What Causes Panic Attacks at Night? Here’s What You Need to Know


Panic attacks are distressing episodes of intense fear and anxiety that can disrupt your life. While panic attacks can happen at any time, experiencing them at night adds an extra layer of challenge.

In this blog post, we will explore the causes behind panic attacks at night and the importance of understanding them. Nighttime panic attacks can have a significant impact on mental well-being, causing heightened anxiety and insomnia. One potential root cause lies in the dysregulation of the nervous system. By understanding the underlying mechanisms, we can seek effective long-term solutions.

Throughout this post, we will discuss common symptoms, factors contributing to nighttime panic attacks, and strategies for regulating the nervous system. By addressing these causes, we aim to provide guidance and help individuals minimize the occurrence of panic attacks during sleep. 

What is a panic attack?

A panic attack is a sudden and intense episode of fear and anxiety that can be overwhelming for those who experience it. During a panic attack, individuals often feel an extreme sense of fear or impending doom, accompanied by a surge of physical symptoms. It is important to understand what a panic attack entails to recognize and address them effectively.

Symptoms of a nocturnal panic attack can vary from person to person but often include rapid heartbeat, shortness of breath, chest pain, trembling or shaking, dizziness, sweating, and a feeling of being detached from reality. These physical symptoms, coupled with intense psychological distress, can be highly distressing and debilitating.

Distinguishing panic attacks from other conditions, such as general anxiety or medical conditions, is crucial. While anxiety disorders can manifest in various ways, panic attacks are characterized by their sudden onset and intense symptoms, often peaking within minutes. This differentiation helps in understanding the specific nature of panic attacks and tailoring appropriate interventions.

Daytime panic attacks and nighttime panic attacks may exhibit some differences. While the symptoms and experiences during the attacks are similar, panic attacks at night can be particularly distressing due to the vulnerability and interruption of sleep. Understanding these differences can aid in developing targeted coping strategies and addressing the specific challenges associated with nighttime panic attacks.

What causes panic attacks at night?

Panic attacks can be triggered by various factors, and understanding these triggers is crucial for managing and preventing them. While triggers can differ from person to person, here are some common causes of panic attacks, including those specifically at night:

Stress and Anxiety

Stressful life events, overwhelming situations, or chronic anxiety can trigger panic attacks. Additionally, sleep anxiety, which is anxiety specifically related to sleep or fear of having panic attacks during sleep, can contribute to nighttime panic attacks.

Sleep Disorders like Sleep Apnea

Sleep disorders, such as sleep apnea, where breathing is repeatedly interrupted during sleep, can lead to primary nocturnal panic attacks. The disruptions in sleep patterns and oxygen supply can trigger heightened anxiety during sleep.

Effects of Certain Medications

Certain medications, including stimulants, antidepressants, or drugs that affect the central nervous system, may have side effects that increase the likelihood of panic attacks, including during sleep.

Existing Mental Health Conditions

Individuals with pre-existing mental health conditions, such as generalized anxiety disorder, panic disorder, or post-traumatic stress disorder (PTSD), are more prone to experiencing panic attacks. These conditions can contribute to experience panic attacks both during the day and at night.

Biological Factors and Genetics

Imbalances in brain chemicals, such as serotonin or norepinephrine, can influence the occurrence of frequent panic attacks. Additionally, a family history of anxiety disorders suggests a genetic predisposition to panic attacks.

Nightmares, feelings of vulnerability, physical discomfort, and changes in sleep patterns or environments can also trigger night panic attacks.

Impact of Nighttime Panic Attacks on Sleep Quality

Nighttime panic attacks not only cause immediate distress but can also significantly impact sleep quality, creating a vicious cycle that exacerbates anxiety and panic attacks.

There is a strong connection between panic attacks and insomnia. The intense fear and anxiety experienced during panic attacks can make it difficult to fall asleep or return to sleep after an episode. This sleep disruption can lead to fragmented sleep, reduced total sleep time, and overall poor sleep quality.

Poor sleep, in turn, can worsen anxiety and contribute to more frequent and intense panic attacks. Sleep deprivation affects emotional regulation and increases vulnerability to stress, making individuals more susceptible to anxiety symptoms. The lack of restorative sleep weakens the body’s ability to cope with stressors, further heightening anxiety levels.

This cycle of anxiety, poor sleep, and panic attacks can be challenging to break. The fear of experiencing panic attacks during sleep can create anticipatory anxiety, leading to a hyper-vigilance towards sleep and perpetuating sleep disturbances.

Understanding the Root Cause: A Dysregulated Nervous System

A dysregulated nervous system refers to the dysfunction in the intricate network of nerves and responses that regulate bodily functions and emotional responses. In the context of panic attacks, a dysregulated nervous system can play a significant role in triggering and exacerbating night panic attacks.

The nervous system is responsible for detecting and responding to threats or perceived dangers. In individuals with a dysregulated nervous system, the body’s stress response may become overactive or overly sensitive, leading to an exaggerated panic response even in non-threatening situations.

During a panic attack, the sympathetic nervous system, responsible for the body’s fight-or-flight response, goes into overdrive. This triggers a cascade of physiological reactions, including increased heart rate, rapid breathing, and a surge of adrenaline, intensifying the panic attack experience.

At night, when the body is in a relaxed state and transitioning into sleep, a dysregulated nervous system can disrupt this process. The body’s ability to switch from an alert state to a calm and restful state may be compromised, leading to heightened anxiety and panic attacks during sleep.

How can I stop panic attacks at night?

While conventional approaches often focus on medical treatments, therapy, or relaxation techniques, taking a step further to address nervous system regulation can provide a solution and prevention strategy for nighttime panic attacks. Nervous system regulation aims to restore the body’s equilibrium and improve its stress response.

Nervous system regulation works by enhancing the body’s ability to maintain homeostasis, a state of balance and stability. By improving the stress response, the nervous system becomes more resilient and adaptable, reducing the likelihood of triggering panic attacks.

Addressing nervous system dysregulation is crucial because it targets the root cause of panic attacks. By reversing dysregulation and improving your body’s stress response, you can experience a reduction in the frequency and intensity of nighttime panic attacks.

To learn more about our world-class program that teaches you how to regulate your nervous system, reverse dysregulation and chronic symptoms, please click here.


Understanding and regulating the nervous system play a crucial role in preventing nighttime panic attacks. By recognizing your triggers and symptoms of panic attacks, you can take proactive steps to manage your nervous system’s response. By addressing the underlying factors and implementing effective strategies to promote nervous system regulation, you can significantly reduce the occurrence of night panic attacks.

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Dr. Linnea Passaler

Dr. Linnea Passaler

Dr. Linnea Passaler has dedicated 20+ years to serving patients, first to a small number of individuals as a successful surgeon and then to thousands of people worldwide as the CEO of a digital health startup. After overcoming her own struggles with a dysregulated nervous system, she created Heal Your Nervous System (HYNS) to empower others in their healing journey. Her combination of neuroscience and somatic work helps those struggling with overwhelm, trauma, burnout, and anxiety to heal their dysregulated nervous systems and thrive.