Panic attacks at night: Causes and how to cope

People may experience a panic attack without warning. Others may have frequent, unexpected attacks.

Those who have frequent panic attacks may begin to identify certain triggers, such as stress at work or fear of flying. However, nocturnal panic attacks may happen without a trigger and even wake a person from sleep.

Some people with a panic attack may feel as though they are having a heart attack and seek medical treatment.

Read on to learn more about nighttime panic attacks, including their causes, ways to cope, and possible treatments.

Panic attacks at night

Since there are several potential risk factors and causes of having a panic attack, it is possible that a person may experience panic attacks at night.

There is very little research on nocturnal panic attacks, however, so doctors are unsure what causes them to occur while a person is asleep.

People who have nighttime panic attacks typically also have panic attacks during the day.

When a panic attack occurs at night or while a person is sleeping, it may be difficult for them to calm down again.

Fear of the panic attack reoccurring can prevent the person from falling asleep again, which may lead to sleep loss and increased stress.


Scientists do not yet fully understand the exact causes of panic attacks, both in the day and at night.

However, some factors can make it more likely that a person will experience a panic attack. These include:

  • genetics, or having family members with a history of panic attacks
  • personality type
  • life events, such as job loss, a public speaking engagement, or a fear of flying
  • brain chemistry
  • underlying conditions, such as social anxiety disorder

A panic attack, during the day or at night, occurs when a person experiences four or more of the following symptoms:

  • sweating
  • chills
  • feeling faint
  • nausea
  • palpitations, a pounding heart, or an accelerated heart rate
  • feeling dizzy or lightheaded
  • feeling unsteady
  • trembling or shaking
  • feeling smothered
  • feeling a fear of dying
  • depersonalization, or the feeling of being detached from oneself
  • sensations of shortness of breath
  • feelings of choking
  • fear of losing control
  • pain or discomfort in the chest
  • paresthesia, or sensations of tingling or numbness
  • derealization, or feelings of unreality

Some people may experience fewer than four of the symptoms listed during an attack. In these cases, a person may have had a limited-symptom panic attack.

Panic attacks are related to anxiety. Anxiety can also cause a person to experience physical symptoms. What makes a panic attack different from general anxiety is the speed of onset (reaching a peak within 10 minutes) and the intensity of the symptoms.

According to the Anxiety and Depression Association of America, anxiety affects around 40 million adults (18.1 percent of the population). However, only 36.9 percent of them seek treatment for it.

Formal treatment of panic attacks will typically involve medications, psychotherapy, or a combination of both.

Cognitive behavioral therapy (CBT) is often the first line of therapy for people who experience panic attacks.

In CBT, a therapist helps a person confront and understand their symptoms of panic attack in a controlled, safe environment. Once the fear is resolved, it can help a person avoid future attacks.

In addition to or instead of therapy, a doctor may prescribe one or more medications to help treat anxiety. Some examples include:

  • selective serotonin reuptake inhibitors, which are antidepressants
  • serotonin and norepinephrine reuptake inhibitors, which are also antidepressants
  • benzodiazepines, which are sedatives that a person should use sparingly due to their risk of addiction

These medications could cause side effects. If a person experiences side effects after taking a medication for panic attacks, they should speak to their doctor.


The best form of prevention is to develop a treatment plan with a doctor and stick to it.

Therapy and medications are both very effective methods to help prevent future attacks and to make symptoms more manageable.


Panic attacks at night are treatable. Most people who follow a treatment plan see positive results and reduced symptoms.

People who experience panic attacks should speak to their doctor about their symptoms and discuss their treatment options.

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