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What are Sleep Panic Attacks?

By Emma Lloyd
Updated May 17, 2024
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A sleep panic attack is a frightening situation in which a person experiences a rapid heartbeat, a feeling of confusion, anxiety, or intense fear, and sometimes nausea while asleep or shortly after waking. Though it's not entirely clear what causes people to feel like this, it's likely connected to anxiety disorder. Several other medical conditions may be associated with night panics as well, including sleep apnea. Generally speaking, this disorder is treatable with a combination of self-care and medication.


Sleep panic attacks typically take one of two forms, both of which can be very frightening. In the first type, a person wakes up feeling like he or she is about to have a panic attack, or is already in the middle of one. The person's heart will be beating very fast, and he or she may feel confused, disoriented, anxious, and disconnected from reality.

The other type happens when a person begins to consciously experience a panic attack while he or she is still asleep. This may have similar symptoms to a waking panic attack, or it may be accompanied by other symptoms like tooth grinding, head pain, and a feeling of pressure in the ears. In most cases, the person may not be aware of being asleep during the event, or may feel that he or she is struggling to wake up.

Possible Causes

The exact cause of sleep panic attacks isn’t well understood. Since they're much more common in people with anxiety disorder than others, however, they're thought to be connected to that condition. Another theory is that a fear response is triggered as a result of increased levels of carbon dioxide. This is most common in people who have a tendency to hyperventilate. The increase in carbon dioxide can cause a sensation of suffocating, which can lead to anxiety.

Other possible medical causes are sleep apnea, heartburn, and myoclonic twitches. Those with sleep apnea have trouble breathing while asleep, which can lead to a feeling of suffocation and fear. Likewise, a person with severe heartburn might get the feeling that he or she is having a heart attack, which can be very frightening. Additionally, some people get scared when they have myoclonic twitches, which are sudden muscle jerks that happen when someone falls asleep. These can sometimes feel like electric shocks or a sensation of falling, which can trigger a panic attack.

Another possibility is that a fight or flight response happens during changes in the sleep cycle. Nocturnal panic attacks typically occur during the second stage of the cycle, right before deep sleep. This leads researchers to believe that this disorder is not connected to dreams, since they appear in the last stage, Rapid Eye Movement (REM) sleep. A frightening dream might cause a person to have an attack after he or she wakes up though.


Treatment for this condition varies depending on other symptoms present. For many people, a combination of medication and self-care can help reduce the frequency of the attacks, and make them easier to cope with when they do occur. Common self-care techniques include understanding what a panic attack is and recognizing the symptoms so that the event won't be quite as traumatic; doing calming activities like tai chi or meditation; breath control; and getting into a regular sleep schedule, since people without one tend to have more panic attacks. Anti-anxiety medication, antidepressants, or tranquilizers may be prescribed depending on the situation, as well as the severity and frequency of the episodes. Psychotherapy is sometimes beneficial as well.


Between 50% and 70% of people who have anxiety disorder will also experience one or more sleep panic attacks. People who regularly experience this problem are also more likely to experience other sleep disturbances, including insomnia and restless sleep.

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Discussion Comments
By anon999264 — On Nov 23, 2017

I'm 22 and earlier I woke up nauseated and quickly went to the bathroom. I was under the impression that I was dying and I was having an irrational fear that I was responsible for killing people. I was hyperventilating and thinking this can't be right. I was getting close to calling 911 because I didn't know what to do. Luckily I talked myself out of it and started to come back to reality. Frightening stuff.

By anon956931 — On Jun 17, 2014

I'm 16 years old and last night I believe I woke up in a sleep panic attack because it was storming last night with heavy thunder and lightning. I was so scared I half sleep walked to my grandma's room to sleep next to her.

By anon954493 — On Jun 02, 2014

I'm 20 and I've been getting these since I was about 10. I only get these panic attacks when I sleep. When the panic attack happens, it keeps happening for a couple days then I stop getting them for a month or so. I get them in the middle of my sleep about 4-5 a.m.

I'm pretty sure I have sleep apnea, also. My heart starts racing and keeps getting faster and faster and I feel like I'm having a heart attack and I feel like I'm paralyzed and can't move or even wake up. I know I'm sleeping but I get scared that I will die because it's racing too fast that I can't breathe and my whole body feels like it's pounding.

