# Panic attacks at bedtime



## sherrywhite20 (May 6, 2012)

I've been suffering from panic attacks at bedtime for around a year now. When they first kicked in I was getting CBT for my SA and told my therapist about them. I had no idea what was going on but she told me she though it was likely panic attacks.

It is absolutely terrifying when it happens, and it only happens at bedtime. If I am going for a nap I am fine. If I know I am going to be sleeping for a full 7-8 hours I get very anxious. It's like because I know I'll be out for so long (and likely coinciding with my fears of someone breaking into my house and killing me) I get more afraid of shutting down. 

Usually it happens just after I doze off. I'll wake up suddenly, sit bolt upright (like a jack-in-the-box) and my chest will be pounding so hard and fast I feel as though I'm having a heart attack (or what I perceive that to feel like, with less pain). It doesn't help that this is often accompanied with pain down my left arm, shoulder and armpit, usually signs of a heart attack. I usually think I'm dying, and because I've just woken I am unable to think rationally. I convince myself this is it for me, and I nearly got my partner to call and ambulance the other day as I truly believed I was dying.

Sometimes I'll just lay there and cry, other times I try to go straight back to sleep and it happens again and again until I give up, and other times I get straight up and pace or talk to my partner. None of it really helps.

My sleeping pattern is so messed up. Just the other day I was totally back to front, fell asleep at 4pm, got up at 1am for breakfast. Yesterday I slept from 4pm-9pm and then again at 3.30am-7.30am. I just want to feel normal again. It is difficult to commit to doing anything when I have no idea how zombified I'll be. The other day we were supposed to go out and it took me 4 days to manage it because I was so sleep-deprived during the day. This just adds to my sense of failure, and along with the SA is really getting me down.

I try sipping Horlicks or Ovaltine at bedtime as it is supposed to help you wind down, but I get so anxious beforehand and I cannot think this helps me any. I also have checking OCD (which I am currently trying to fight) so even if I get sleepy on the sofa before bed, I then wake myself up again by wandering the house checking all the doors are locked, light and switches are off etc. 

I'm firmly at a loss. 

Apologies for the essay, just really had to get all that out. 

Any other sufferers of this horrible condition, either with hints/tips, or just to share and know we aren't so alone in our suffering.


----------



## Music Man (Aug 22, 2009)

You could ask your doctor for melatonin which helps to get your sleep pattern back on track (take 1 hour before bed).
You can get it over the counter in America but in the UK you need a prescription.

Also, maybe an underlying fear which you may or may not realise is worrying about death, as in going to sleep and not waking up, which is quite a common fear.

Have you ever had a break in?
If not then you can tell yourself - don't worry, it's never happened before I'll be fine. May not feel like it will work to begin with but eventually it may work.

Things like this can take time - I used to have common panic attacks every day and only after 9 years is it pretty much under control.

What is your room like?
As in the temperature at night, humidity etc

Is your bed comfortable and did your room feel a relaxing place to be before you had panic attacks?


----------



## sherrywhite20 (May 6, 2012)

Thank you for all your suggestions and for taking the time to respond Music Man.

Firstly, melatonin- I am very much against using any sort of chemical remedies. I have tried herbal remedies but I have a real problem with swallowing tablets so it often puts me off taking them. For reference I have used Valerian. I'm not sure if they actually help or if it is more of a placebo effect. They generally just made me feel a bit more relaxed. 

As to your suggestion that there is an underlying fear of death- This is very possible. I am terrified of dying and I often feel like I am going to die young. I'm not sure why, it's just a feeling I get.

I've given this a lot of thought, trying to come up with possible catalysts for the attacks and your question of whether or not I've had a break in brings this to mind.

Although we didn't have an actual break in, years ago my mum and siblings had gone to sleep and I was the last one up and was laying reading in bed. Literally within a couple of minutes of me turning my bedroom light out (which was at the back of the house) some guy tried to get in our back door, which opened into my mum's room. It woke her and we called the police and noone was caught but it always terrified me thinking this guy likely knew there were people in the house because the timing was too coincidental. I always wondered why if you just wanted to steal things you'd knowingly break into a property with people inside (and not, say, somewhere where the residents have gone on holiday), and it made me wonder if his intentions were far more sinister than that. 

