Panic attacks just after falling asleep?

Question

I need to know if anyone has experienced this or knows what it is. I will drift off to sleep, or have just fallen asleep, when I am suddenly hit by the fact of my own mortality, and I realize that someday I am going to die. Grief overwhelms me, and I start screaming, "It's not fair." I wake up sobbing and moaning this phrase, and it takes me a while to come awake, then the sadness sits with me the rest of the evening. Sleep comes again, with difficulty.

Answer 1

I'm not sure if sleep anxiety is exactly what you are looking for... it seems like the root of the problem isn't your anxiety or concern over sleep itself, but rather deeper philosophical issues that may creep in when you are tired and relaxed and when your mind is free enough to let them in (i.e. right as you are about to sleep). I have had this often for the past three weeks, and it is very frustrating. Perhaps if you talk to someone about your fears then they won't seem as foreign and impossible to understand. I'm not sure of the answer, because I will probably be startled awake with the same problem tonight, again.

Answer 2

Yep, way common. In fact, if you are having panic attacks while sleeping or while falling asleep, it is a HUGE signal that your anxiety is being caused by a biochemical brain imbalance. See a doctor and try something like Celexa or Zoloft (any of the newer SSRI drugs). You will feel a little better after a couple of weeks, and likely a lot better after 4 weeks on the meds. You should stay on them gor 6-12 months, and then follow doc's instructions for weaning off. You may need to be on the medication for more than a year, but there are no known bad long-term effects.

Answer 3

They fall under the categroy "Night Terrors"...you can actually Hallucinate somoene being in the room with you..it sometimes includes sleep paralysis...where you are wide awake but cannot move, the only way to come out of it is to go back to sleep and allow yourself to wake up again..very hard when you are in such a helpless state and are seeing "something" in the room with you that you know wants to hurt you. This disorder is ususally brought on my stress..includes severe bouts of insomnia, can include PLMD (Periodic Limb Movement Disorder) in which after falling asleep there is a tiwitching, sometimes actual thrashing, of the legs and flailing of arms...You have to get to the unerlying cuase of the stress and/or fear that is causing this. Actual panic attacks usually occur while one is awake...what you are experiencing is heavier, the Night Terrors, but do include panic attacks during your waking hours...you are under some kind of extreme presure or stress...I have been there...took me 2 years and made me physically ill...but I did survive...you have to really dig deep down isnisde and find out what it is you are REALLY afraid of...to me, Death seems to represent someting or someone in your life that is even scarier...and believe me, there are worse things than death out there...I was on the streets 4 years....what you are experiencing is real..you are NOT mentally ill..you are not imagaining this..it is REAL and don't let anyone tell you you're just paranoid..of course you are..but of what? Paranoia ..a fear of a certain thing, is so powerful and so scary to you that your mind will block it out trying to protect you. You have to get beyond that ..it is the hardest thing you may ever have to do, but it must be done...and yes, it CAN kill you...if you let it....In fact, I have been awakened by a loud booming voice calling my name, even!

Answer 4

It might not be a panic attack, I get the same thing after exercising too soon after eating. not totally sure what happens but I felt like it was my heart for ages, but after it happened a few times I was certain it was just my wind pipe, maybe linked to indigestion. I sometimes get short of breath for a few seconds after it. Some problems associated with exercise are also felt through just being really tired in general, maybe you were really worn out.

Answer 5

I do, but not to that degree. I wake up just after falling asleep (or early in the morning) and start to freak out about my whole life . . .a good friend does it too. We both just finished college and moved away from each other to opposite coasts. Are you in a major transition right now?

Answer 6

I have been having panic attacks the same as you for years take medicate as needed and try not to let anything bother me ,help a lot .

Answer 7

Yes I have. Worry about what you can control. If a Panic attack hits...best advise I can give, go OUTSIDE!!.. Fresh air helps.

goodluck

Answer 8

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Answer 9

I get that, it's called Sleep Anxiety. I suggest daily meditation and maybe clinical treatment.