Once I wake up, I can't go back to sleep because the second I close my eyes my heart starts racing. I thought it was because I wasn't getting enough oxygen while I sleep so when my heart was starting to race, I took deep breaths, but it didn't make a difference. I booked an appointment with my doctor and I hope I can get treatment or solution because it's the worst feeling ever!

By anon948511 — On Apr 30, 2014

I dream regularly that I shouldn't swallow in my sleep. I then wake up with severe panic, heart beating rapidly with fear that I'm dying. I then run around panicking as I'm not ready to die. Can't be good for the heart!

By anon943225 — On Mar 31, 2014

I don't get dizzy exactly, but if I'm asleep or about to wake up and I hear anything (especially if it sounds like my mother) my heart races and I get so frightened. My chest tightens and I curl up into a ball. My mother has borderline personality disorder and always goes off on rages and gets verbally abusive all the time. I think she has contributed a lot to my social anxiety and depression and feelings of worthlessness.

By anon356028 — On Nov 21, 2013

I awoke one night with the feeling of complete dread with visuals of horror, death and could not make it stop. I started feeling like I was dying and I started screaming no no no no no as loud as I could.

My family members who saw this were horrified at the expression on my face when they came into the room. They calmed me down some but I still went to the hospital. The doctors at the hospital said it was a panic attack but it felt like so much more. I have not felt like my old self since and this happened in 2006. I have had no more attacks like this.

By anon342763 — On Jul 23, 2013

I wake up to a panic attack as you've called it, and my heart is racing and I feel paralysis, and I am going through horrible muscle spasms that are extremely intense and let up, only to become worse than before. I hardly have the ability to make noise and I say that because I have no control over my lips and therefore cannot get words out. It's more of a death moan. I can hardly get a sound out while exhaling, in some hope someone will hear me.

I can feel this whole event start to set in and I try to get up but it's too late. By the time it wakes me up, I'm already paralyzed and going through what I could only assume is a seizure. During this time, mind, you it takes everything I have just to get in a breath. I'm afraid one of these days I'm not going to have enough in me to get that breath in and it's going to be all over.

By anon342458 — On Jul 21, 2013

I am 20 years old and at night I fall asleep fine, but in the middle of the night, I'll be dreaming and will notice I am moving all around my bed and eventually I wake up curled up in a ball with massive anxiety and breathing very heavily. It feels like I am not getting any air, though, and also my heart is racing. If anyone has the same symptoms and has some information, please reply.

By anon342349 — On Jul 19, 2013

Every now and then I have a dream where I get to a point and I'm struggling to breathe, its difficult waking up but when I do its usually with a gasp and a kind if mouth snort. Its very scarey, I'm usually aware I have to wake up but its hard making myself.

I have anxiety and depression but can keep it in check mostly without medication. I also have a thyroid issue.

By anon332594 — On Apr 30, 2013

This article gives several information about panic attack and panic attack symptoms which are very much useful for the people who are suffering from these panic attacks.

By anon327031 — On Mar 26, 2013

@anon321794: You are experiencing a rare phenomenon called exploding head syndrome. My boyfriend has it too.

By anon321794 — On Feb 24, 2013

I don't know what is going on with me, but when I go to sleep, I wake up gasping for air. But before I wake up, it is like a explosion in my head and everything goes black, then I wake up. I don't feel any pain to my head or chest, but I have a hard time going bake to sleep. I do have sleep apnea, and I spoke to my doctor about it. We are going to try sleep lab. I am over 50 years of age, and have had at least 10 episode over a year's time.

By anon311719 — On Jan 03, 2013

I have panic/anxiety attacks where I'm asleep and all of a sudden I feel my chest tighten. It's like I can't breathe, yet I'm able to breathe. I also feel like I have to curl up in a ball and I feel the pain radiate through my back and through my stomach. I have been having them since I was 13 and now I'm 30.

Over the years, I have learned to cope with this issue. I learned how to control my breathing and understand in the midst of the attack that it's just that: a panic/anxiety attack. I have been to the ER as most of you have been and they run their tests only to tell you that there is nothing wrong with you. It is just an anxiety/panic attack.

