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


11 thoughts on “Night Panic

    1. Thank you for being part of our community! If we stick together, we can learn to live well despite anxiety.

      Abs & Mags

  1. I cannot express how grateful I am for this page and now this post in particular. I have had anxiety for many years, but just recently started experiencing these night time attacks. Aside from the obvious anxiety, I am being medically evaluated for sleep issues. Last night I woke from a dream (fairly realistic situation in the dream) in a mad panic and was able to bring myself back to normal with the advice given. I honestly didn’t know this was a thing until recently and am just so glad to have some survival tips!!

  2. I’m 61 years old now and had my 1st panic attack at 11 years old…long before the term “panic attack” was ever coined. Long before there was an internet to explore my symptoms. Even my Dr was stumped so I just thought I was crazy and that made them even worse. My siblings and I were raised by my father, a man who loved his whiskey, women, and had a propensity for severe corporal punishment. It wasn’t until I was in my 40’s that I found my faith and have since come to terms with my upbringing and forgiven my father. My siblings and I have all succeeded beyond our expectations and I personally have found a sense of peace and serenity in the last 17 years I’d only once dreamed about but still once in a while a panic attack will sneak in. I’m not afraid of them anymore. In fact, when I feel one coming on I just roll with them and in return, they either stop or are much shorter and milder. It’s kind of like I say “go ahead and shoot me!” only to find they were just bluffing.

  3. I believe I have “night terrors “, will wake up and have to change my pj’s because I’m soaked in sweat. I will have indentations in the palms of my hands, as if my fists had been clenched and my jaws are sore from tmj.
    Thank goodness I don’t remember the dreams!
    By the time I change my pj’s and pillow case, get something to drink and remind myself it was only a dream, I can usually go back to sleep.
    I live alone and sometimes I have a hard time with that too.

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