To Stop Panic Attacks At Night
Create a calm environment
Reduce worry and anxious thinking by labeling your thoughts and detaching yourself from the worry
Refocusing your attention
Deep breathing to re-balance the level of oxygen and carbon dioxide in your body
Progressive muscle relaxation
Panic Attacks At Night
Although there is no specific identifiable cause for panic attacks at night, most people who have panic attacks at night also have panic attacks during the day.
In a 12-month period, it is estimated that approximately 11.2% of adults in the United States and up to 3.3% of Europeans experience panic attacks.
Most people can probably relate to having increased stress and tension at bed time, making it difficult to relax, and in some cases, can lead to experiencing insomnia.
When our heads hit the pillow there are no more distractions, allowing our minds to wander, worry, and spin out of control.
Tension and stress from daily life events and activities has a way of building up and overwhelming us.
You may worry about relationships, school performance, work performance, financial difficulties, and physical health. These issues start to pile up on each other creating more stress and anxiety.
It seems that the body's nervous system is saying, "It's not time to sleep! You are still in danger!"
Letting your guard down when experiencing stress and anxiety may be the perfect recipe for triggering a panic attack.
If you are on guard constantly for any sign of danger your body will have a tough time turning that off when it's time to relax and this could cause panic attacks at night.
People can also have panic attacks while asleep. These are called Nocturnal Panic Attacks.
What Is A Panic Attack?
A panic attack is a very brief episode of intense fear and discomfort. Note that a panic attack can occur from a calm state or an anxious state. Symptoms reach a peak within minutes and then subside within minutes. A person may return to a reduced state of anxiety or to a state of calm.
Symptoms of a Panic Attack
Palpitations, pounding heart, or accelerated heart rate
Trembling or shaking
Sensations of shortness of breath or smothering
Feelings of choking
Chest pain or discomfort
Nausea or abdominal distress
Feeling dizzy, unsteady, light-headed, or faint
Chills or heat sensations
Numbness or tingling sensations
De-realization (feelings of unreality) or depersonalization (being detached from oneself)Fear of losing control or “going crazy”Fear of dying
Although scientists have not fully determined the exact cause of panic attacks, there are some factors that may make it more likely for someone to experience a panic attack. These include:
Family history of anxiety: Some research indicates that first-degree relatives of patients with panic disorder have higher rates of panic disorder than relatives of patients with major depression and relatives of healthy controls (Goldstein et al 1994).
Respiratory illnesses: Conditions such as asthma can cause breathing issues that lead to shortness of breath and feeling dizzy. This could cause the fear of internal physical danger, triggering a panic attack.
Environment: Physical and psychological abuse, traumatic events, the death of a loved one, divorce, abandonment, and maladaptive behaviors learned from parents pose a greater risk for the development of an anxiety disorder such as panic disorder. Those with an anxiety disorder may have inherited anxiety from their families as a result of stressful family and life circumstances.
Psychological issues: There may be a psychological issue fueled by underlying feelings and beliefs created by past experiences. We can often trace the root causes for our current psychological issues back to negative experiences beginning in early childhood and extending to early adulthood.
How To Stop Panic Attacks At Night
Try not to get out of bed or leave the place where you are having the panic attack.
Avoiding your bed just confirms and maintains the belief that your bed is dangerous and you will quickly associate your bed with panic attacks.
1. Create Calm
To reduce the possibility of panic attacks at night, create a feeling of calm. Make your space calm and create calming routines such as:
Add things that are comforting and relaxing to your touch and sight
Play relaxing music
Use calming aromas such as lavender
Drink calming teas
Take warm baths or showers
Watch something funny
2. Reduce Worry and Anxious Thinking
Panic attacks at night can often be caused by worried thinking. Reduce your worry by labeling the worried thoughts and by detaching yourself from the thoughts.
Label Your Thoughts
Instead of focusing on the content of the worry, such as “What if I can’t remember what to say during my speech, I will look stupid,” focus on it being an unhelpful thought that causes anxiety.
This will move you away from the emotional content of the thought.
Label thought, “It’s just an anxiety provoking thought.” Focusing on the content of the worry keeps you spinning round and round on the merry-go-round.
Labeling the thought as an “Anxiety Provoking Thought” allows you to step off the merry-go-round and observe it with some safe distance.
Detaching Yourself From The Worry
Sometimes the harder you try to stop a worry, the more you will have it. So instead of stopping the worry, detach yourself from it.
Here are some ways to detach yourself from the worry:
Allow the worry to flow into your head. Close your eyes and imagine the worried thought and/or image floating out of your head like a leaf, landing on a stream of water, and gently floating down the stream. Repeat this each time the worry pops into your head.
Close your eyes and project the worry on a black chalk board, then erase it with a large chalk eraser. Allow the worry to appear on the chalk board several times and erase it each time. You can then write more helpful words or thoughts on the blackboard such as “Calm” or “Sleep” if you are trying to get to sleep.
Close your eyes and imagine sitting in a large movie theater alone and project the worried thoughts as images onto a large movie screen and watch them while sitting in the back of the theater. You can imagine yourself eating popcorn while watching. Then imagine yourself watching from the projector booth where you can fast forward, rewind, and pause the images.
3. Refocus Your Attention
Focusing on the physical symptoms of a panic attack and the fearful thoughts adds more fuel to a panic attack.
Refocusing your attention shifts your brain from the cycle of panic by pulling your attention out of your head and outside of your body.
