Why Does Panic Disorder Cause Sleep Issues?

When panic attacks and anxiety keep you up at night

woman checking phone from bed in the dark
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People with panic disorder, panic attacks, and other anxiety disorders are often susceptible to sleep issues. Worrisome thoughts and fears may keep you from falling asleep at night. While troublesome symptoms of panic and anxiety can wake you from your sleep. Are persistent fears, anxiety symptoms, and panic attacks preventing you from getting the rest you need?

The following describes some common sleep issues for people with panic disorder, along with ways to get these problems treated.

Are Worry and Anxiety Keeping You Up?

Many people with anxiety disorders have a difficult time managing negative thoughts and worries. As a person with panic disorder, you may be all too accustomed to the uncomfortable feeling of frequent worrying. You may find yourself worrying about many aspects of your life. Perhaps you worry about events that have passed, your current situation, or what is ahead in your future. You may worry about your career, relationships, and other responsibilities in your life.

Regardless of the source of your worrying, these feelings of uneasiness can also be a source of stress that prevents you from getting a good night’s rest. Worrying at night can make it difficult to “shut off” your mind and get the rest you need. Troublesome thoughts can even lead to sleep disturbances, such as insomnia, making it difficult to fall or stay asleep over prolonged periods of time.

Nocturnal Panic Attacks

Panic attacks are the main symptom of panic disorder but can also be associated with other mental health conditions, including agoraphobia, depression, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and specific phobias. These attacks may also be linked to a medical condition, such as irritable bowl syndrome (IBS) or gastroesophageal reflex disease (GERD).

Panic attacks are often experienced through a combination of physical, mental, and emotional symptoms. Typical somatic sensations that occur during a panic attack include heart palpitations, trembling, shaking, feelings of numbness and tingling, chest pain, dizziness, shortness of breath, excessive sweating and nausea. The person may become frightened and have symptoms of depersonalization and derealization, experiencing a sense of disconnection from the self and reality. When panic strikes, a person may also fear losing control, going insane, or even possibly dying from these symptoms.

Nocturnal panic attacks share these same symptoms as panic attacks that occur during the day. However, nocturnal panic attacks occur when the person is asleep. Waking from a panic attack can heighten fear and anxiety, potentially leading to sleep issues. When awakened from a panic attack, a person may find it difficult to fall back to sleep. If this occurs regularly, the person may become prone to sleep deprivation.

Nocturnal panic attacks have been linked to other sleep disturbances, including:

  • Sleep apnea – One of the most common sleep disorders, sleep apnea causes a person to have a sudden break in breathing or extremely shallow breath while asleep. Some of the symptoms of sleep apnea, such as shortness of breath and feelings of suffocating, overlap with that of nocturnal panic attacks.
  • Sleep paralysis – Often a frightening experience, sleep paralysis occurs when a person becomes consciously awake but cannot move, speak, or gain control over the body. When sleep paralysis occurs, a person may become afraid of being moved or fearful of never waking up. Sleep paralysis often sets in as a person is either falling asleep or waking up and is caused by a disruption to the sleep cycle. This condition includes sensations of choking and fears of losing control. Some studies have found a significant co-occurrence between sleep paralysis and anxiety disorders, including panic disorder.
  • Nightmares – Scary or upsetting dreams may occur with the onset of nocturnal panic attacks. A person may awaken from a nightmare and begin experiencing the uncomfortable symptoms of a panic attack, such as excessive sweating, accelerated heart rate, or overwhelming fear and anxiety.
  • Night terrors – Night terrors are more common among children but can be present in adults. Much like nocturnal panic attacks, night terrors involve intense feelings of fear and apprehension, trembling, sweating, shaking, and feelings of fear and dread. Night terrors are different than panic attacks in that they occur during a severe nightmare and often involve screaming, thrashing movements, and crying. A person experiencing night terrors is often unaware of their symptoms, which subside once they awaken.

Getting Treated for Panic Disorder, Panic Attacks, and Sleep Problems

Panic attacks and anxiety should not prevent you from getting the rest you need. Schedule an appointment with your clinician if you believe you have developed a sleep disturbance and/or are experiencing the symptoms of panic disorder, anxiety, and panic attacks. Medications for panic disorder, such as antidepressants and anti-anxiety medications may help ease the severity of your nocturnal and daytime panic attacks. Psychotherapy can also help you develop ways to stop worrying, acquire good sleep hygiene, and learn effective strategies for getting through panic attacks.

Sources:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Illnesses. 2013.

Cervena K, Matousek M, Prasko J, Brunovsky M, Paskova B. Sleep Disturbances In Patients Treated for Panic Disorder. Sleep Medicine. 2005; 6(2),149-153. 

Papadimitriou GN, Linkowski P. Sleep Disturbances in anxiety disorders. International Review of Psychiatry. 2005; 17(4), 229-236. 

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