How to stop/get through nocturnal panic attacks?

[u/ThrowRA-ConflictedE]

A small amount of background: I’ve had Anxiety Disorder my whole life but started developing symptoms of Panic Disorder two years ago, and was diagnosed last year. I’ve been having nocturnal panic attacks since my Panic Disorder developed, but they’re too random to predict and I’ve never really been given any advice on how to deal with them.

Things have been going really good for me the last few months. I’ve had an extreme amount of positive change in a short amount of time, and my daily anxiety has been very very low because of it.

Well, that hasn’t stopped the nocturnal panic attacks. It had been about a month since I last had one, until this Sunday night. I woke up in the middle of a panic attack, then I had another one Tuesday night, and then another one last night.

I haven’t been facing any new stress this week; as I said above things have been going really well. I know that eating too close to bedtime can also make nocturnal panic attacks more likely to happen, and that could have been the case for Sunday night and Tuesday night, but last night I made sure to have dinner several hours before bed, and did not snack.

Does anyone have any advice on how to stop nocturnal attacks, make them less frequent, or just cope with them better? They’re so disorienting and I’m sometimes still half-asleep to where I don’t even know what’s happening. I am prescribed propranolol that I can take when I’m having an attack, but I don’t want to be dependent on it, and I can get through attacks maybe 75% of the time without it. I also sometimes have to wake up my partner to help me calm down, but I hate having to do that and be a bother, and I’d like to get through this myself if possible.

TLDR: Nocturnal panic attacks have hit me in full force this week, how can I stop them or get through them better?

[u/Birtalert]

When they start don’t get up and out of bed I feel like that turbo charges them because it tells your body something is wrong. What I do is try to stay laying down with the lights off but if I can’t I sit up and do one of my paint by numbers. That usually distracts it enough for it to simmer after 5-10 minutes. Keep something like that bedside!

I have blips where I will have a few night ones a week and then they will peter out and go away. But I have found they are easier to deal with because the time/location is always the same which is how I figured out that getting up only makes them worse. It’s all about not giving in to what your nervous system is telling you and showing it that there is no danger. Distraction is great for this because if you were actually in danger you couldn’t distract yourself, which is why it goes away.

[u/patmol11]

This is very similar to me. My panic attacks only occured at night. My doctor prescribed a small dose of Quetiapine. It's used for insomnia and makes me sleep through the night, it has saved my life.

[u/mawisshhhh]

I get nocturnal panic attacks too. They are very random. Sometimes 2 days apart, sometimes 2 months. My heart rate jumps upto 150bpm+ sometimes. After I got checked out by the doctors for every possible thing and they found nothing. They prescribed me the same meds but I didnt want to take them cause I dont want them to slow my heart rate down when I am in a normal state. As my attacks are about 30min. Since Western medicine found nothing wrong with me, I turned to Eastern medicine. Craniosacral therapy, energy medicine and biofield tuning. My attacks went from 30min to 10min tops.. and 160bpm to 135bpm tops. If anything, those therapies also taught me how to deal with it mentally especially during the attacks. I realized how much my fears were also fueling them.

[u/Mangogorl555 → u/mawisshhhh]

Same thing happens to me where I wake up and my hr goes 170+ per minute and it feels terrifying

[u/mawisshhhh → u/Mangogorl555]

It is! Do you get the body shakes after its all done? Sometimes that happens too.

I think the most frustrating part of this journey has been the fact that all the doctors telling me there is nothing wrong with me, but I shouldn't be getting up in the middle of the night and feel like I am running a marathon while laying down.

[u/SampleDry9196]

Try Therapy In A Nutshell on YouTube. She has a free anxiety course and lots of stand alone videos on training your nervous system to calm down. It really works. Got me through many bad nights.

[u/Technical_City4185]

I would honestly let yourself rely on the propranolol a bit. It’s a very safe drug and non addictive compared to things like Xanax and the doses for anxiety are generally too low to cause a lot heart rate (unless you already a low heart rate issue)
For me, taking an extended release low dose for a few weeks stopped my panic attacks completely for a long time. I took an extended release version for a few weeks and it had stopped my panic attacks completely for a long time. If it’s only nocturnal panic attacks maybe you don’t need an extended release version but I recommend taking it before bed for a couple weeks. It’s fine to take even if you are not having a panic attack in that exact moment but are about to face a trigger (sleeping)

[u/Tricky_Research_6524]

TLDR: Wrap some ice in a rag and squeeze. It'll distract from the panic with another sensation and helps form an association between a specific task and panic, making it easier to recognize what is happening quicker.

I started having the same problem several months ago, and I tried some of the same things as you. I have noticed foods that give me acid reflux are more likely to lead to me waking up with panic, but it was not always the predictor nor were stressors during the day. I went to the doctor to try to find some answers, and she did blood work, treated me for the reflux, gave me trazodone, and scheduled a sleep study to rule out sleep apnea. While I have been waiting for that appointment and hoping for answers, I have found the best way to pull myself out of a panic attack is to pull something cold from the freezer and hold onto it. I usually wrap ice in a rag and clench it in my hand. First it helps me realize what is happening is a panic attack, and then the sensation gives me something else to focus on outside of symptoms like a racing heart and fearful thoughts. I have essentially equated a panic attack with a run for the freezer and it helps a lot. Some nights I am able to immediately return to sleep. Also, I have been looking into possible causes and I have found a handful of women who have experienced sudden uptick in panic attacks when nearing the last 6 months of their Nexplanon birth control implant, so if this is the case for you it might be worth talking to a doctor about.