A panic attack is the sudden onset of great fear that produces a bodily response. Common panic responses include sweating, shaking and choking. Panic attacks may be caused by psychological distress or medicinal drugs. When these episodes occur during sleep, they are called nocturnal panic attacks. Nighttime attacks can occur as isolated incidents. They can also be symptomatic of an underlying illness.
Partial epilepsy occurs when only one part of the brain shows seizure activity. Such epilepsy is often misdiagnosed as an anxiety disorder because patients typically show symptoms of panic attack. A 2010 case report published in the medical journal "Epileptic Disorders" illustrates the complex relationship between epilepsy and other disorders. A young boy experienced panic attacks about an hour after falling asleep each night. These attacks featured inconsolable crying and errant searching. Yet the patient remained alert and conscious. Diagnostic tests revealed the possibility of partial epilepsy, panic disorder, night terrors or nightmares. Epilepsy was favored because of a positive family history and the efficacy of anticonvulsant therapy.
Nocturnal panic attacks are most commonly associated with panic disorder. These attacks are considered more severe and less cognitive than those experienced in the daytime. A 2008 report in "European Psychiatry" reveals that people who experience nocturnal panic attacks represent a distinct subgroup of patients. These people score higher on obsession-compulsion, anger-hostility and interpersonal sensitivity scales. They also experience more respiratory distress during their attacks.
Sleep paralysis is an unexpected loss of muscle tone during sleep. It is often associated with hallucinations and headaches. While it is a symptom of narcolepsy, it can also occur in isolation. A 2008 study presented in "Depression and Anxiety" indicates that one-third of sleep paralysis episodes also include nocturnal panic attacks. Previous trauma also plays a role in sleep paralysis and nocturnal panic. People who have experienced extreme trauma are more likely to display both disorders.
Posttraumatic Stress Disorder
Posttraumatic stress disorder is caused by exposure to a terrifying event and the threat of physical harm. Former prisoners of war often report symptoms of this anxiety disorder. Such people usually have a difficult time sleeping and frequently experience nighttime panic. A 2009 report in "Culture, Medicine and Psychiatry" describes the sleep-related nightmares of Cambodian refugees diagnosed with posttraumatic stress disorder. These refugees lived through the trauma of being violently forced out of their homes in the 1970s. Years later, their dreams still reflected this violence-filled past. In addition, they often had panic attacks immediately upon awakening from sleep.
Night terrors can be distinguished from nightmares based on the stage of sleep in which they arise. Nightmares primarily occur during rapid eye movement, REM, sleep, whereas night terrors mostly happen in deeper stages of sleep. A 2007 review in the "Annals of Pharmacotherapy" describes a patient experiencing both night terrors and panic attacks. These experiences were apparently brought on by the drug rabeprazole, which the patient was taking to combat indigestion.