Panic disorder, the most treatable anxiety disorder, is the fear of certain disaster or losing control. For those who suffer from panic disorder, anxiety manifests itself in the form of an attack. The typical symptoms include pounding heart, sweatiness, weakness, faintness, and dizziness.

Experts are not entirely sure why some people have panic attacks. They may result from residual stress during the day, or because of respiratory problems that disrupt sleep.

What many people don't know is that panic attacks can happen anytime—even when you're sleeping. Nocturnal panic attacks typically occur within three hours after you fall asleep, frequently between sleep stages two and three (we cycle through four progressively deeper stages of sleep every night).

What to Do

Panic attacks are stressful enough, but when you awake in the night in the throes of one, it can be especially distressing. If you have a nocturnal panic attack, don't try to immediately fall back to sleep. Wake up and get out of bed.

The Counseling and Mental Health Center at the University of Texas, Austin, suggests three relaxation steps you can take to relieve tension and anxiety when you have a panic attack. First, try to change your breathing. When we're tense, we tend to hold our breath or take frequent shallow breaths. However, slow, deep breathing is calming. Start by fully exhaling to empty your lungs, and then breathe in through your nose, filling your lungs from bottom to top.

The second step is to progressively tense and then relax your muscles, starting with your feet and working your way to your head. Finally, use mental imagery to take yourself to a peaceful, relaxing place.

Minimize nocturnal panic attacks by making a few lifestyle changes. Reduce or eliminate caffeine and sugar, which are stimulating rather than relaxing, and exercise to reduce anxiety.

Cognitive Behavioral Therapy (CBT) is also effective for reducing nighttime panic attacks. A good CBT program includes elements specific to this problem, including education about nighttime panic attacks. During CBT, you'll learn how to breathe before falling asleep, establish good sleep hygiene (habits), and mentally rewire your sleep-related fears.

Dave Carbonell, aka "the Anxiety Coach", recommends a five-step process to control panic attacks-day or night.

A - Acknowledge and accept your panic attack. This is an important step in overcoming panic.

W - Wait and watch instead of immediately reacting, which gives you time to bring your thoughts under control.

A - Take Actions to make yourself more comfortable, such as deep breathing or positive self-talk.

R - Repeat these steps if you experience another panic attack

E - Remind yourself that your panic attack will End


National Institute of Mental Health. "When Fear Overwhelms: Panic Disorder." Web. 23 April 2010.

National Institute of Mental Health. "Panic Disorder." Web. 7 July 2009.

Counseling and mental health center, University of Texas at Austin. "Are you living in fear? Getting a handle on panic attacks." Web. 16 April 2007.

Hsu, A., Sandbrand, D., Nazarian, M., Hurtado, L., Yocum, M., and Craske, M.G. " Does cognitive change predict treatment outcome for nocturnal panic: A preliminary analysis." Paper presented at the meeting of the Association for Advancement of Behavior Therapy. Web. November 1997.

"Nocturnal Panic Attacks." Web.