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If you wake up with a panic attack, you might be experiencing a nighttime, or nocturnal, panic attack.

These events cause symptoms like any other panic attack — sweating, rapid heart rate, and fast breathing — but because you were asleep when they began, you may wake up disoriented or frightened by the feelings.

Like daytime panic attacks, you can take steps to relieve the intense distress or fear and other symptoms.

If these happen regularly, you might be able to find treatments that can help stop panic attacks altogether. Read on to learn more about panic attacks that wake you up.

The primary symptoms of a panic attack at any time of day can be divided into three categories. In order to be a panic attack, you must experience four or more of these different symptoms at once.

Physical symptoms

  • sweating
  • chills
  • nausea
  • heart palpitations
  • feeling faint or unsteady
  • trembling or shaking
  • feeling dizzy or lightheaded
  • shortness of breath
  • chest discomfort or pain
  • sensations of tingling or numbness
  • hot flashes or chills

Emotional symptoms

  • having a sudden fear of dying
  • fear of losing control
  • fear of being under attack

Mental symptoms

  • feeling smothered or choked
  • feeling disconnected from yourself or reality, which are known as depersonalization and derealization

It’s unclear what causes panic attacks, or why 1 in 75 people develop the more chronic condition known as panic disorder.

Researchers have identified underlying factors that might increase your risk for a nighttime panic attack. Even still, not everyone with these risk factors will wake up with a panic attack.

Here are the potential triggers for any type of panic attack.

Genetics

If you have family members with a history of panic attacks or panic disorder, you might be more likely to experience panic attacks.

Stress

Anxiety isn’t the same thing as a panic attack, but the two conditions are closely related. Feeling stressed, overwhelmed, or highly anxious can be a risk factor for a future panic attack.

Brain chemistry changes

Hormonal changes or changes from medications may impact your brain’s chemistry. This may cause panic attacks.

Life events

Upheaval in your personal or professional life can bring about a great deal of worry or concern. This may lead to panic attacks.

Underlying conditions

Conditions and disorders may increase the chances of a panic attack. These may include:

Individuals with specific phobias may also experience panic attacks that wake them up.

Previous panic attacks

Fear of having another panic attack may increase anxiety. This could lead to sleep loss, increased stress, and higher risk for more panic attacks.

Blood tests, imaging tests, and physical exams can’t determine if you’re having a panic attack or if you have panic disorder. However, they can rule out other conditions that could cause similar symptoms, such as thyroid and heart diseases, among others.

If these tests results don’t show an underlying condition, your doctor may discuss your symptoms and health history. They may also ask about your current stress levels and any events that are happening which could trigger panic attacks.

If your doctor believes you’ve been having panic attacks or have panic disorder, they may refer you to a mental health specialist for additional evaluation. A therapist or psychologist can help you understand causes of panic disorder and work to eliminate them.

While panic attacks may be unpleasant, they’re not dangerous. Symptoms can be bothersome and may be frightening, but these treatment measures may help reduce and stop them altogether. These treatments for panic attack include:

Treatment in the moment

If you’re experiencing a panic attack, these steps may help ease symptoms:

  • Help yourself relax. Instead of thinking about the rushing feelings you’re having, concentrate on your breath. Focus on taking slow, deep breaths. Feel the tension in your jaw and shoulders, and tell your muscles to release.
  • Distract yourself. If the symptoms of the panic attack feel overwhelming, you can try to distance yourself from the physical sensations by giving yourself another task. Count backward from 100 by intervals of three. Talk to a friend about a happy memory or funny story. Focusing your thoughts away from the sensations in your body helps them ease their grip.
  • Chill out. Keep ice packets ready to go in your freezer. Apply them to your back or neck. Sip a glass of chilled water slowly. Feel the “cooling” sensation as it overtakes your body.
  • Go for a walk. A bit of light exercise might help your body soothe itself. Ask a friend to walk with you if you can. The additional distraction will be welcome relief.

Long-term treatments

If you have regular panic attacks, you may want to talk with your doctor about treatments that can help you reduce the attacks and prevent them from happening in the future. These treatments include:

  • Therapy. Cognitive behavioral therapy (CBT) is a form of psychotherapy. During sessions, you will work with a therapist to understand possible causes for your panic attacks. You’ll also develop strategies to help you ease symptoms quickly if they happen again.
  • Medication. Your doctor may prescribe certain medications to help prevent future panic attacks. If you do experience a panic attack while on these medications, the symptoms may be less severe.
When to See Your Doctor

These signs might indicate it’s time to talk to your doctor about your panic attacks and possible treatments:

  • you’re experiencing more than two panic attacks in a month
  • you’re having difficulty sleeping or resting for fear of waking up with another panic attack
  • you’re showing signs of other symptoms that might be related to the panic attacks, such as anxiety disorders or stress disorders

If you wake up with a panic attack, it’s natural to feel very disoriented. The symptoms may seem overwhelming.

You may have difficulty knowing if you’re dreaming or not. You may even think you’re having a heart attack. Symptoms like chest pain aren’t uncommon.

Most panic attacks last no more than 10 minutes and symptoms will wane throughout that phase. If you wake up with a panic attack, you may be nearing the peak of the symptoms. Symptoms could ease from that point.

It’s not clear why people experience panic attacks, but certain triggers may make the chances of waking up with one more likely. You may have just one panic attack, or you may have several.

This is a treatable condition. You can take steps in the moment to ease symptoms. You can also work to prevent future panic attacks with therapy and medications.