Nocturnal Panic Attacks: The Causes and Treatments

Whether they are due to medical or psychological reasons, if we have ever suffered from night panic attacks it is important to tell our doctor so that they can help us resolve this
Nocturnal Panic Attacks: The Causes and Treatments
Valeria Sabater

Reviewed and approved by psychologist Valeria Sabater.

Written by Valeria Sabater

Last update: 27 May, 2022

Nocturnal panic attacks appear unexpectedly in the middle of sleep. They come with the feeling of suffocation, tachycardia and sweating.

From a clinical point of view, it’s common for this to happen in patients who also suffer from panic attacks in the daytime.

However, it’s known that panic attacks experienced at night are experienced with greater intensity and suffering.

It’s also important to highlight a curious thing about them. 10% of people who suffer from anxiety, and who are under pressure and suffer high levels of stress due to their lifestyle, can also suffer from nocturnal panic attacks from time to time.

On the other hand, there are other groups in society who are also more sensitive to this kind of situations due to personal factors and medical conditions.

Sometimes, these cases can become a real problem.

Let’s have a look at some more information.

Nocturnal panic attacks: who can suffer from them?

Nocturnal panic attacks

We don’t talk about nocturnal panic attacks much…So much so that many people are surprised to learn of them.

When we talk about panic attacks, we typically imagine someone who is captive to fear. We picture a person who is paralyzed and suffering from tachycardia in some daytime situation. We probably assume there is some danger or cause of anguish.

At night, and in a safe context like our bed, it’s difficult to imagine why we should experience this kind of situation. However, it’s more common than we might think.

Let’s see what kind of people are more susceptible to suffering from nocturnal panic attacks:

  • Patients who already suffer from panic attacks at any time of day
  • People who are in the midst of situations that put great psychological or emotional pressure on them
  • Those with hyperthyroidism or hypothyroidism
  • People who suffer from apnea
  • Gastroesophageal reflux can also cause it
  • People who have just experienced a traumatic event: the loss of a loved one, being victim of an accident or the witness of one.

What are the symptoms of a nocturnal panic attack

The symptoms of a nocturnal panic attack

Nocturnal panic attacks tend to appear in the non-REM phase of sleep. Thus, it’s when we are most calm and, curiously, most relaxed. (It’s most common for them to happen around 2 in the morning).

We wake up suddenly and violently, as if someone had activated a mechanism which all of a sudden “pulled us” out of our sleep.

This awakening comes with a feeling of intense fear, panic or doom. It is accompanied by a suffocating feeling, tachycardia and sweating.

The person tends to have the impression that the situation has lasted a long time. However, it tends to be quite limited and brief, never more than 15 to 20 minutes.

It’s also important to point out that these situations are experienced with more confusion than daytime panic attacks.

They come out of “nowhere”, in the middle of our rest. They appear out of the blue from this unconscious, relaxed world where the last thing we’re expecting is a panic attack.

The lack of control is therefore immense. This confusion tends to intensify the fear and discomfort even more, which makes the anxiety increase even more.

What can we do to deal with and reduce nocturnal panic attacks?

As we have already mentioned, nocturnal panic attacks can happen due to a range of causes. However, we can differentiate between two main causes: medical and psychological.

Panic attacks for medical reasons

Panic attacks for medical reasons

Factors such as thyroid problems, apnea and reflux can lead to these violent and exhausting night time awakenings.

Thus, it’s advisable to put the following strategies into practice:

  • Tell your doctor what is happening.
  • Continue with the appropriate treatment for your illness: thyroid problems, gastroesophageal reflux…
  • Follow medical recommendations to get a good night’s sleep.
  • Find out whether the medication you’re taking can affect your quality of sleep.
  • Try living an active life, as physical exercise is a good regulator for anxiety attacks.
  • After a nocturnal panic attack, it’s recommended to get up and do some non-stimulating daily routine: tidy something up, brush your teeth or hair…
  • It’s not a good idea to go and watch TV or have a shower, because in this case you’ll have trouble getting back to sleep.

Panic attacks for emotional or psychological reasons

  • Identify the origin of your emotional problems or the trigger of the anxiety.
  • Learn to manage your emotional world with the help of a professional or through appropriate personal coping mechanisms.
  • Practice some kind of breathing or relaxation techniques before going to sleep.
  • Mindfulness is very suitable for dealing with these situations.
  • Yoga is also very useful.
  • Swimming, dancing or walks in natural environments are relaxing activities that are suitable for this type of disorders.

To conclude, never hesitate to tell your doctor about any kind of sleep disorder.

Nocturnal panic disorders always have a biological or psychological origin that is important to identify.


All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.


  • Mario R. Garcia Palmieri. Lo Que Debes Saber Sobre Tu Salud. La Editorial, UPR, 2000.
  • Pablo Manzano. Temperamento y Personalidad – Libros Ilustrados. SteelBrush, 2014.
  • JP Nicolais. Soluciones Simples a los Trastornos del Sueño: Cómo Sacar Provecho de Sus Sueños. Alchemy Solutions LLC, 2014.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.