Answer 10

Lorazepam (marketed under the brand names Ativan®, Temesta®, Tavor®) can solve your problem. But this drug causes addiction and dependency. You can use it for a short term, not more than 4 - 6 weeks. Daily doses vary greatly, from 0.5 mg to 2.5mg. Take Lorazepam and go to bed when you feel really sleepy.

You have to consult a Clinical Psychiatrist to solve your problem permanently.


A panic attack is a period of intense fear or psychological distress, typically of abrupt onset and lasting no more than thirty minutes. Symptoms may include trembling, shortness of breath, heart palpitations, sweating, nausea, dizziness, hyperventilation, paresthesias (tingling sensations), and sensations of choking or smothering. Repeated and apparently unprovoked panic attacks may be a sign of panic disorder, but panic attacks are associated with other anxiety disorders as well. For example, people who suffer from phobias may experience panic attacks upon exposure to certain triggers.

Most sufferers of panic attacks report a fear of dying, "going crazy", or losing control of emotions or behavior. These feelings generally provoke a strong urge to escape or flee the place where the attack began ("fight or flight" reaction) and, when associated with chest pain or shortness of breath, a feeling of impending doom and/or tunnel vision, frequently result in the sufferer seeking medical attention.

The panic attack is distinguished from other forms of anxiety by its intensity and its sudden, episodic nature. Panic attacks are often experienced by sufferers of anxiety disorders and other psychological conditions involving anxiety, though panic attacks are not always indicative of a mental disorder, nor are they uncommon. Up to 10 percent of otherwise healthy people experience an isolated panic attack per year, and 1 in 60 people in the U.S. will suffer from a panic disorder at some point in their lifetime.

People with phobias will often experience panic attacks as a direct result of exposure to their trigger. These panic attacks are usually short-lived and self-limiting, as they will subside once the trigger is no longer present.

In conditions of chronic anxiety, one panic attack can roll into another, leading to nervous exhaustion over a period of days.

The symptoms of a panic attack appear suddenly, without any apparent cause. They may include:

Racing or pounding heartbeat or palpitations
Sweating
Chest pain/PVCs
Dizziness, lightheadedness, nausea
Difficulty breathing (dyspnea)
Hyperventilation
Tingling or numbness in the hands, face, feet or mouth (Paresthesia)
A sudden feeling that everything around the person represents a threat. This can cause a person to either behave extremely defensively (perhaps even assuming the fetal position), or to become enraged and lash out violently.
The loss of the ability to react logically to oncoming stimuli, and the loss of cognitive ability in general. One suffering from a panic attack will often only feel the attack and will be unable to assess why they are feeling the attack or what they can do to stop the sensation.
Flushed face and chest
Chills
Dream-like sensation or perceptual distortion (derealization)
Dissociation, or the perception that one is not connected to the body or is disconnected from space and time (depersonalization)
Terror, or a sense that something unimaginably horrible is about to occur and one is powerless to prevent it
Vomiting
Tunnel vision
Fear of losing control and doing something embarrassing or going crazy
Fear of impending death
Feeling of impending doom
Trembling or "shivering"
Crying
Heightened senses
Loud internal dialogue
Exhaustion
Vertigo
A panic attack typically lasts from 2 to 8 minutes. More severe panic attacks may form a series of episodes waxing and waning every few minutes, only to be ended by physical exhaustion and sleep.

The various symptoms of a panic attack can be understood as follows. First, there is the sudden onset of fear with little or no provoking stimulus. This leads to a release of adrenaline (epinephrine) which brings about the so-called fight-or-flight response where the person's body prepares for major physical activity. This leads to an increased heart rate (tachycardia), rapid breathing (hyperventilation), and sweating (which increases grip and aids heat loss). Because strenuous activity rarely ensues, the hyperventilation leads to a drop in carbon dioxide levels in the lungs and then in the blood. This leads to shifts in blood pH which can in turn lead to many other symptoms, such as tingling or numbness, dizziness, and lightheadedness. It is also possible for the person experiencing such an attack to feel as though they are unable to catch their breath, and they begin to take deeper breaths, which also acts to decrease carbon dioxide levels in the blood.

