Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: February 5, 2026
Fact checked
Quick Summary
  • If you have ever had a panic attack in life, you probably know how scary the experience is.
  • Such attacks take you by surprise and feel as though they last for an eternity, even if they are a minute-long in real life.
  • At the same time, multiple triggers may provoke panic attacks at any point during the day; some experience it in the dark of the night.
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If you have ever had a panic attack in life, you probably know how scary the experience is. Such attacks take you by surprise and feel as though they last for an eternity, even if they are a minute-long in real life. At the same time, multiple triggers may provoke panic attacks at any point during the day; some experience it in the dark of the night. Also known as nocturnal panic attacks, these attacks represent an underlying panic disorder, or less commonly, withdrawal from substance abuse, and may warrant professional help depending on the cause.

A panic attack refers to an intense wave of fright that comes unexpectedly and can be extremely debilitating with an immobilizing intensity. You may feel like your heart is pounding, your breathing rate is going down, and your mind is shutting off. Panic attacks commonly strike out of the blue with no prior warnings and, in most cases, with no apparent trigger. They may even occur while you are sleeping peacefully, a phenomenon known as nocturnal panic attacks. (source: SAMHSA, n.d.)

For some, a panic attack at night might be a one-time occurrence, although others may experience repeat episodes in the future. Such recurrent panic attacks are usually triggered by a particular situation, such as public speaking. These panic-inducing situations are often the ones that you cannot escape and in which you feel endangered. As a result, the body’s fight-or-flight response gets triggered, leading to the following panic attacks symptoms at night: [2]

  • Feeling disconnected from your surrounding
  • Chest pain or tightness in the chest
  • Shortness of breath
  • Feeling dizzy, faint, or lightheaded
  • Nausea
  • Hyperventilation
  • A racing heart
  • Muscle spasms
  • Palpitations
  • Shakiness
  • Numbness and tingling in different areas of the body, such as in fingers or around lips
  • Excessive sweating
  • Feeling out of control
  • Fluctuation in body temperature, i.e., feeling too cold or too hot

The above-mentioned nocturnal panic attack symptoms can be so severe that they may make the sufferers believe that they have a heart attack. (source: NICE, 2011)

If you wake up from your sleep with extreme fright every other day, you might wonder what causes panic attacks at night. Unfortunately, experts are not sure about why these nighttime panic attacks occur. However, what is known so far is that because the brain does not entirely switch off even when we sleep, there is a small chance for any pent-up troubles or worrisome thoughts to manifest in the brain unconsciously, leading to these attacks. Additionally, a history of daytime panic attacks also makes it much more likely to suffer from similar episodes at night. (source: StatPearls, 2024)

While panic attacks at night can be frightening, they are a relatively common mental health issue. But what are the causes behind it? So far, research suggests multiple factors may increase the risk of suffering from panic attacks, both day and night time. These causes include: [5]

  • Experiencing longstanding stress in everyday life
  • A history of other mental health issues, such as depression, anxiety, posttraumatic stress disorder, and obsessive-compulsive disorder
  • Chronic physical ailments, such as cancer
  • Side effects of certain medicines
  • Recent significant life changes, such as becoming a parent, moving houses, or losing a job
  • A recent personal loss, such as grief, breakup, or a financial loss
  • Using certain substances, such as cannabis or caffeine
  • Withdrawal from drugs, alcohol, or medication
  • Having a close relative (for example, a sibling or a parent) who suffers from panic attacks
  • A lack of assertiveness with a passive style of communication

If you wake up in the middle of the night with chest tightness, shortness of breath, and heavy limbs, know that you are in the middle of a panic attack. Here is what you can do to calm yourself down as quickly as possible: (source: NIMH, 2024)

Let it pass

If you suddenly wake up to find yourself in the middle of a panic attack, do not fight it, as doing so will only make things worse. Accept the attack for what it is and allow the anxious feelings to wash over you. Keep reminding yourself that all this is temporary and will go away on its own. (source: NHS, 2022)

Relax yourself

Inhale deeply and exhale slowly to relax your mind and body. Try focusing your mind on positive images and thoughts as you practice deep breathing. [8]