However lately, I've been having them consecutively right after one another. They may last 5-10 minutes but when you add five attacks together and maybe a few minutes between those attacks, it adds up. Last night was the first time I had five of them back to back and I dealt with it for two hours. I only used to have one at time, then it increased to three at a time and now it's five at a time. Has anyone else encountered this issue with their anxiety/panic attacks?

By anon311068 — On Dec 29, 2012

I am 13 and I suffer from an unusual type of anxiety. I get very shaky and worried when everyone else in my house is asleep. I can't seem to calm down and get to sleep and I have sometimes even not slept all night because every time I shut my eyes, my heart races and I think to myself "here we are again." Throughout the day I dread sleep time and my parents are not very understanding and it's hard to explain the feeling that I get.

The feeling is like worry, but I don't know what it's about. Say if you are going on a big roller coaster or something, it is like that. I experience this on a on off, on off pattern, or sometimes every night for a week.

If someone else sleeps in my room or I share a bed I am fine and if I sleep somewhere else, I am also fine.

I don't know what triggers it but I hate it. I have even been sick a few times with fear. I don't know what to do anymore as it is ruining the fun I have day to day.

By anon295005 — On Oct 04, 2012

I'm a 22 years old boy from smallest country among the South Asia(Nepal). My problem is that when I sleep and wake up in the morning or sometimes I sleep in the afternoon. Then, I go to the toilet or somewhere and I faint down. My mother doesn't know when I faint or becoming unconscious. What kind of disease is it? Please, kindly tell me a solution.

By anon292096 — On Sep 18, 2012

@Anon288653: It's called sleep paralysis. You can research it. I actually got used with it. Also, check out lucid dreaming and astral projection.

By anon288653 — On Aug 31, 2012

I've been searching the internet but I couldn't find anything that I had that was exactly like it. I go to bed at the right time but something seems to annoy and scare me a lot, making me scared of sleeping. This happens almost every single day when I sleep.

I'm lying in bed and I feel as if my eyes are open but I can't move (I know that it is happening again), I can't talk or scream but I can twitch my fingers a little bit. Then after a while of being paralyzed, I hear a noise which increasingly becomes louder (it can be a bang, high frequency sound or beeps- it depends) and then I feel that my ears are exploding even though it doesn't hurt.

Then I try to bring myself back, which sometimes works and sometimes doesn't and then I wake up, scared but drowsy. There is a feeling when I know it is going to happen again. I can't describe it but if I fall asleep right after this happens, it repeats. I once fell asleep three times in a row and had to experience this three times. When I force myself to stay awake for a few minutes, it doesn't happen again. Does anybody know what this is?

By anon284033 — On Aug 07, 2012

Lately I've been having these attacks while I'm sleeping. I feel like, instead of me sleeping, I begin to do other things but really I'm asleep. The first night I had an attack, I felt as if it was so real. I was in the backyard. I came in and everyone in my house was sleeping and for some reason I said, Turn on the lights,” because I couldn't see. Nobody answered and for some reason, I felt my mom was there in the room with me. In my dream, I begin asking my mom to hold my hands and forgive me for all that I've done and she wouldn't respond to me. In my sleep, I felt I was being loud, and I felt that everybody in the house heard me talking and crying at one point. Out of nowhere, I snapped out of it and I walked back my to room thinking, “What just happened? Did I just do what I think I just did?” It just seemed so real. I walked back to my room and everyone was sleeping.

The next day, everybody in my house told me they didn't hear anything. It's weird, because when I snapped out of it completely, I was in between both twin beds in my room, just standing. Then a night after that I dreamed I was in bed and out of nowhere I fell asleep. In my dream, I saw myself get up quick and start yelling to my sister, who was next to me, not to open it, or I was trying to stop her from something and out of nowhere again, I snapped out of it thinking again, “What did I just do?” Since my sister was awake, I asked her, “Did I just tell you not to open something or yell at you?” and she said no.

The night after that, I had another weird, scarier dream. My sister said before I went to bed I started doing weird things. I went to get my clothes or shower and instead of walking to the shower, I stood at the door of our room and I started opening and closing the door and my brother was there standing next to me looking at me, wondering what I was doing. My sister then said after that that I just threw myself on the bed and fell asleep. I don't remember doing any of that, nor do I remember seeing my brother next to me, standing and just watching me.

