Night Panics and Anxietyby Jerry Kennard, Ph.D. Medical Reviewer
Night panics typically occur during the early hours of sleep and estimates suggest that about a half of people who experience panic disorder will have at least one night panic. Around a quarter however will suffer night panics on a more regular basis. Although the sensations of night panic are broadly similar to those at other times of the day, more people complain of choking sensations. In fact in people who experience night panics around half mention the sensation of choking as their primary symptom upon waking. Night panics can last for some time. Around 30 minutes seems to be the average time but there can be quite a bit of variation even in the person who experiences them.
And the cause of night panics? Well, things are less clear, but we do know they aren't triggered by bad dreams and we also know the person is conscious during the attack. People who experience night panics are not only attentive, they can later recall their attack quite easily. A long-standing view amongst some clinicians is that respiratory disturbances cause the attack. Others point out that laboratory observations don't support these claims. Another theory is that in people with severe panic their state of vigilance is so high that they may respond excessively to sounds, vibrations, smells or other stimuli associated with the fearful state. Perceived loss of control may be key to such reactions and it may also account for the reason some people panic during attempts at relaxation.
The need to avoid or escape the conditions associated with panic are a feature of panic disorder. Typically, once the person removes themselves from these situations their symptoms begin to recede. Night panics differ because the person is in bed and there is nowhere to escape to. However, as in all cases of panic the physical and emotional sensations of panic always pass.
The issue of control is always a factor in panic attacks and one of the most difficult things to appreciate is the difference between trying to exert control and actually gaining control. During a panic event it isn't uncommon for people to try and impose their will over the situation. This doesn't work. Attempts to fight symptoms invariably makes the person more anxious and more aware of their situation. At night it is probably simpler and more effective to accept what is happening in the knowledge that it will pass.
Imagination, especially at night, can become vivid and all-encompassing. Many therapists suggest trying to focus imagination towards things that symbolises peace and tranquility. This won't necessarily prevent a panic event but many people find it a useful resource that can take the sting out of the panic and reduce its intensity and duration. It's something that takes time and practice so when panic does occur you have some training to fall back on.