Nocturnal Panic Attacks: What Causes Them?

Nocturnal Panic Attacks: What Causes Them?

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Last Updated on Aug 16, 2022

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    Does this ever happen with you, when you are on the verge of falling into a blissful land of dreams, your body jerks you up? And now you are unable or are too anxious to sleep back? 

    This isn't because of those extra cups of coffee or that unintentional noon nap. Instead, this happens when you are experiencing hypnic jerks. 

    A hypnic jerk is usually involuntary muscle contractions when you are falling asleep, but some part of your brain remains in the state of consciousness. A hypnic jerk is also called a "hypnagogic jerk" or "sleep starts." Although hypnic jerks are not a severe problem, they may occur once or multiple times; and can happen to anyone in their lifetime, at any age. However, they seem more common among adults.

    You might think that once you shut down your brain and rest, the stress may go away, but it might not be the case. This leads you to experience a nocturnal panic attack.

    Usually, panic attacks are sudden and happen when something triggers fear or distress. And those experiencing frequent nocturnal panic attacks may recognize the cause of stress from work, school, and college. But there might be many underlying leading causes for you to be jolting awake from sleep anxiety.

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    Symptoms Of Nocturnal Panic Attack

    A nocturnal panic attack or nighttime panic attack is when you are awoken from sleep anxiety

    When you are experiencing a nocturnal panic attack, a hypnotic jerk isn't the only movement you might feel. It can also be sweating, waking up gasping for breath, reoccurring dreams, or hallucinations like hearing snapping or banging sounds or other sensations on your body.

    And although the panic attack lasts for a few seconds, it may take a while for you to calm down and go back to sleep. And if you aren't able to connect the dots from stress to sleep, you may not understand the symptoms of your nighttime anxiety.

    Signs of a nocturnal panic attack may include,

    • Sweating
    • Trembling
    • Heavy breathing (hyperventilation) 
    • Shortness of breath
    • Sense of impending doom
    • Rapid heart rate
    • Chest pain
    • Chilling or hot flush
    • Lightheadedness
    • Nausea
    • Feeling choked or smothered 
    • Feeling as if falling to your death

    When the above symptoms occur while you wake up with a jerk or distortion, you will now be aware of what the problem may be. And might be able to deal with it accordingly.

    What Causes Nocturnal Panic Attack?

    Stress might be the leading cause of many major and minor deteriorations of health. Panic attacks are one of them; it doesn't matter if it's a daytime panic attack or a nocturnal panic attack. Unfortunately, people who suffer panic attacks usually mistake it for a heart attack.

    But, there might be many other causes that must be considered before jumping to conclusions.

    Genetics

    Many physical and psychological illnesses stem from your ancestors that you are now suffering from.

    Studies of psychiatric illness association revealed that about 43% of panic attack disorder is hereditary. Research funded by the (NIMH) National Institute of Mental Health shows that many mental disorders are caused by biological, environmental, psychological, and genetic characteristics.

    Chronic Physical Illness

    Chronic physical illnesses like diabetes, cancer, asthma, or other life-threatening diseases that may be managed but can't be cured cause significant stress on the mind and body. 

    Patients suffering from chronic diseases are constantly under intense stress and worry over everyday situations. The slight worrying and the minor episodes of panic attacks during daytime lead to you jolting awake from sleep in anxiety, a.k.a nocturnal panic attack.

    Significant Loss

    Environmental or eventual influences like traumatic events and losing an important figure or presence in life can also increase the prevalence of panic attacks. And then fear of panicking or traumatic nightmares may keep one from falling asleep.

    Side Effects of Medication 

    Some medications cause different side effects in different people. And feeling anxious and uncomfortable can be a side effect of one of the medicines that cure entirely other ailments. 

    Or it may be the reaction of the combination of food or beverages taken along with the pills. 

    For example, caffeine and sugar are the two major components that do not go with many medicines, and doctors would usually advise that one mustn't take them together.

    Withdrawals 

    When a person is trying to withdraw from a toxic habit like alcohol or cigarettes; this

     can unintentionally lead to anxiety and panic attacks.