Distract your mind

You may find it difficult to go straight back to sleep once a panic attack is over. Instead, you can involve yourself in some other activity to take your mind off what has happened. Get out of bed and indulge in something that relaxes you, such as stretches, yoga, music, or book reading. [9]

Go back to sleep when the time is right

Once a panic attack has passed, do not try going back to bed unless you begin to feel tired and are ready to sleep. Keep yourself calm by practicing deep breathing even when you are back in bed. (source: MedlinePlus, 2024)

Take enough time to sleep adequately

Panic attacks can greatly reduce the duration and quality of sleep, drastically affecting your performance the following day. Hence, make sure you cover up for any sleep loss that you may have encountered. Ideally, you must go to bed at least eight hours before the time you need to get up. Going to bed later than this can provoke anxious thoughts in your mind, which, in turn, paves the way for a panic attack to kick in. [11]

Be ready for the following day

A lot of people struggle to sleep as they are too anxious about the following day, such as the night before the exam. Try reducing this by ensuring you are well-prepared for what lies ahead. For example, if you have a meeting early morning, make sure that your clothes are laid out and ironed. [12]

Sometimes, panic attacks set off even before you realise that you are under stress. Doing everything mentioned above can significantly calm you down in the middle of an attack and can event prevent future attacks. However, if you still struggle to find an effective solution to end this misery, professional help is available. Multiple rehabs with qualified therapists broadly offer help to the victims of panic attacks and a consequently reduced quality of life. These centres conduct an in-depth assessment to evaluate the level of care you require and use different therapies, such as cognitive behavioral therapy and exposure therapy, to help you take charge of your life once again. Any concurrent issues, such as drug addiction, are also taken care of under specialist supervision for a lasting recovery. [13]

So if you or a loved one are battling panic attacks, contact us to book an initial evaluation today. [14]

FAQs

Are panic attacks related to substance abuse?
Doctors have been unable to find an exact cause leading to panic attacks; however, certain things can certainly increase the risk. Of these, substance abuse tops the list. Whether it is because of the altered mental sensorium or the physical symptoms, you are more vulnerable to experiencing a panic attack, both day and night, if you abuse alcohol or drugs. Even going through a detoxification process can lead to panic attacks. Hence, it is essential to learn how to stop panic attacks at night before bed if you have a history of addiction.
What does a panic attack at night feel like?
Nighttime is a relatively common time for an individual to experience a panic attack. In most cases, the attack begins with reduced breathing or elevated blood pressure that induces a sense of suffocation. This is followed by a feeling as if their limbs have stopped working as normal, accompanied by a feeling of being too cold or hot. The sweat starts permeating through the body as anxiety slowly takes over your brain. Despite the duration of these attacks being restricted to 15 minutes or so, panic attacks at night can lead to significant disorientation that may make them seem much longer and more painful.
What are catastrophic misinterpretations?
Once someone starts experiencing a panic attack, different thoughts may jump into their heads. Sometimes, these thoughts may lead to false conclusions relative to what is being experienced at the moment. If the sufferer fails to realise what these thoughts and conclusions really are, they can have negative consequences.
For instance, if you feel your heart pounding in the middle of a panic attack, you may falsely believe that you are having a heart attack. Similarly, altered breathing, another panic attack symptom, may lead you to believe that you are slowly suffocating to death. Conclusions like these contribute to the fear and intensity of an episode as they make the sufferer believe that they are in the middle of a catastrophic event. This phenomenon is, therefore, known as catastrophic misinterpretations.
I am unable to sleep at night for fear of experiencing a panic attack. What should I do?
Worry and anxiety can easily feed upon your ability to get a good night’s sleep. Because intense forms of panic attacks can stir up racing thoughts and deep emotions within the subject, this can be a hurdle to sleeping peacefully at night. However, it is crucial to recognize that worrying about the what-if scenarios cannot improve the situation in any way. So letting go of these thoughts is important as this dispels the consistent anxiety and stress. Ask yourself why you cannot sleep and work on addressing the feelings and thoughts that lie at the very center of the problem. If the problem is severe and cannot be solved with self-help, professional help can be sought.

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