Around a quarter of people who experience panic will also experience panic during the early hours of sleep. The person wakes up in a state of panic along with all the associated sensations of sweating, rapid pulse, shaking and shortness of breath. Around half of those affected say their first concerns relate to whether they are dying, whilst the remainder may experience an acute sensation of choking.
The typical media portrayal of a person waking up in a cold sweat following a bad dream is not a good example of nocturnal panic. In such examples the person soon realises the cause of their discomfort and they quickly recover. Nocturnal panics, by contrast, do not appear to be triggered by bad dreams but the person probably will wake up in a state of some distress. Unlike a bad dream the person affected is awake, attentive, responsive and able to recall the event without difficulty. Although nocturnal panic can be relatively short-lived they tend, on average, to last anywhere between 20-30 minutes and be fairly severe.
Quite why people experience nocturnal panic isn't clear. The suggestion that respiratory problems may contribute appears a little thin on evidence. Psychological explanations largely revolve around the person retaining some ongoing sense of vigilance. We know, for example, that a mother caring for a sick child will retain a heightened sense of awareness for distress during the night. By extending the principle to people who are vigilant because of anxiety, it is possible to see how panic might result from an awareness of body sensations.
One of the curious things about vigilance is the association it has with personal control. One of the most well known techniques for helping to induce a state of calm is through relaxation techniques. In some cases however the onset of relaxation actually seems to trigger panic. Of course a focus for relaxation techniques revolves around the person being aware of their body in order that they become used to the sensation of relaxation as much as of tension. This attention to bodily sensations seems, when combined with a heightened sense of vigilance, to be sufficient to trigger panic. It is just possible that a similar mechanism exists with nocturnal panic. As awareness of bodily sensations occurs, attention becomes rapidly focused and a state of panic follows on.
Despite the distress caused by nocturnal panic the fact remains they are self-limiting and the sensations do pass. Treatment for nocturnal panic is the same as for panic experienced during the day and may involve medication, cognitive or some other form of psychological therapy, and self-help measures such as diet and exercise.
Published On: December 15, 2010