Hyperventilation alone can bring about some of the symptoms of a panic attack. However, the person experiencing the panic attack often does not realize this and sees these symptoms as further evidence of how serious their condition is. An ensuing positive feedback loop of adrenaline release fuels worsening physical symptoms and psychological distress.

While the symptoms and the seriousness of panic disorder are very real, the feelings of panic or impending death that accompany many attacks are exaggerated. Many physicians tell panic disorder sufferers that while their body is affected by the attack, they are not in any risk of fatality (except due to auxiliary reactions such as crashing a car, bothering strange animals; i.e lions, bears and tigers, running into traffic, committing suicide, etc). If a sufferer can anticipate an attack and find a safe place to release, there is little immediate risk.

Panic disorder is real and potentially disabling, but it can be controlled. Because of the disturbing symptoms that accompany panic disorder, it may be mistaken for heart disease or some other life-threatening medical illness. This misconception often aggravates or triggers future attacks. People frequently go to hospital emergency rooms when they are having a panic attack, and extensive medical tests may be performed to rule out these other conditions, thus creating further anxiety.

Treatment for panic disorder includes medications and a type of psychotherapy known as cognitive-behavioral therapy, which teaches people about the nature of panic attacks, the cycles of negative thoughts, and demonstrates ways to interrupt the panic process.

Medications can be used to break the psychological connection between a specific phobia and panic attacks. Medications can include antidepressants (SSRI's, MAOI's, etc.) taken every day, or anti-anxiety drugs (benzodiazepines, e.g. -- Valium, Ativan, Xanax, etc.) during or in anticipation of panic attacks. Exposure to the phobia trigger multiple times without a resulting panic attack (due to medication) can often break the phobia-panic pattern, allowing people to function around their phobia without the help of medications. However, minor phobias that develop as a result of the panic attack can often be eliminated without medication through monitored cognitive-behavioral therapy or simply by exposure. The decision to participate in this therapy personally or through a registered practitioner should always be made in conjunction with a medical professional.

Often, a combination of psychotherapy and medications produces good results. Some improvement may be noticed in a fairly short period of time--about 6 to 8 weeks. Thus appropriate treatment by an experienced professional can prevent panic attacks or at least substantially reduce their severity and frequency--bringing significant relief to 70 to 90 percent of people with panic disorder. Relapses may occur, but they can often be effectively treated just like the initial episode.

In addition, people with panic disorder may need treatment for other emotional problems. Clinical depression has often been associated with panic disorder, as have alcoholism and drug addiction. About 30% of people with panic disorder use alcohol and 17% use drugs such as cocaine or marijuana to alleviate the anguish and distress caused by their condition. Research has also suggested that suicide attempts are more frequent in people with panic disorder, although this research remains controversial.

As with many disorders, having a support structure of family and friends who understand the condition can help increase the rate of recovery. During an attack, it is not uncommon for the sufferer to develop irrational, immediate fear, which can often be dispelled by a supporter who is familiar with the condition. For more serious or active treatment, there are support groups for anxiety sufferers which can help people understand and deal with the disorder.

Other forms of treatment include journalling, in which a patient records their day-to-day activities and emotions in a log to find and deal with their personal stresses, and breathing exercises, such as diaphragmatic breathing. In some cases, a therapist may use a procedure called interoceptive exposure, in which the symptoms of a panic attack (such as hyperventilation) are induced in order to promote coping skills and show the patient that no harm can come from a panic attack. Stress-relieving activities such as tai-chi, yoga, and physical exercise can also help ameliorate the causes of panic disorder. Many physicians will recommend stress-management, time-management, and emotion-balancing classes and seminars to help patients avoid anxiety in the future.