    Life-changing Events

    Say, you got a call from that one company or firm you wanted to deal with or had just experienced a terrible break-up, or when the doctor calls you and says the test results for so and so are out. 

    In situations like these, you hear people say, "Gosh, just the idea of it kept me awake and anxious all night…" or, "the sleep was hard for me…."

    It isn't because they were just excited or anxious, but because of the anxiousness due to the uncertainty of events. It is the unknown that bothers them. 

    Use of Certain Foods Like Cannabis or Coffee

    Uses of a particular food like a well-known and everyone's top beverage coffee, or any other caffeinated food or drinks, food additives, processed food, cannabis, fried food, sugar, etc., can be the main reason you cannot be able to fall asleep. 

    One study shows people who stopped taking caffeine or any of these substances six hours before bedtime still had trouble falling asleep.

    High sugar intake has been the lead cause of many major and minor physical and mental health issues like obesity, blood pressure, anxiety, etc.

    Social Phobias

    A strong urge to withdraw from your social circle and then circumstances forcing you back into that circle are the common telltale roots of anxiety and depression.

    For people with social anxiety, everyday interactions and the presence of strangers (or friends and relatives too sometimes) in the same room as themselves cause unreasonable fear and anxiety. 

    It is becoming more common to have social anxiety, which is anything but minor. But, most likely, everyone is aware of and is dealing with it their way.

    Mental Health Conditions 

    Usually, panic attacks are associated with many mental health conditions like panic disorder, depression, post-traumatic stress disorder (PTSD), social anxiety, or phobia like somniphobia, chronophobia, etc.

    How to Deal with Panic Attacks at Night?

    We discussed the symptoms and the causes. How would you deal with it when you think you are experiencing the attack? 

    There are many ways to deal with the situation that can be done as first aid when you think of it as your first attack. But, first, you might want to calm down your mind before you calm your body.

    Deep Breathing 

    Breathing is the most effective way to bring your concentration to one side and think straight. When you wake up feeling anxious and uncomfortable, take a long breath in and stop, count to five, and then let it out and stop again, count to three, and repeat. This may help you wonderfully.

    Lavender

    Lavender is known to help manage anxieties and restlessness. 

    You can use lavender-flavored scented candles or apply a few drops of lavender oil on your arms, wrists, or the nape of your neck to help you relax and sleep soundly.

    Although, ingesting lavender oil can be toxic. So please avoid ingestion until prescribed otherwise by the doctor.

    Count Backwards

    It's the classic way to calm down and fall back asleep. When you feel yourself losing to anxiety, take a quick scan of your room and start counting backward.

    Looking around will help you gain back a little bit of awareness and help you concentrate on counting backward. 

    Grounding

    It might be hard to move a single muscle after jolting awake from sleep anxiety. So, try concentrating on one sense at a time. Follow the 3-3-3 rule.

    First, take a scan around your room with your eyes and name three objects you recognize.

    Second, take a deep breath and concentrate on listening, and name the first three sounds you hear.

    Lastly, try to move your three limbs or parts of your body, like legs, fingers, toes, etc.

    This will help you divert your attention from negativity, regain your consciousness, and calm your racing heart.

    Work With It

    It often happens that you are unable to concentrate and do any one thing and are just confused with tasks. This can cause you to feel more anxious and restless. 

    In this case, don't just sit back. Work with it. You may do anything to distract yourself from the unpleasant and uncomfortable mindset. For example, you can try drinking water, sitting up, standing up, or doing any simple thing you feel comfortable doing at the moment.

    Get Up

    When you feel anxious and restless, moving your body around is better. You may sit up, get up and walk around your room; forget the water at the nightstand, get another glass from the kitchen, get up and open the window (if your room got one), or simply turn on/off the fan.

    Do Menial Chores 

    Doing menial chores, like washing, laundering, sweeping, dusting, or simply doing any chore can also be effective when anxious. Many people find it soothing and like to do these menial chores.

    Yoga

    Studies show that yoga is an inexpensive, safe non-pharmactuel way of overcoming stress and anxieties.

