yourself what’s happening

One of the main symptoms of panic attacks is the impending doom you experience. For example, you think you’re having a heart attack or dying. But use your logical mind to override the fear. Indeed, remind yourself it’s a panic attack and that it won’t last forever. Additionally, tell yourself that it creates discomfort but doesn’t cause any real harm by remembering past panic attacks and noting that they were temporary and weren’t dangerous.

4. Shift your focus

Waking up in a state of fear is not fun. But one of the best ways to cope with nocturnal attacks is to shift your focus through grounding. For example, 

  • Keep an object like a stress ball or crystal by your bed. When you wake up, hold it and focus on how it feels
  • Grab a calming essential oil for anxiety like lavender or vanilla and smell it
  • Notice your surroundings by naming objects you see, colors, or shapes 
  • Grab your pillow and squeeze it as tightly as you can 
  • Sleep with a weighted blanket and notice its security 

5. Relax your body

After the initial panic subsides, it’s common to feel resulting anxiety about falling asleep. To help combat this, practice muscle relaxation, a home remedy for anxiety and panic attacks, to create a sense of calm. 

  • Start with your toes and squeeze them for 10-15 seconds, then release while counting for 30 seconds 
  • Move to your legs and repeat the process. For example, your quadriceps, then your calves 
  • Then your buttocks, clenching them for 10-15 then slowly release the tension for 30 
  • Move to your hands, arms, then shoulders and neck repeating the same steps
  • And ending with your jaw and forehead 

6. Visualize the intensity decreasing

When your panic attack is in full force, visualize the discomfort as waves. It’s a guided imagery technique that will decrease anxiety. To start, welcome the uncomfortable sensations instead of ignoring them, and imagine you’re at the beach, standing in front of the rolling waves. Feel the sand beneath your feet, smell the salt, and visualize each sensation as a wave coming to shore. See it reach your feet for a few seconds and withdraw back into the ocean.

7. Track your triggers

Either following your panic attack or the next day, grab your trusted journal and document the experience. For example, write about what you did that day, discuss your work, stress levels, corresponding emotions, and anything that comes up. Indeed, writing about your attacks is a preventive process that will allow you to discover possible triggers and increase your awareness about the warning signs.

8. Create better sleep habits

Unfortunately, sleep and anxiety share a strong relationship. For example, not enough sleep can cause anxiety, and anxiety can cause insomnia. But following better sleep hygiene tips for anxiety can limit the number of panic attacks you have. Here are a few examples

  • Limit your caffeine intake throughout the day. Consider natural ways to boost your energy instead 
  • Avoid working or checking social media at least one or two hours before bed
  • Meditate for 15-20 minutes before sleep
  • Limit outside noise with a sleep machine, fan, or calming white noise 
  • Eat well-balanced meals throughout the day

9. Receive support

Whether you’re experiencing daytime or nighttime panic attacks, help is available. Indeed, speaking with a therapist and receiving gold-standard cognitive behavior therapy will empower you to identify your triggers and cope with your panic attacks in a safe and supported environment. It will also help you manage intrusive thoughts and fear that accompany anxiety. Also, consider talking to a loved one to vent any day-to-day stress and frustrations.

Every form of a panic attack can feel frightening. But making a few changes to your sleep routine and following a few grounding techniques can help you decrease the severity and teach you how to cope with nocturnal attacks. And remember to give yourself love and self-compassion through every step of your healing journey.

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9 Ways to Cope with Nocturnal Panic Attacks | Waking up in the middle of the night experiencing a panic attack is extremely frightening, leaving you anxious, stressed, and sleep deprived. And since sleep (particularly deep sleep) is so important for anxiety management, it can feel like a vicious cycle. From identifying triggers, to controlled breathing, to visualization and more, we're sharing our best tips and coping strategies so you feel in control of your nighttime panic attacks.

And if you’re looking for more tips and ideas to help you live your best life please follow our Mental Health board where we share all kinds of helpful ideas we find each day!

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