Nocturnal Panic Attacks – While Sleeping

Dr Elaine Ryan
Written by Dr Elaine Ryan Psychologist and Founder of MoodSmith® Elaine obtained her Dr in Psychology from the University of Surrey and has worked in psychology for 20 years. Dr Ryan specialises in Intrusive Thoughts, OCD and anxiety-related conditions.

What is a nocturnal panic attack?

nocturnal panic attack explanation on whiteboard

A nocturnal panic attack is an attack that occurs in your sleep and will result in you waking up in a panic, often sweating, with palpitations and feeling extremely fearful.

What causes panic attacks in your sleep?

There is no cause specifically for nocturnal panic attacks; instead, if you seek to understand how they happen, you should read the explanations for panic attacks or panic disorder.


If you meet with your doctor or mental health professional, they will use diagnostic criteria for panic attacks or panic disorder.

During the assessment, your mental health professional will ask about other conditions you may have. This part of the assessment is necessary to rule out medical conditions that may be causing sleep problems. You might be asked about

  • Sleep apnea; obstructive sleep apnea, or
  • if you have any other respiratory symptoms or
  • have been diagnosed with post-traumatic stress.

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What are the symptoms?

The symptoms of panic attacks that occur during your sleep are the same as those of attacks that occur at other times.

  • chest pain
  • shortness of breath
  • increased heart rate

My personal experience ( I had panic attacks during the day but mostly experienced them when woken from my sleep) caused me to experience much more fear, verging on terror.

I think this was due to not having any warning, as I was sleeping. Once you wake in a panic, I think it can be more frightening as it takes you several minutes to understand what is happening, and once you do, you may be alone.

If you experience panic attacks while you are sleeping, you probably find it difficult to fall asleep; you might be fearful of going to bed or have a fear of dying.

You may also experience insomnia. Unfortunately, any sleep disturbances will not help reduce your anxiety; as you will know, sleep is essential for both your body and mind and your ability to cope with your day-to-day life.

I would urge you to start some form of relaxation training in the evening to help to reduce any anticipatory anxiety you experience and help reduce your heart rate before going to bed.


The recommended treatment is Cognitive Behavioural Therapy; CBT

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