    Exercising yoga poses such as Child pose, Happy Child pose, Easy pose, Standing Forward Bend pose, etc., are proven to help calm down while experiencing panic attacks.

    Acupuncture 

    "When acupoints are applied to areas of stagnation or along energy channels where energy is not flowing properly, it can improve the flow of Qi and resolve those symptoms, resulting in relaxation and relief, feeling the way we should when our bodies are getting what they need," - Vander Baan.

    According to Traditional Chinese Medicine(TCM), acupuncture relieves stress by stimulating the flow of Qi. 

    Although there are few acupoints that you can do yourself, it's better to visit a professional for promising results. 

    Family Support 

    Family and friends can help you on your journey of anxiety. Sometimes, you may feel suffocated, but at the end of your tunnel, they are the ones waiting for you with open arms.

    However, if you support someone with anxiety, then there are some do's and don't to keep in mind.

    Do's:

    • Support your friends or family members by facing their fears.
    • Help them open up to topics and social circles that are difficult for them little by little.
    • Remember, you are only a partner/supporter in their journey of getting better. 
    • Be patient with their emotions and thoughts.
    • Offer them emotional support when visiting the doctor.
    • Understand their sensitivity to specific topics. They might be challenging to manage, but the emotional turmoil inside them isn't their choice.
    • Try to treat them as normally as possible. They often feel too conscious; making them feel comfortable around themselves can be the first step.

    Don'ts:

    • Don't help them avoid their fear.
    • Don't force them out of their comfort zone. Let them step out on their own.
    • Don't try to fix their problems with your perspective. You have zero ideas about what's going on in their head.
    • Instead, be patient and listen to what they have to say; never insert your own experience; you are not the same.
    • Sometimes people with anxiety can say or do things that may upset you. But, you have to understand and be patient. Because their emotions are taking heights, and so is their guilt. It may cause them to stress more.
    • Don't give them too much special treatment. They might start feeling awkward. Instead, allow just enough attention to their situation for them to do things on their own. 'Wanna stay' or 'Leave,' let it be their choice. 

    Laugh it Off

    You might've heard, "Laughter is the best medicine." Well, the thought isn't completely wrong. 

    Laughter may help you in the short-term curing of anxiety. You can watch sitcoms, memes, or any comedy movie or show to stimulate laughter; the results will be the same.

    Laughter stimulates positive hormones. It regulates the high intake of oxygen that stimulates the heart, lungs, and muscles. It soothes and regulates blood circulation and relaxes tensed muscles in the body.

    Medical Treatment for Panic Disorder

    Minor, short-term, or rarely occurring panic attacks can be relieved with self-treatments. However, if you feel it occurring frequently, and if the situation feels out of hand, or when you start having suicidal thoughts, seek medical/professional care immediately!!!

    Prescription Medications

    Instead of googling or inquiring about the types of medicines that can help with your panic attacks, better knock at the doctor's office. Since getting professional help and support will guarantee your fast recovery. 

    Also, beware of the side effects of overdosing on medications. 

    Psychotherapy 

    There are many effective ways to manage your anxiety, and one among them is psychotherapy. 

    Psychotherapy approaches in five broad categories:

    • Psychoanalysis Therapy:

    In this approach, therapists and patients work in a close therapeutic relationship to analyze problematic behaviors, thoughts, feelings, and ways to change them.

    • Behavior Therapy:

    In this approach, a therapist focuses on developing and learning both normal and abnormal behavior of the patient.

    The therapist associates Ivan Pavlov, Pavlov's famous dog drooling research; "Desensitizing"- the therapy where patients are repeatedly exposed to whatever causes them anxiety; or E.L. Thorndike's Operant Conditioning methods to deal with the problem.

    • Cognitive Therapy:

    Major figures in Cognitive therapy like Albert Ellis and Aaron Beck believe that dysfunctional thinking leads to dysfunctional behavior or feeling. And changing one's thoughts may change how one feels or behaves.

