Pyjamas? Check. Alarm set? Check. The fear? Check.
February 28, 2011 7:48 AM   Subscribe

Am I having panic attacks while I am sleeping? Is that possible? Is this something else to get all anxious about? Or is it merely the onset of normal, adulthood worries?

Lately, I've been having an issue with what I am going to call Sheer Existential Terror. On a somewhat regular (and, disconcertingly, increasingly frequent) basis, I will wake up in a blind panic over the meaning of my existence and rapidly approaching death.

Example 1: This last Friday, I went to bed mildly fretting about a guy I've gone on two dates with, and who canceled the third because he had a work emergency and couldn't make it to dinner. I was wondering whether he was actually trying to do a polite brush-off, but then told myself that there was nothing I could do about it and that this is a pretty low-stakes/early relationship anyway, so I might as well just relax and wait to see what happens. So I stopped worrying about it, rolled over, thought about whatever, and then fell asleep, until - I woke up absolutely terrified, in a pure panic, with my inner monologue turned up to volume 10, screaming, "You have NEVER been loved, are NEVER going to be loved, and are going to always wake up alone, until the day that you die alone...which will be soon, since you are going to die soon. Maybe NOW!"

Example 2: I was in bed, thinking about whether school is the best option for me, until I decided that the best I could do is roll over, get a good night's sleep, wake up and work on what I have to do, and debate things later. So I stopped worrying about it, rolled over, thought about whatever, and then fell asleep, until - I woke up, in a pure panic, with the monologue screaming, "You are wasting the last precious moments of your life on a program that is sucking your soul and wasting your time! Why aren't you actually out there, living life, doing something actually valuable before you die?! Which will be soon. Maybe NOW!"

The reasons for waking up in a panic vary somewhat, and having included my lack of travel, the current state of the economy, and whether I am managing my finances efficiently, among other things. However, each incident is marked by some commonalities: I always wake up in a panic (this isn't something that happens when I am trying to sleep, nor when in a deep sleep, but am already at least half-asleep, within half an hour of going to bed), I am filled with a sense of absolute panic (feeling like to I want to run away screaming into the night, clutch my pillow and start crying like a lost child, or call my mother), and the concern is always framed in terms of death (both my inevitable mortality and the possibility that I am actually dying right now!).

1. Could this be a panic attack? Generalized stress? Something else? Or is this normal and something that happens to others?
2.'s not possible that I really am dying of some undiagnosed condition, is it? I've also started having recurring dreams in which I die, and every time I wake up, I wonder whether this is a sign of something physical. Could it be?
3. What can I do to make this stop?

Some disclaimer statements: I actually just finished a yearlong round of therapy, and had been hoping to take a break and see how things go on my own. I was not being treated for any sort of anxiety disorder, as I do not have one. And, yes, I am currently in a stressful life situation, but things have actually been getting much better over the last few months, so I don't know how much can be blamed on external stressors. Also - I am not particularly panicky or anxious during the day, but it's starting to get to the point where I don't look forward to sleep, because I am starting to fear that I'll be hit by another of these uncool little incidents of doom.

Thanks. I feel a bit ridiculous for asking, but this is starting to become worrisome. And annoying.
posted by sock puppet of mystery! to Health & Fitness (19 answers total) 3 users marked this as a favorite
Google 'night terrors.' This sounds a bit like the symptoms.
posted by By The Grace of God at 7:56 AM on February 28, 2011

You're interpreting these events as, "I am worrying about x, so I wake up in a panic-like state." But it seems plausible that you have the causal chain backwards: "I wake up in a panic-like state, so I am worrying about x." The human mind is incredibly good at coming up with rationalizations for its condition--could it be that you actually have some physiological disorder that you're mistaking for psychological?

I'd suggest you see a sleep specialist.
posted by meese at 8:04 AM on February 28, 2011 [1 favorite]

Entirely anecdotally, I've heard that certain kinds of vitamin supplements (particularly B) can cause this sort of thing. Have you recently started taking any? Or changed brands?
posted by Lebannen at 8:08 AM on February 28, 2011

the response above should be your first move. but also....

1. Consider that you may be developing sleep apnea, and the breath cessation is being "explain" in your dream with a panic scenario (as you may dream you're swimming if it rains on a camping trip). Try not sleeping on your back.

2. Forgive my laziness in not providing a citation, but the latest sleep research indicates that dreams are a method by which we "practice" daytime scenarios. You can eventually come to see that nothing can actually harm you in a dream. It's all in your mind. Seemingly bad things can happen, but you can neutrally observe it like the movie it actually is (the big secret is that waking life is the same deal....but that's a much harder lesson to learn. In fact, that's the lesson all this "practicing" in dreams is trying to eventually teach us).

