Can I Have a Panic Attack While I'm Sleeping?

Panic Attacks Can Ruin Your Sleep Patterns and Affect Your Health

Asian woman with night sweats sitting up in bed
Peter Dazeley/Photographer's Choice/Getty Images

Many panic disorder sufferers may be awakened out of their sleep from anxiety and other panic-related symptoms like excessive sweating, shaking, shortness of breath and choking sensations. These attacks may also be the result of a medical issue or other mental health disorder and can seriously affect your quality of sleep and your health. 

Nocturnal Panic Attacks

If you have panic attacks while you're asleep, they are called nocturnal panic attacks.

Much like daytime panic attacks, they can affect you on physical, emotional and cognitive levels. Any panic attack can be a very stressful and frightening ordeal, but can be even more difficult to manage if they awaken you at night. These nighttime attacks have the potential to disrupt your life if they persist. 

Upon waking from a nighttime panic attack, you may feel a little foggy and light headed. It is not uncommon to experience symptoms of depersonalization and derealization, feeling as though you are losing touch with yourself and your surroundings. You may feel that you are still dreaming or that you are watching yourself from a distance.

If you are startled awake by panic symptoms, you may think are having heart attack or other medical emergency. These symptoms can also contribute to worries about losing control of oneself or going insane. Even though fears and other symptoms of panic attacks tend to reach a peak within 10 minutes and then subside, you may feel anxious long after symptoms diminish.

It's possible for you to remain keyed up, finding it difficult to settle down and fall back to sleep.

What Causes Nocturnal Panic Attacks?

The cause of nocturnal panic attacks is unknown, but may be attributed to a mental health or medical disorder. Panic attacks are considered the main symptom of panic disorder, but these symptoms can also occur with other similar anxiety disorders, such as agoraphobia, specific phobias, generalized anxiety disorder (GAD) and social anxiety disorder (SAD).

Nocturnal panic attacks may be experienced as part of other types of mental health disorders, including obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), depression, bipolar disorder, personality disorders and substance-related disorders. Additionally, these panic attacks may be attributed to a medical condition, such as gastroesophageal reflex disease (GERD), sleep apnea, and night terrors.

How Can I Manage Nocturnal Panic Attacks?

If you are experiencing nocturnal panic attacks, consider talking with your primary care physician or consulting with a therapist specializing in anxiety disorders.

Treatment for nocturnal panic attacks may include prescribed medication, psychotherapy or self-help strategies. Medications can lessen the intensity and frequency of your panic attacks, including those experienced while you are asleep. Attending psychotherapy will teach you  ways to cope with nocturnal panic attacks, such as breathing or meditation techniques to help sooth yourself and get back to sleep. 

Nocturnal panic attacks can greatly disrupt your life, lowering the quality of your sleep and potentially preventing you from getting the amount of rest you need. Fortunately, these attacks can be treated.

By working with healthcare professionals, you can expect your nocturnal panic attacks to lessen and become more manageable.


American Psychiatric Association  Diagnostic and Statistical Manual of Mental Disorders, 5th edition, 2013. 

Craske, M. G. & Tsao, J. C. "Assessment and Treatment of Nocturnal Panic Attacks", Sleep Medicine Reviews, 2015. 

Continue Reading