    • Humanistic Therapy:

    Humanistic philosophers such as Jean-Paul Sartre, Martin Buber, and Søren Kierkegaard influenced this therapy. 

    In this approach, therapists analyze people's capability to make rational choices and ways to develop their potential to the maximum.

    • Integrative or Holistic Therapy:

    This approach does not specify the type of direction of the treatment. Instead, the therapist blends each approach according to the needs of their patients.

    Beta-Blocker Medication

    It is a type of medication that helps your 'Fight or Flight' situation. It helps block out the adrenaline from rushing to the heart, making it pump faster or harder.

    There are many beta-blockers available, but some of the common ones are:

    • Acebutolol (Sectral)
    • Bisoprolol (Zebeta)
    • Carvedilol (Coreg)
    • Propranolol (Inderal)
    • Atenolol (Tenormin)
    • Metoprolol (Lopressor)

    Propranolol and Atenolol are the two beta-blockers that are usually prescribed for anxiety. 

    But make sure you take the beta-blockers according to the doctor's prescription.

    Evaluation 

    Under this, you will be examined thoroughly, all from your physical to your mental examination.

    Physical examination includes a blood test, thyroid check, tests on your heart, etc. During a mental exam, they may ask you about your mood, feelings, behavior patterns, etc.

    In the end, after evaluating everything, they will decide on better treatment for sleep anxiety.

    Things To Do To Get Better Sleep

    A good night's sleep is as essential as eating healthy and exercising. But over a few years, sleep's quantity and quality have been regularly ignored, leading to many health problems, such as obesity, stress, etc.

    With little effort and attention, this problem can be fixed as well.

    Stick to a Sleep Schedule

    Sticking to a sleeping schedule is essential. And an average human must and should get at least 7-8 hours of sleep. 

    To manage the right schedule, count eight hours backward from the hour you are supposed to wake up, and then get ready to sleep on time. 

    If you cannot fall asleep at the set time, get out of bed and do some chores, listen to soothing music, or read and then get back to bed when you're tired. 

    Don't force yourself to fall asleep, and never force yourself to be awake at night.

    Pay Attention to What You Eat and Drink

    Paying close attention to what you are eating and drinking before going to bed can significantly impact your sleeping schedule. 

    Avoid consuming caffeine, nicotine, alcohol, processed food, or any stimulant food products that can keep your mind active. 

    Also, avoid sleeping on an empty stomach. Make sure to have a light and fulfilling meal 2-3 hours before your bedtime.

    Create a Restful Environment

    Create a soothing and calm environment where you are supposed to rest. Darken your room, light some scented candles, allow your room temperature to be at the right amount of cooling, and set a comfortable bed.

    Limit your screen time before going to bed. Ensure the environment is quiet. Also, taking a hot bath before bed promotes better sleep by relaxing the tension in the muscles.

    Limit Daytime Naps

    To ensure a good night's sleep, avoid resting or napping during the daytime as much as possible. This way, your body will feel more tired and fall asleep as soon as it hits the hay.

    However, if you need to work during the night, take a long and late nap during the day to wake up before your work schedule.

    Include Physical Activity in Your Daily Routine

    Physical activity is crucial in the daily routine. It can be any type of physical activity; you can exercise, work, do chores, or all of the above. However, avoid doing any physical activity before bedtime. 

    Because any physical activity can keep your mind and body active, so make sure to wrap it up early in the morning or before the evening.

    Manage Worries

    Managing stress can keep every activity peaceful. Try to resolve most of your worries before bedtime. 

    Keep a journal, make schedules, meditate, or organize your thoughts. 

    Following and managing minor steps and behaviors can help you fight off anxiety effectively. And if you feel you cannot manage it by yourself, get help from a professional or reach out to your family and friends.

    Final Words

    Remember not to force your anxious friend or relative against their will. Be patient and let them come out at their pace. Next, consult a doctor before taking any medicine, and take it as prescribed. 

    Make sure to get enough sleep because a well-rested body and mind are gold and diamond mine.

    This article is for informational purposes and should not replace advice from your doctor or other medical professional.
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