The next thing I remember was I could hear voices coming and going, and in my head, my vision was blurry. I could feel me moving my leg like it was weak and just falling. What scared me the most is out of nowhere in my head, I felt like something said to me, ''You're going to die right now.” As soon as I felt death coming to me, the person I asked for was my mom. I began to say. “Where's mom at? Call my mom.”

In my head, during my sleep, I began to see so many colors and I could feel my hands moving and I was saying, “Mom, can you feel me holding you?” Because I felt like I couldn't feel anything and I couldn't see anything. I asked her, “Do you feel me holding you?” while I was putting out my arms as if I were holding somebody. Then again, I began snapping out of it slowly. I began to see my mom was not in my arms, and I was able to see again and before I started seeing naturally again I could only see black and white. I started like panicking, getting off my bed and saying, “Where's my mom?” I started saying, “I'm OK! I'm OK! Where's mom at?” I saw my six year old sister was scared because I started asking and yelling for my mom. I remember grabbing my sister telling her, “No, I'm OK” and as I ran to my mom's room, I saw all my brothers and sisters crying.

I ran into my mom's room and I grabbed my mom telling her, “Mom I'm OK, I'm OK” and then I started yelling out, Where's my mom? Where's my mom?” I was going crazy like panicking, and my sister told me that as soon as I ran to my mom's room, I started saying, “Where's my mom? Where's my mom?” and then I began to panic. I started throwing myself around asking for my mom.

Between my mom and sister, they had to hold me until I calmed down. Then once again, I snapped out of it. I started hugging my mom, and all my brothers and sisters because I felt I had dodged death. I felt like I was about to die. I felt I had survived something and I wasn't going to die because I survived. What scares me the most is it feels so real because I'm in my bed, and it's like if I really haven't gone to sleep and I just begin doing these things and when I snap out of it I don't even remember what I had done. Can somebody help?

By anon283134 — On Aug 02, 2012

I am 40 and mine started at around age 5. They began with a huge explosion that left me alone in the universe in total blackness. Or Spock from Star Trek would hit the roof of my house with a device that created a sonic boom and planned to kill my family. Very terrifying.

As I became a teen, whatever was in my hand in my dream was suddenly in my mouth and going down my throat: needles, broken glass, film cartridges, etc. Each time, to stop the sleep panic, I had to get a glass of water. As I got older, got married, had a son, and this swallowing issue grew to become a government requirement to take medication. So, I would dream that my family forgot to take the medication, which meant we could all die. I would even go to my husband and son and ask them to take the imaginary pill that was in my hand. Fortunately, there was nothing in my hand. I even told my son that if I tried to give him a real pill at night to not take it. I didn't mention that I would go from sleeping soundly to sitting or standing on the bed and my husband restraining me. He is very kind to do this until I awaken. I think I am not breathing, but he tells me I am.

I realized in the last few years that in these dreams I am in a land of no oxygen, and as I am waking up, I am transported to my bedroom where there is oxygen, but the gasping for air is what makes me think there is none. I am shaking uncontrollably and my heart is pounding out of my chest. I really have felt like I am dying and even have told my husband this during such episodes. These days, I am on Lamictal and occasionally Xanax (which may have triggered the pill panics). These have helped, though, and I have learned to cope quite well. I still have these attacks, and still wake up my family, but as soon as someone tells me everything's okay, I can go back to sleep without even fully waking up. Sometimes I do still need water. I don't understand it, but there it is.

I do not have panic attacks in waking life. However, I sometimes can't breathe, which feels like one is starting, but deep breaths take that away pretty quickly.

By anon273068 — On Jun 04, 2012

For the past couple of months, I have been experiencing these odd 'episodes.' Do they sound like a panic attack to you guys?.

I get to that point when I'm almost unconscious and asleep, not completely gone, but past the point of coherent thoughts. It feels like I'm having a really really intense head rush, like I'm fainting. Everything around me is muted and I can't see very well, and everything is in slow motion.

Sometimes I'm in my bed, or sometimes standing outside. I always fall down/faint and I can feel my consciousness fading and the ground coming growing closer. Eventually, I think I can feel myself waking up, or coming back from fainting, or the head rush. Sometimes I try and get myself up to get help, but I am so physically weak I can barely manage to push myself up and stumble out of my room. I then always fall down, and everything is slow motion, and there is no pain when I hit the ground, although I know there should be. About this point, I become fully awake/snap out of it and realize that none of that actually happened and I'm actually in bed, and it was all in my head.

