Symptoms and Features of night panic attacks
Panic attacks are a very common problem and manifest themselves, in most cases during the day. But they can also unexpectedly reach during the night.
The most frequent symptoms of these sudden night awakening are a sense of deep anguish, tachycardia, sweating, lack of breath, tremors, hot flashes, chest pain.
It follows that the subject will have Difficulty in regulating themselves For the fear that these sensations can be remedied.
What distinguishes the Night panic attacks From those who arise during the day it is the level of awareness and vigilance. At night the subject is in a condition of greater fragility and helplessness. In this situation of greater vulnerability, people are particularly frightened and can come to request medical intervention by fearing a heart attack or other potential death threats.
In fact, the night panic attacks involve a strong anguish but are not harmful to the physical health of the individual. In some cases, a state of continuous alert is experienced, especially in the hours preceding the falling asleep, for the fear that the symptoms can reappear. You can get to try to avoid and/or delay to go to bed so as not to repeat the distressing experience.
In this way the subject will develop a tendency to have a lighter sleep and will have a greater probability of awakening up to manifesting real sleep disorders.
Prevalence and characteristics of panic attacks in the night
The Night panic attacks They are much more frequent than you can imagine. It is estimated that 50-70% of people suffering from panic attack disorder At least once, an attack of night panic attack. These individuals show more intense levels of concern for night crises.
The DSM-5 ranks night anxiety attacks within the largest category of unexpected panic attacks. That is, that they occur independently of triggering situational factors (APA, 2013). Night attacks do not present different symptoms from daytime.
Searches
According to some research (The Fear of Loss of Vigilance Theory; Tsao & Craske, 2003), those suffering from night panic fear the situations in which the attention paid to external stimuli is reduced. As in moments of relaxation and therefore also during sleep. In fact, in such circumstances it can be more difficult to predict and protect yourself from any dangers.
Other authors (Smith, Albanian, Schmidt & Capron, 2019) have hypothesized that Those who suffer from night panic crisis show greater intolerance to uncertaintythat is, they hold unpredictable and uncertain situations with greater difficulty.
In this case, the subject would be more afraid that an unexpected event can happen during the night to which he is not ready to react. Compared to those suffering from only daytime attacks, those with night attacks are also less able to act in unpredictable situations.
In addition, those who experience night attacks fear more to be unable to protect themselves from the unpleasant consequences of harmful events. Research underlines in addition that the person who suffers from night anxiety crisis It turns out to be more sensitive to anxiety, taking care of the judgment or refusal of others. This data could mean that individuals who have night panic attacks manifest symptoms of social anxiety and therefore fear that the person with whom they sleep can notice and negatively judge their difficulties related to sleep.
Night panic attacks, Pavor Nocturnus and night apnea
The Night panic attacks They must be distinguished from the Pavor Nocturnus and the night apnea. The Pavor Nocturnus It is a very common sleep disorder in children. It typically occurs in deep sleep and manifests itself as a sudden awakening. Often in tears, strong anxiety and vegetative symptoms such as tachycardia, sweating and short breath.
The first difference therefore between panic attack and Pavor Nocturnus is the time when they take place. Panic attacks generally present themselves between half an hour and three hours after falling asleep, then in the non-Rem sleep phase.
The night terror It happens in the REM phase and is linked to a nightmare and as soon as the person realizes he has made a bad dream calm down and manages to fall asleep. In the panic attack there are only anguished sensations, there is no memory of a dream and the subject is unable to easily relax and fall asleep.
Instead the awakenings caused by sleep apnea They are not typically characterized by strong anxiety. But this sleep disorder could have a link with the origin of night panic attacks, influencing heart rate and blood pressure.
Possible causes of the night panic attack
The Night panic attacks They can be conditioned by the events and situations that we live during the day, by the consumption of drugs or alcohol and the greater individual activation linked to the presence of an anxiety disorder.
A common condition between those suffering from night panic attacks is stress with a consequent greater production of adrenaline and cortisol by the body. Thus the subject will live a condition of continuous alert, with a greater predisposition to the awakenings in panic.
In addition, the Fear of having other panic attacks (Fear anticipatory) can hinder the falling asleep, causing a general worsening of sleep quality, the development of sleep disorders and the increase in the level of stress.
Although the researchers have not yet clearly identified the causes of night and day panic attacks, it is possible to identify some common risk factors:
- Genetic factors/familiarity (family members with a story of panic attacks)
- Personality traits and psychological disorders below social anxiety, phobias etc …
- Stressful life events such as work loss, loss of a loved one, family problems, separation/divorce etc …
What to do and to whom to contact to receive help
It is very difficult to go back to falling asleep after a panic awakening and wait for sleep to be back is not the best solution. Instead, it may be useful to get up, resort to slow and deep breathing techniques or other relaxation techniques (e.g. yoga, autogenic training, muscle relaxation).
To prevent thearise panic attacks It is important to adopt a lifestyle that allows a better Stress managementlearning to dedicate time to pleasure and personal care.
It is important to reach a correct diagnosis, excluding physical conditions such as heart or thyroid problems, which can present similar symptoms.
Once the problem has been identified and undertaken adequate treatment, healing occurs in a few months, but it may take longer depending on the specific case.
Psychotherapy
Cognitive behavioral therapy is the first choice treatment for panic disorder and helps people understand and manage panic attacks.
Cognitive behavioral therapy aims to modify dysfunctional styles of thought and behaviors implemented in certain situations.
It may happen that people in an attempt to facilitate sleep use incorrect strategies that do nothing but feed the problem (eg abuse of alcohol and psychotropic drugs or intake of exciting drinks such as coffee or energizing drinks).
The therapist’s task is to guide the patient to learn techniques to manage and reduce anxiety symptoms And sometimes psychotherapy can be coauded by the use of drugs. However, drugs should be used in parallel with psychological therapy. Most of the patients treated only pharmacologically have a relapse once the pharmacological intake ended.
