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Nocturnal Panic Attacks

illustration of panic attack at night time

Panic Attacks at Night: Why They Happen and How to Manage Them

 

Waking up suddenly in the middle of the night, heart pounding, adrenaline surging, and an overwhelming sense of doom washing over you—it’s terrifying. If this sounds familiar, you’ve likely experienced a nocturnal panic attack, a common symptom of anxiety disorders. You’re jolted awake, feeling like something awful is about to happen, even though nothing has changed around you.

 

I know how unsettling this can feel because I’ve been there too. Let’s break down why panic attacks at night happen, what’s going on in your body, and how you can begin to manage them.

 

What Are the Symptoms of Panic Attacks at Night?

 

The symptoms of nocturnal panic attacks are similar to daytime panic attacks but often feel more disorienting because they happen while you’re asleep. Common symptoms include:

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• Waking up suddenly with an intense feeling of dread or terror.

• A racing or pounding heart.

• An adrenaline surge, leaving you alert and restless.

• Sweating, trembling, or difficulty catching your breath.

• A strong sense that something terrible is about to happen, even though there’s no clear threat.

 

These episodes often occur about an hour or two after falling asleep, just as your body is settling into deeper stages of rest.

 

Why Do Panic Attacks at Night Happen?

 

1. Being in a Sensitised State

 

Night-time panic attacks are common for people who are in a sensitised state—when your nervous system is stuck in high alert due to stress or anxiety. Even when you’re asleep, your brain remains hyper-aware, ready to detect any signs of danger. This overactivity can trigger the fight or flight response, waking you up with intense panic symptoms.

 

2. The Fear of Fear

 

If you’ve experienced a panic attack at night before, it’s easy to become anxious about it happening again. This creates a cycle where you go to bed fearing anxiety, which keeps your nervous system primed for more panic. It’s often referred to as the “fear of fear,” and it’s one of the main reasons nocturnal panic attacks feel so relentless.

 

3. The Role of Digestion

 

The timing of when and what you eat can also play a role. Anxiety slows down digestion, so if you’ve eaten later at night, your body might still be processing food when you fall asleep. This can cause discomfort and disrupt your sleep cycle, making it more likely for your body to misinterpret normal sensations as a threat.

 

4. Stress and Adrenaline Dumps

 

When your body is stressed during the day, adrenaline can build up. At night, this adrenaline may be released suddenly, jolting you awake. It’s not dangerous, but it can feel overwhelming if you’re already in a sensitised state.

 

What About Screens and Sleep?

 

If you’re anything like me, you might be tempted to scroll on your phone or binge-watch something late into the evening to wind down. But the truth is, screens can overstimulate your brain and delay your natural sleep cycle.

 

Rather than focusing on “reducing screen time,” think about preparing yourself for bed in a way that feels calming and natural. Allow yourself to go to bed only when you feel genuinely tired, rather than forcing sleep. Anxiety can make you feel like you need to control everything, but letting go of that pressure and easing into relaxation can work wonders.

 

How to Manage Panic Attacks at Night

 

1. Acknowledge What’s Happening

 

When you wake up in a panic, remind yourself: This is an adrenaline dump. It feels scary, but it’s not dangerous. This simple acknowledgment can help stop you from spiralling further into fear.

 

2. Don’t Try to Fix It

 

It’s tempting to lie in bed and ruminate about what just happened, but this often keeps the threat response active. Instead, focus on redirecting your attention:

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• Sit up and read a book or listen to an audiobook.

• Walk around the house to release the excess adrenaline.

• Do something neutral or calming until you feel ready to return to bed.

 

3. Let Go of Sleep Pressure

 

Anxiety loves to convince us that we need to “fix” everything, including our sleep. But the more you force sleep, the harder it becomes. Instead, allow yourself to drift off when you feel naturally tired and calm. If you wake up panicked, remind yourself that you don’t need to force sleep—your body will take care of it when it’s ready.

 

4. Address Underlying Stress

 

If you’re dealing with high levels of stress during the day, your body may carry that tension into the night. Consider building small relaxation practices into your daily routine, whether it’s going for a walk, practising mindfulness, or doing something that helps you switch off.

 

When to Check with a Professional

 

While panic attacks at night are often tied to anxiety disorders, it’s always a good idea to rule out other potential causes. Speak with a healthcare professional to check for:

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• Thyroid issues, like hyperthyroidism.

• Sleep apnoea or other sleep-related disorders.

• Hormonal imbalances.

 

If your night-time panic attacks involve vivid flashbacks, nightmares, or re-experiencing trauma, you might be dealing with PTSD. Trauma-focused therapy can be incredibly helpful in these cases, as it addresses the root cause of the distress.

 

Final Thoughts

 

Nocturnal panic attacks can feel scary and isolating, but they are not dangerous, and they don’t have to control your nights. By understanding why they happen and approaching them with a sense of curiosity rather than fear, you can begin to break the cycle.

 

Remember: it’s okay to wake up panicked—it doesn’t mean something terrible is happening. With time and patience, your body can learn to relax again.

 

For more tips and support, follow me on Instagram at @anxietyjosh or tune into our episode on anxiety at night time on the Disordered Podcast.

 

Disclaimer: This article is for informational purposes only and should not replace professional medical advice. If you’re concerned about your symptoms, consult a healthcare professional.

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©2025 by School of Anxiety Limited

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