Panic attacks are generally considered to be one of the more manageable types of mental disorder.
Drug therapies are quite successful at helping people cope with panic, but of course many people prefer to avoid the side effects and other complications of extended medication.
Luckily, equally good if not better long-term results have been obtained by treating panic disorder and sleep panic attacks through cognitive behavior therapy (CBT) and other non-drug treatment methods.
Panic attacks that occur at night are a different story, however.
In most ways they are identical to daytime panic episodes-the symptoms are pretty much the same (choking or suffocating feeling, accelerated heartbeat, dizziness, hot and cold flashes, sweats and tingling).
And in fact most people who have nighttime attacks also have them during the day.
But from a treatment perspective nocturnal attacks are very different.
For cognitive behavioral therapy to work, "cognitive" is key.
The whole process relies on taking conscious control of one's thoughts and behavior and gradually, patiently, overtime reconditioning, dehabituating, teaching new patterns and guiding them in new directions.
This patient has to be able to take an active part in this process-which is pretty much impossible when you are asleep.
No one seems to have investigated the extent to which CBT and other conscious reconditioning approaches may carry over to reduce the incidence of panic attacks at night as well as during the day.
While the jury is out on the usefulness of CBT for nocturnal panic, there are some other practical steps that people suffering from this problem should take.
1.
Get checked out by a doctor to find out whether your panic attacks might actually be symptoms of other medical disorders such as hyperthyroidism, sleep apnea, gastroesophageal reflux disease (GERD), etc.
2.
Sedatives are often effective in treating nighttime panic.
Prescription meds can be quite habit-forming, however, and some of them become less effective as your body gets habituated to them.
If you don't choose to go that route, perhaps the use of natural sedative substances and techniques can help.
Some that have been recommended include valerian, tryptophan, melatonin, and theanine (an amino acid found in tea).
3.
Investigate the underlying sources of stress in your life.
Some that have been linked to panic attacks may be easy to eliminate-alcohol, caffeine, sugar, exercise and other overly stimulating activities (including mental activities) in the evening too close to bedtime.
Deeper and less tractable sources of stress you may not be able to change, but dealing with them to whatever extent possible-through talk therapy, through a variety of relaxation techniques, might help decrease their eruption into your night mind.
If particular problems are causing you to feel anxious during the day, try to plan out practical solutions so you can put them aside when you go to bed.
4.
Practice good sleep hygiene: develop habits that support a restful night's sleep.
There is a lot of advice available on this in our sleep-deprived world.
Again, avoid stimulants like as caffeine (remember that chocolate is a prime source of caffeine) and don't use your bedroom for non-sleep activities like working or watching TV if you can avoid it.
5.
Cognitive behavioral therapy.
Since many people with nighttime attacks also experience panic episodes during the day, CBT is probably an avenue worth exploring for relief at night as well.
One of the peculiarities of panic disorder is that panic begets panic.
Each episode you experience tends to increase the anticipatory anxiety that raises your chances of another attack.
So the more daytime attacks are controlled, the lower your general level of anxiety is likely to be, which may in turn decrease the tendency for nocturnal episodes.
There's no guarantee that these approaches will cure nighttime panic attacks, but there is a good chance that some combination will at least reduce their number and restore your chances of getting a good night's sleep.