Tell yourself that it's only a panic attack and you know it will end.
Stop focusing on your symptoms and start focusing on something else in your environment, like how many colors there are in a picture on the wall or sounds that you can hear.
The symptoms of a panic attack begin to decrease because you are moving away from the danger of focusing on the uncomfortable symptoms and repeating something like “OMG, OMG, I’m going to die.”
4. Deep Breathing
Deep breathing, also known as diaphragmatic breathing, by far is the most helpful strategy to manage and minimize the symptoms of a panic attack.
Deep breathing gives you a sense of control over your body when feeling out of control during a panic attack, especially if you are hyperventilating or feeling dizzy.
When we are anxious we tend to breathe faster. We take in more oxygen and breathe out carbon dioxide. This causes an imbalance with too much oxygen and too little carbon dioxide in our blood. This condition is called respiratory alkalosis.
The extra oxygen can cause us to feel light-headed and feel tingling in our fingers and toes. Deep breathing helps correct the oxygen and carbon dioxide levels during panic attacks.
Deep breathing works to activate the parasympathetic nervous system which is responsible for producing a calm and relaxed feeling. The parasympathetic nervous system is also called the “Rest and Digest” response.
Deep Breathing Exercise
Inhale through your nose slowly by expanding from your belly first then fill your upper lungs for a count of 5
Hold your breath for a count of 2
Exhale slowly and forcefully through pursed lips for a count of 10
Repeat this 5 to 10 times or do it for at least 1 minute 2.
5. Progressive Muscle Relaxation
Progressive muscle relaxation is often used in conjunction with deep breathing to activate the parasympathetic, rest and digest, system.
As you tense and then release a muscle, it has to relax. Tensing each muscle group and then relaxing causes your muscles to become more relaxed than they were before tensing.
As a result the heart slows down because relaxed muscles don’t need as much oxygen. Breathing and blood pressure also slow down.
Progressive Muscle Relaxation Exercise
Begin by tensing your legs and buttocks for a count of 5, then relax
Tense your abdomen for a count of 5, then relax for a count of 5
Tense your arms for a count of 5, then relax for a count of 5
Shrug your shoulders to your ears and tense for a count of 5, then relax for a count of 5
Press your tongue to the roof of your mount for a count of 5, then relax for a count of 5
Tips: Let all of the tension release and flow out or your muscles. Exhale as you release the tension and relax. You should feel the muscles become loose and limp. Focus on the difference between the tension and relaxation as this is the most important part of the exercise.
When To Seek Treatment
If you are unable to cope with panic attacks and you believe you could have Panic Disorder it will be helpful and important to seek consultation with a mental health professional to first verify the diagnosis and then receive appropriate treatment.
What Is The Treatment for Panic Disorder?
Treatment often consists of a combination of medication and psychotherapy. Medication helps take the edge off the physical symptoms of anxiety and psychotherapy helps to challenge irrational thinking and beliefs that lead to the panic attacks.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is a well-researched and highly effective form of talk therapy that focuses on learning more helpful ways of thinking and behaving.
You learn different ways of responding to the symptoms of a panic attack.
CBT helps challenge and change unhelpful beliefs that cause anxiety by restructuring your automatic thinking.
CBT sessions also provide education on the symptoms of panic disorder.
Cognitive restructuring is used to identify and dispute unhelpful, automatic, and irrational thinking so that you can create highly effective thoughts with the power to alter your emotions and behavior.
An example of an irrational thought is “What if I can’t escape from that place. I’ll have a panic attack and lose control.” We develop beliefs about ourselves, other people, and the world.
These beliefs influence how we think. If you believe that the world is basically a dangerous place, then your thoughts will follow. If you believe that you are defective and not a capable person, then your thoughts will reflect those beliefs.
It is not the public place that causes the anxiety, it’s your thinking and beliefs that cause the fear and anxiety.
Exposure therapy, also known as prolonged exposure, is a form of CBT.
As with most anxiety disorders, in order to learn how to overcome the symptoms of panic disorder, you need to have the experience of successfully managing the symptoms.
This often means exposing yourself to the thoughts, images, and the public places that trigger the panic attacks, and then applying the coping strategies until the thoughts, images, and public places no longer produce the same level of fear.
Please consult with your primary care physician or a psychiatrist regarding the use of any medication.
Medication can help reduce the symptoms of anxiety that occur in public situations that you have been avoiding such as school, work, and any other necessary public location.
Commonly prescribed medications include benzodiazepines, anti-depressants, and beta blockers.
Benzodiazepines are quick acting sedatives that are generally safe and effective for short term use. However, the long term use of benzodiazepines is associated with the risk of developing tolerance, dependence, and possible other adverse effects.
Commonly prescribed benzodiazepines are:
Anti-depressant medications are also effective at reducing symptoms of anxiety on a daily basis. This helps dampen the physical and emotional effects of anxiety and increases a person’s capacity to cope with stressful situations.
Commonly prescribed anti-depressants are:
Beta Blockers are used to treat high blood pressure, heart arrhythmias, and migraines. They are also prescribed for off-label use by physicians to help reduce the physical symptoms of anxiety. Beta blockers have the ability to control rapid heartbeat, shaking, trembling, and blushing in response to a panic attack. Beta blockers do not interfere with cognitive performance and are by far my favorite for removing the jitters before a speech.
Commonly prescribed Beta Blockers:
Metoprolol (Lopressor, Toprol-XL)