Genetics and mental health conditions might contribute to panic attacks in your sleep, but it varies from person to person.

There’s a strong relationship between our sleep and anxiety. When you don’t get enough sleep, it can make coping with anxiety symptoms more challenging and affect your mood. On the other hand, experiencing anxiety might cause insomnia.

Even if you can fall asleep with ease, you may still awaken with anxiety or even symptoms of a panic attack in the middle of the night. Plus, when your mind is racing with worry, it may be tough to fall back asleep.

But there are ways to get a better night’s rest while calming your anxiety symptoms.

The causes of panic attacks are unknown, but researchers agree on many potential factors such as:

One study found that people diagnosed with a panic disorder also show signs of depression and insomnia. Also, other evidence shows that depression and panic disorders occur together often, which indicates a possible relationship.

Michelle Craske, PhD, director of the UCLA Anxiety and Depression Research Center, presented a theory called the Fear of Loss of Vigilance to determine what types of people are more prone to nighttime panic attacks.

It’s suggested that people prone to nocturnal panic may have difficulty letting uncertainty occur in their lives. They might always attempt to control situations to feel prepared for catastrophe.

Panic disorder symptoms include:

  • nervousness
  • breathing difficulties or increased breathing rate
  • chest pain
  • restlessness
  • a feeling of impending doom
  • tense muscles
  • sweating
  • shakiness

Nocturnal panic attacks occur before you enter the rapid eye movement (REM) cycle of your sleep (between light and deep sleep), which may be why your mind reacts first to a feeling of anxiety as the body sleeps.

Future research may be needed to conclude any symptom differences between daytime and nighttime panic attacks since there’s still much to understand about the condition and why it occurs.

When you experience insomnia or a lack of sleep for weeks or even days, it can impact your physical and mental health. You may want to talk with a medical professional if you’re experiencing consistent signs of anxiety, whether they occur day or night.

A doctor will perform an exam and ask questions about your symptoms and sleep. To receive an accurate diagnosis, it’s important to be as open and honest as you can.

According to the Anxiety & Depression Association of America, only about 3% to 6% of people experience a panic disorder, but 40 million adults have been diagnosed with an anxiety disorder.

If you receive a diagnosis of anxiety, you’re not alone. There are many treatment options available.

If you experience anxiety and panic attacks, you may need several types of treatments to manage your symptoms.

A doctor or mental health professional can help you choose an approach that best fits your needs.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is commonly used to assist those with panic disorders and anxiety. Here, you work with a therapist to redirect unhelpful thoughts and behaviors.

A mental health professional may also suggest exposure therapy, a specific type of CBT that’s often used to treat post-traumatic stress disorder (PTSD) and phobias.

Interoceptive exposure, a form of exposure therapy, is also effective. It helps you identify and decrease the fear that may be associated with the physical sensations of anxiety.


Even with therapy, your doctor may suggest medication, especially if your symptoms are severe.

There are many types of medications used to treat anxiety symptoms, including anti-anxiety medications, antidepressants, and beta-blockers.

Speaking with your doctor can help you determine whether a combination of therapy and medication can help reduce your experience with nocturnal panic attacks.

Coping with nighttime panic attacks can be difficult, but it’s not impossible. Trying different methods will help you discover what works best for you.

Relaxation techniques

When you practice specific relaxation techniques, you may become more aware of factors contributing to anxiety and learn how to cope with it differently. Some techniques include:

Build better sleep habits

As mentioned, the quality of your sleep can impact your mental health. While improved sleep can help treat anxiety, it’s most effective in reducing anxiety in conjunction with treatment options such as CBT and medication.

Is your bed comfortable? You may need a more firm or softer mattress. Maybe your pillow is losing its fluffiness, and it’s time for a new one.

Once you’ve got a comfortable sleep spot, consider your environment.

  • Is the room too hot or too cold?
  • Do you sleep better in the quiet, or does some white noise help?
  • Do you need to check social media before bed, or should you read instead?
  • Is your room dark enough?

You may also consider what you’re eating and drinking before bedtime. Sometimes, eating too close to bedtime can cause indigestion and discomfort that inhibit sleep.

Do you drink caffeine at night? This habit can also prevent you from sleeping. Maybe switch to water or non-caffeinated beverages after a particular time of day to ensure your body is ready for sleep.

You may have to try strategies to find your sweet sleep spot. For example, there are relaxation apps that offer a variety of sounds and stories to help calm your mind.

Keeping a sleep journal at your bedside is a great way to monitor your activities on the nights you awaken to panic symptoms or when you feel more tired than usual the following day. Documentation may also guide your doctor when determining a diagnosis or recommending treatment.

Keeping a sleep diary

When you worry at night, it can negatively impact your ability to fall and stay asleep. But keeping a bedtime journal may help improve your sleep routine. Here are prompts that you can try each night right before bed:

  • your comfort level
  • any food or drink consumed in the hours before
  • events of the day like naps or exercise
  • time you lie down and wake up
  • thoughts or stress of the day
  • symptoms felt when awakened
  • any new medications taken
Was this helpful?

When you have a panic attack at night, it isn’t associated with dreams or nightmares and doesn’t mean you have a sleep disorder.

Instead, it’s a sign that you have some underlying anxiety and may even need help to manage your symptoms. Consider speaking with a healthcare professional about the various treatment options ideal for your symptoms.

Your doctor or a mental health professional can help treat your anxiety, which may help improve your sleep patterns and experience fewer panic attacks. You can also try free online therapy or mental health apps if that’s a better fit for you.