By lauralai79 — On Feb 16, 2012

I had them six or eight times every night for the last two months of my pregnancy with my daughter a few years ago. I was ready to down a bottle of sleeping pills by the end of the pregnancy, just to get some sleep! Luckily, she came just in time and the attacks pretty much stopped.

I'm now 27 weeks pregnant, with 12 more to go before my c-section and I'm having them again. I've tried talking to someone (because we do have a lot of stress going on right now) but that doesn't seem to help. I hate waking up and feeling scared, especially when I can't breathe, I'm having chest pain, nausea and I feel like if I pass out, I won't wake up. I'm tired of these.

I already have a 3 year old with Autism who barely sleeps, which has made me sleep deprived. I don't need this too.

By anon238651 — On Jan 04, 2012

I have had panic attacks infrequently in the past, but recently woke up in the middle of the night with what felt like pressure waves going through my head in waves, a very strange feeling, then I got up and measured my pulse and found that I had a pulse of 180 for no reason it was very worrisome.

I tried sitting down on the floor to try and calm down and it felt like I would be harmed by such a fast pulse occurring for no reason and I live alone so I called 911. They arrived seven minutes later with about eight people coming in the door. They checked a bunch of things, including my blood sugar, which were all normal except my blood pressure was a little high, probably because of the fast pulse because otherwise my blood pressure is normal.

After seven hours in the ER, with blood testing and other checks they said I most likely have a thyroid problem, but for the short-term, they prescribed xanax to use as needed. I have a thyroid that is larger than normal. Next time I would like to just take one xanax right away (used rarely) and try and calm down without the $2,000 incurred with every ER visit. I don't want to rely on xanax, but only just as needed to avoid the panic/ER expense. I have an endocrinology follow up.

By anon164437 — On Mar 31, 2011

I'm 16, and i had my first one a month ago and i knew what it was because my brother suffers from them. i was terrified to sleep for a week, but i got over it, then at the beginning of the week, it happened again and then it happened last night, which was scary, because after it happened i told my sister. She said move on your side, and as i moved it happened again and i was awake and if i tried breathing it was very painful. I've seen the doctor, but he thinks i could suffer from side effects from tablets due to low blood pressure, so I'm stuck and scared to sleep.

By anon157559 — On Mar 03, 2011

I had one last night that was super intense. The worst feeling I've ever had in my life, and I've had plenty of anxiety and or panic attacks in the past. This is the first time it has happened to me. I woke up and as soon as I opened my eyes, I immediately realized I was having an extreme panic attack. I also felt like vomiting but held it.

Panic and mental disorders run deeply in my past family members and ancestors. It's genetic, I guess. I guess I'll just have to cope with them for the rest of my life because I don't like medication. I only see medication making things worse and making the attacks worse and more frequent when not on the medication, making you become addicted to the drug.

By anon141222 — On Jan 09, 2011

I'm only 15 and I've had about five since early last year. usually i wake up randomly and it starts off as if someone is stepping over my body then i can't move or talk as hard as i try no words will come out and my heart begins to beat rapidly. I'm thinking of going to a therapist.

By anon129056 — On Nov 22, 2010

I had an attack just last night. I realized it was a dream as soon as I screamed. Went back to sleep but the rest of the family woke up. I have them three to four times a month.

By anon128882 — On Nov 21, 2010

I never knew that this was a serious medical condition till I stumbled upon it. I've had one panic attack that I can definitively say was a panic attack while I was awake. It now occurs to me that this happens to me very often in my sleep. I sort of wonder how closely this condition is related to sleep walking.

By anon113144 — On Sep 23, 2010

I have sleep panic attacks almost every night, sometimes two or three in one night. I didn't know they were called sleep panic attacks until I saw Russell Brand have an attack in the movie "Bedtime Stories." I had one last night which led me to search the subject.

I've had so many that when it happens most recently, I already know it's a dream and can immediately go back to sleep, without worry.

By anon58473 — On Jan 02, 2010

Ugh. sleep panic attacks were the worst for me, and medications helped, but they only reduced the frequency of them.

This is a great resource and really does describe the symptoms well. Make sure you talk to a doctor if you have symptoms of panic attacks while sleeping. -Sarah

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