A panic attack is characterized by an intense feeling of fear or discomfort and behavioral or cognitive symptoms of anxiety.
It is accompanied by a sense of danger and an impulse to escape.
Panic disorder is associated with different physical symptoms, functional disturbances and medical illnesses.
It is a very common clinical situation that causes great suffering and changes in the lives of people and their families.
Fear and concern that seizures will recur inevitably increase individuals’ general alertness and arousal.
When these crises happen during sleep (learn more) sensitivity to anxiety is increased.
Anxiety levels and seizure duration seem to be higher and somatic symptoms are more numerous. Comorbidity with other diseases is frequent.
Night panic is characterized by a sudden awakening with feelings of fear or terror and intense physiological activation.
It happens during phases of slow sleep, especially phases 2 and 3.
The most common complaints of patients with panic disorder, in relation to sleep, include initial or maintenance insomnia and non-restorative or fragmented sleep.
When compared with individuals in control groups, panic disorder patients have slightly increased sleep latency and reduced sleep efficiency.
There is an increase in movement time during sleep (learn more), but there is no temporal relationship between this movement and nocturnal panic attacks.
An important consequence of nocturnal panic attacks is chronic sleep deprivation (learn more). Indeed, these patients develop anticipatory anxiety and avoidance behaviors.
In the specific case of sleep panic attacks, many patients develop a fear of sleeping and delay falling asleep.
These crises may show similarities with sleep disorders related to nightmares, night terrors and sleep apnea, but they are clinically distinct phenomena.
There are some explanatory hypotheses:
Biological- the dysregulation of the respiratory system or a choking alarm mechanism.
Another hypothesis highlights the similarity between slow sleep (in which nocturnal panic occurs) and the state of relaxation (reduction in blood pressure and heart and respiratory rates).
These changes in the internal state can trigger crises in individuals predisposed to panic and, therefore, vigilant even in this sleep phase for personal/physical stimuli that are significant to them.
Previous experiences of traumatic events seem to put people in a situation of (hyper)vigilance, a mechanism that itself triggers panic attacks.
Faced with a nocturnal panic attack, what to do?
- Stand up;
- Don’t struggle with the crisis;
- Avoid the why;
- “Counter” hyperventilation;
- Do a physical task that you don’t like and that makes you want to sleep again.
- Apply some relaxation techniques.
The treatment involves the support of health technicians and the involvement of the individual in this process, as this problem also occurs (in a large percentage) during the day.
The individual will have to learn to act on panic attacks and on the processes that are responsible for the onset, maintenance and relapse.
Regulating anxiety and helping reduce the tendency of patients to interpret bodily sensations as catastrophic are effective instruments in prevention.
The maintenance of positive results after a treatment (psychological and pharmacological) depends on the cognitive alterations that occur during therapy.