Another thing that could be a catalyst- My mum's partner had a heart attack while in bed and died in his sleep. He had spent the entire day thinking he'd strained himself as he had muscle pain all down the left side of his upper body (he worked in construction). He didn't stay with us at the time, so he went home that night and we never saw him again.

These are two things I can think of which clearly link in with my OCD (checking the door), my fear of intruders and not being awake to hear a break in, my fear of having a heart attack and dying young, and perhaps like you suggest the fear that I wont wake up again if I sleep. 

But I have no idea what to do with this knowledge, or how to use it to help myself. 

And finally, about my room- I think the temperature is ok. We had it too hot for too long but that has been sorted for a while now. And I find the room relaxing so I don't think that's the issue.

I think I answered all your points now. Thanks again for your time. I think for now perhaps trying the Valerian again will help me, but it is only short term. In the long run I have to deal with the issues behind this. I guess that is the uphill struggle.


----------



## Music Man (Aug 22, 2009)

You've mentioned a lot in your post and these things are would be useful to talk to a counsellor about (find a good one as I know some are not that good).

Also, about melatonin, it's a natural substance which is made by our brain - the levels build up during the day until they reach a certain level, which makes you sleep at night (usually, although sometimes your brain can mess around causing your sleep pattern to change). Melatonin 'medication' can put it back to normal.
It's fine to use because (as mentioned), it's a natural substance our brains produce and it's not addictive, you can take it whenever you want.

It helps you to sleep but it does not affect anxiety levels.


----------



## tennisfanatic27 (Jun 11, 2012)

Panic attacks can get you at anytime. I more so have panic attacks the moment i wake up in the morning. Has there been something in your past that you feel guilt or shame over that you have not confronted or gotten over? More or less what i am trying to ask is...is there something that you did to someone or maybe even yourself that you are not able to get it out of your head? Just a question of curiosity.


----------



## tennislover84 (May 14, 2010)

Hello. I have suffered from the same problem since I was 11 years old. All the same kind of things that you mention... fear that I'm having a heart attack, or that one is imminent. And often I'll be about to fall asleep, then be struck by this overriding panic that I'm about to die, and will wake up shouting for somebody to help me. I also interpret all my body's signals as evidence that there's something wrong with my heart, etc.

Of course, the signals like noticing my heartbeat or having some aches and pains, are totally normal things that most people just ignore. And some things are bound to be caused by my increased anxiety, like my heart beating faster, or shortness of breath. I also have some pretty specific fears of different ways that I might die, which I won't go into because I don't want you to start thinking about it too. I'm so sorry that you're having the same problem, because we all really need sleep and it's the worst thing to have bedtime turned into something terrifying.

I have spent years staying up into the early hours of the morning, to avoid going to bed, basically. Which has had the result of me feeling like a zombie most days. I've found that if I stay up long enough, eventually I get so incredibly tired that I can fall into bed and crash out straight away. I'm too tired to be anxious anymore.

Obviously I wouldn't recommend doing that. It makes it really hard to function properly during the day, and it's just avoiding the problem. 

It's good that you recognise some of the things that have happened in your life, that might be triggering these fears. When you asked how you can use this knowledge to help yourself, what my CBT therapist tells me is to recognise that these things are just thoughts, rather than reality. Has your therapist not said something similar? I know it's really difficult. I really do understand. But I think reminding and reinforcing to yourself that these things are only thoughts, is probably the best way to cope with it better.

Again it is just thoughts that you're having, so remind yourself of that when the panic attacks are happening. Also, remember why you're probably having these thoughts. It does really help if you can sort of analyse what is happening and why, while it's happening. Then you can start to counteract the thoughts, by remembering things that would suggest you're not in any danger of a heart attack. You know... if you really had a heart problem, you'd probably know about it. I know there are always exceptions, and I have this problem of trying to find holes in people's helpful suggestions. But you probably realise that it's much more likely that you're healthy and fine, than in danger of dropping dead. If you've seen a doctor anytime recently and there was nothing wrong, or if you can do exercise, go for walks with no problem etc... all this is evidence that there's nothing wrong with your heart.  You can try to replace your scary thoughts with these more sensible ones.

I hope this helps somewhat. I can't always put these things into practice myself, and I still struggle with panic attacks. But it is a lot more under control for me, after using these strategies. You may still have the panic attacks, but hopefully you'll be more aware of the process of panicking, rather than believing that it's a heart attack.


