For the last few weeks, I have been waking up with panic attacks in the middle of the night. After the panic attack, I have so much trouble getting back to sleep. I am exhausted but I’m afraid to go to sleep at night. What do I do?
Many Anxiety Sisters can empathize with your plight. Nighttime panic attacks are incredibly frightening and disruptive of our sleep cycles. Of course, not getting enough sleep can easily lead to more anxiety. It can feel like a never ending cycle.
First, please remember we are not doctors, but we think it is important to see one about this issue. Yes, it is probably anxiety. However, it is important to rule out other medical issues such as sleep apnea, thyroid imbalances, gastrointestinal distress, and other conditions which can wake us up and mimic the symptoms of panic attacks. Some doctors suggest sleep studies and other tests to rule out a variety of causes.
The treatment for middle-of-the-night panic is pretty similar to the treatment of daytime panic (we prefer the term “spinning”—it’s less anxiety-provoking). Cognitive Behavior Therapy (of which there are many variations and types) is often helpful in dealing with spinning. Some people find great relief from medication as well. According to current research, a therapy/drug combo is often the most effective intervention for acute episodes of anxiety.
Our go-to strategy for managing spinning episodes is a three-pronged approach called TLC: (1) Talk to yourself (2) Loosen all constraints (3) Cool down. You can read more about TLC here, but the idea is to repeat a soothing word or phrase ALOUD, make sure you are not feeling constricted in any way, and do something to cool your body’s temperature (heat and anxiety often go hand in hand). This can be a cold drink, an ice pack or even a cooling shower.
There has been some research suggesting that how you speak to yourself before you go to bed influences your sleep experiences. This is why we encourage night anxiety sufferers to repeat a mantra like “I am at peace,” “Breathe in, breathe out,” or something equally soothing. Some people find it helpful to do a guided meditation before going to sleep. One Anxiety Brother has told us he likes to listen to the sounds of the rain forest as he falls asleep. Soft music is another idea. You can download free recordings of all types from the internet. We particularly like Jason Stephenson’s Sleep Meditation Music and this 15 minute “Calming Visualization for Sleep” by David Procyshyn, founder of DoYogaWithMe.
Lastly, in dealing with panic–day or night–try not to fight the anxiety. Struggling against it and trying to “make it stop” will only serve to intensify the spinning. Remember that these episodes pass in their own time and that you will be okay.
Also, we have a panic button on the homepage of our website which is a five-minute recording of Abs talking you down from the ledge. Feel free to press it as many times as you need. For other techniques for managing panic, please visit our website at anxietysisters.com.