What a Nocturnal Panic Attack Feels Like (And How I Overcame Them)

What Is a Nocturnal Panic Attack?

A nocturnal panic attack is essentially a panic attack that happens at night, often waking you abruptly from sleep. Unlike daytime panic attacks, which sometimes come with a sense of build-up, nocturnal panic attacks often hit at their peak intensity, leaving you disoriented and terrified.

Common Symptoms:

• Sudden awakening with a racing heart
• Sweating and trembling
• Feeling disoriented or disconnected
• Intense fear, often accompanied by a sense of impending doom
• Physical sensations like a pounding heartbeat or head pressure

My Experience

My first nocturnal panic attack came during a particularly stressful time in my life, marked by severe agoraphobia and constant daytime panic attacks. One night, I was woken up abruptly by a family member, and because I was already in a state of heightened anxiety the confusion sent me straight into a massive panic attack. My heart was racing, my head felt like it was going to explode, and I was convinced I was dying. From that point on, the attacks came nightly, often at the same time: 1:30 AM, it was as if my body remembered that moment and repeated it every single night.

At the height of these attacks, I would become so consumed by fear that I found myself running around the house and calling for help. Even when I moved out of my family home into a flat share, I’d sometimes panic so much that it felt like I had no choice but to knock on my housemates' doors, begging for help, in whatever form that may be. Even as I got better at managing my daytime panic attacks, and they became fewer and further in between, nocturnal panic attacks were still an almost nightly occurrence for almost two years.

I noticed that nocturnal panic attacks felt more intense than daytime ones, likely because I would wake up already at the top of the attack, and the added confusion/disorientation of waking up suddenly would make it harder for me to understand and rationalize what was going on.

I would find that if I were able to suppress a nocturnal attack, as soon as I went back to sleep, it would happen again, and again, until finally it led to a culmination of a massive attack. Once I had a large nocturnal attack, it was as if I had paid my dues, and I was finally able to sleep for the night.

I also noticed that if I did not have a panic attack in the daytime, I would be MORE likely to have a nocturnal attack.

It was as if there was a ‘panic tax’ that I had to pay every single day, and if I didn’t I would always pay for it during the night.

Another very unfortunate pattern I found was that if I felt very confident that I would not have an attack, even if I believed I felt fine and would not have one and went to bed in peace, I would still wake up with incredibly terrifying nocturnal panic attacks that would completely deplete my confidence and made me feel hopeless.

I felt like nocturnal panic attacks would be something I would be stuck with for the rest of my life.

Theories Behind Nocturnal Panic Attacks

While the exact cause of nocturnal panic attacks isn’t fully understood, a few theories helped me make sense of my experience:

Fear of lack of vigilance: People who are constantly scanning for threats during the day may struggle to relax at night. Their bodies become conditioned to stay alert, even during sleep transitions. This would explain why I would jump into a panic when my body was transitioning into a sleep state, and not just when I was laying or closing my eyes.

Body’s Stress Response: For those of us who’ve experienced ectopic heartbeats or hyperawareness of bodily sensations, the body might interpret minor changes as a threat, triggering panic.

Processing Daily Stress: Sleep is a time when the mind processes the events of the day. High stress levels can manifest as intense panic during sleep transitions.

What Helped Me

1. Sleep Hygiene:

• Avoid screens at least two hours before bed. - I noticed that watching TV, documentaries, movies, etc to help me fall asleep would increase the likelihood of waking up with a nocturnal attack. This made it very difficult for me as these things felt like they actually helped me to fall asleep as otherwise I would be too scared,
• No heavy meals, especially sugary or caffeinated ones, late at night. - The later I would eat, the more likely I would wake up with a nocturnal panic attack, this was especially true with sugary snacks.
• Use calming music rather than TV to wind down. - Music was a good compromise that would help me to sleep, but not act as a trigger for panic.

2. Acceptance Over Resistance:

When a panic attack strikes, resisting the symptoms often makes things worse. Instead, I practiced accepting the feelings, observing them without judgment, and allowing them to pass. This WAS much harder than daytime panic, because there would be a certain amount of time after waking where I almost had no clue what was going on, and was going off pure panic instinct, but as I reorientated myself, it would be just the same as a daytime panic attack. The disorientation would only be a matter of seconds after waking, but those few seconds of a head start for the panic would definitely make it harder to accept the panic, but not impossible. The more I practised acceptance (as soon as I could) the more this acceptance became the norm, even whilst I was still disorientated. There came a point where I would wake up with nocturnal panic attacks and accept them before I would wake up fully, and I would go right back to sleep, not being sure if I had even had a nocturnal panic attack that night.

3. Breaking Safety Behaviors:

I realized that calling someone for reassurance or relying on rituals like spraying lavender water on my face and calling someone for help were crutches. By letting go of these behaviors, I retrained my body to trust that I could handle the attacks on my own.

4. Addressing Daytime Anxiety:

The more I worked on managing daytime anxiety through exposure therapy and mindfulness, the less frequent my nocturnal attacks became. I also stopped hyper-checking my body and learned to embrace uncertainty. All of these small behaviors add up and contribute to overall anxiety levels and unconscious anxiety-provoking habits.

5. Lifestyle Adjustments:

Regular exercise, a balanced diet, and limiting sugar and caffeine were game-changers. True physical tiredness from an active day made it easier to fall asleep and stay asleep. Ironically, tiredness is a feeling that I’ve often found would trigger my anxiety and even panic, probably due to the idea of “fear of lack of vigilance” mentioned earlier, but true tiredness is actually something that really helps with anxiety. Strangely, I observed this through my experience of raising my dog Caesar. Caesar is a miniature poodle which due to their high intelligence can be quite an anxious breed, the more tired he is from exercise, play and mental stimulation, the less his anxiety levels would be. If he was not tired, he would cry and whine when being left alone because he was anxious to be by himself felt he was being abandoned, wanting to know where his owners were, but if he were very tired, he would take the opportunity to rest and relax, feeling satisfied and happy, without excess energy to help fuel his anxiety. I have found that this concept definitely applies to humans, or at least, me, as the more busy I am, the more exercise I get, the less anxious I am and the more I am able to relax, without letting the anxiety take over.

Encouragement for Your Journey

If you’re experiencing nocturnal panic attacks, remember this: they’re terrifying but not dangerous. They’re your body’s fight-or-flight system overreacting. With consistent effort, you can retrain your body and mind to respond differently. Remember, if they were dangerous, they would not be called panic attacks.

I also encourage you to seek professional help if you’re struggling. Therapy can provide tools and guidance tailored to your needs. If therapy isn’t accessible right now, try focusing on small, actionable changes like improving your sleep hygiene or practicing mindfulness.

Lastly, know that you’re not alone. Many people experience these attacks, and sharing your journey can help you feel connected. If my story resonates with you, leave a comment or share your experience—I’d love to hear from you.

Watch the Video

For a more detailed account of my experience and practical tips, check out the video accompanying this blog post.