----------



## Farideh (Nov 13, 2011)

I've had the exact same thing happen to me twice when I was just lying down in my bed. I also thought I was going to die from a heart attack until I tried to calm myself down by wrapping a warm blanket around me and drinking some orange juice. For some weird reason that made my heart stop pounding all fast and I was calm now.


----------



## tennislover84 (May 14, 2010)

Sorry that my post is so long. I've got OCD too, so I try to make sure I've mentioned every last thing, lol. Which is maybe why I'm making this post. But I think it's important enough to do so. 

I just want to add, when you feel like you've failed because you were too tired to do something... please remember you had a good reason. Anybody who was suffering this kind of thing would struggle to get enough sleep, and consequently struggle during the day too. You haven't asked for this to happen to you, and I'm sure you are doing your best. Forgive yourself for your understandable difficulties, and just try to face the problem  That way things can get better.


----------



## sherrywhite20 (May 6, 2012)

Thanks for all the responses and advice everyone.

Firstly, *Music Man*- Thanks for explaining to me what melatonin is. Now that you mention it I remember hearing about melatonin and seratonin, both chemicals naturally produced by our brain, although I am more familiar with seratonin, the happy chemical! Now that I better understand what melatonin is I will certainly consider giving it a shot. I had assumed it was sleeping pills, something I'm very much against taking.

*tennisfanatic*- Interestingly there is something in my past that I am ashamed of. Probably many things but this one stands out. You think this could have something to do with my panic attacks? I don't really see any link but am open to being corrected.

*tennislover*- Thanks for the time and effort you put into those well thought out responses. Your posts have made me feel so much better!

When I am awake I know that I do not have any heart problems. I can be rational then. But when I am woken up with my heart pounding in my chest, pain in my left arm, a feeling of someone sitting on my chest and just generally feeling very disorientated and frightened it is more difficult to rationalize, and that is probably when I need to do so the most. I'm sure you understand this with your own situation. I really believe I am dying during the attacks. It's almost a certainty in my mind.

But thanks for reminding me not to be so hard on myself when I am unable to get things done during the day due to sleep depravation. It is good to relieve myself of some of the guilt I feel because this only adds to my worries and stresses, and that most certainly does not help my recovery. You have put things into perspective for me. :yes

And you have given me a lot of great advice which I intend to use well, so I am going to practice a few of the things you have suggested. Wish me luck with it, and although I undertsand you've been having them for 17 years, I wish you all the best too in your fight against the attacks. May we both see the other side. 

*Paloma*- Thanks for your tip. I will be sure to try it out, and I do hope your attacks are just a one-off.


----------



## tennislover84 (May 14, 2010)

Yes, good luck!  And although I've suffered with this for a long time, it's because I'd never gotten any help with it all that time. Things can improve, and I really hope it will get easier for you.


----------



## joenonymous (Jul 13, 2013)

http://www.medlink.com/medlinkcontent.aspttp://www.medlink.com/medlinkcontent.asp experience what i have thought are panic attacks at bedtime. i also suffer from chronic insomnia, and i take stimulant medication for a.d.d. due to my lethargy and lack of focus during the daytime, especially in the afternoon. strangely my stimulant meds started making my insomnia go away. my doctor is now theorizing that i may have narcolepsy, explaining all my symptoms. my panic attacks may actually be a mild version of sleep onset paralysis that makes me feel like i can't breathe*, and my inattention may be due to never sleeping properly at night or by entering waking "microsleep periods" during the daytime. i am now on narcolepsy trial meds and sleep feels different and i feel more wakeful during the day. i am going to have a sleep study to confirm. you seem to have narcolepsy symptoms, including terrifying sleep onset hallucinations. you should see what a doctor thinks. if you are so opposed to meds, daytime napping can be a partial treatment.
*"Sleep Paralysis" article at medlink.com


----------



## Cletis (Oct 10, 2011)

This is very common and treatable. See your doctor about some sleeping pills or some benzos. SSRIs are slower to take affect but are longer lasting and are best for long-term treatment of anxiety related issues.

Good luck.


----------



## StacieM (Jul 26, 2013)

I used to have panic attacks at bedtime as a teenager. I had this intense fear of not being able to go to sleep, resulting in me being exhausted in the morning. It eventually went away. It was horrible.


----------