If #2 is too speculative/philosophical for you and not news you feel you can actually use, my very strong suggestion is to try meditation. Meditation teaches you to let go, and not let externalities upset and disrupt you. In time, it gets to your dreams. In time, you apply it, per above, to your waking life. Hence "Awakening". I recommend this method, fwiw, which is really stripped down and non-religious/ritualistic:
posted by Quisp Lover at 8:08 AM on February 28, 2011 [1 favorite]

"the response above should be your first move."

I meant the one about night terrors (the subsequent answers came in while I was posting!)
posted by Quisp Lover at 8:09 AM on February 28, 2011

I don't have the references with me right now, but we just studied panic attacks and panic disorder in my abnormal psychology class. I was surprised to learn (as you may be too!) that a high percentage of panic attacks occur while people sleep, or that they are woken up by them. These panic attacks are most definitely not nightmares or night terrors (although it could be any of these options that you're experiencing). WHen I get home to my books I will post more definitive info on this.
posted by whalebreath at 9:18 AM on February 28, 2011

Well I didn't get my books but I did google 'panic attacks while sleeping'.
Things to take from this (if you are having panic attacks):
1. not dying of anything (good news)
2. nighttime attacks will most likely be influenced from events of the day, drugs or alcohol, or a high level of anxiety
3. many people come to fear night/going to sleep
4. to stop them, address root cause of anxiety (or seek therapy for elevated general anxiety...)
posted by whalebreath at 9:30 AM on February 28, 2011

I wake up with panic attacks on a regular but infrequent basis and they feel very like this. I got prescribed a sedating non-benzo anxiolytic for it. I still can't really explain it because I don't really have an anxiety problem normally that I can tell. I wake up with one of those, I pop my pill, I'm back asleep in fifteen minutes. Since I started doing this, they seem to less often be about specific stuff, so I'm inclined to believe in that idea of imposing worries as an explanation for the panic. A friend of mine who sometimes has the same thing says Benadryl works, too, but I haven't tried it. Morning kind of sucks if they happen late enough in the night, but I usually just have an extra cup of coffee.
posted by gracedissolved at 9:42 AM on February 28, 2011

To throw some additional info out there:

I do take a B complex, but I have been taking it regularly for the last three months. It may have made my dreams a little weirder, but this type of existential panic predates the vitamins, anyway.

I am currently reading about night terrors, but I feel I should point out that I don't seem to have amnesia about the event (unless this happens more frequently than I think!) and I have never woken up screaming or crying. At most, I wake up clutching at my pillow like a rat clinging to a sinking ship. And though we can blame this "lack" of screaming on amnesia, none of my exes ever reported waking up to the sound of horrified wailing or anything during our relationship.

And for what it's worth, I have never experienced a panic attack in the daytime.
posted by sock puppet of mystery! at 9:49 AM on February 28, 2011

Are you taking any kind of medicine (not just the vitamins) that could be effecting this? Especially any recent changes? My Wellbutrin causes me to have really vivid and strange dreams, which is a rather common side effect for the drug.
posted by Logic Sheep at 10:01 AM on February 28, 2011

I am going to stop interjecting in a minute, but to address some of the physiological questions: I am a lady, late-20s, in good shape, on no medication (aside from the Mirena IUD and daily vitamins, including a multi, b-complex, and calcium supplementation). I am probably stressed in my waking life, but I would not say that I am marked by a high level of anxiety (nor would my very recent ex-therapist say the same thing). My biggest medical concern would be dry skin, but I blame winter for that. Damn winter...
posted by sock puppet of mystery! at 10:07 AM on February 28, 2011

Chiming in to second the possibility of sleep apnea. The waking up with a jolt of pure terror, gasping for breath, with suffocation/death/misfortune dreams right before happened to me pretty frequently- and I've got the apnea.

See a sleep specialist. They can tell you whether you've got that or give you some insight as to what's going on.
posted by bluejayway at 10:23 AM on February 28, 2011 [1 favorite]

The waking up with a jolt of pure terror, gasping for breath, with suffocation/death/misfortune dreams right before happened to me pretty frequently- and I've got the apnea.

Same here... I had frequent nightmares that I was being strangled/drowning/dying of anthrax/dying of hypothermia and would wake up in a panic.

They stopped once I got my CPAP machine...
posted by Hot buttered sockpuppets at 10:47 AM on February 28, 2011

I have a heart murmur/arrhythmia and it pops me awake in the middle of the night feeling like hell. I used to associate it with I'M DYING THE WORLD IS OVER but now that I know it's my heart, I take a beta blocker (Atenolol) and go back to sleep once my heart chills out.

Surprise, when I went on beta blockers regularly my "anxiety" was reduced significantly.

Before you go to a sleep specialist, I suggest a GP in case it is an issue that needs treatment by another specialist.
posted by the young rope-rider at 10:54 AM on February 28, 2011

OH, I didn't get diagnosed with a heart issue until I was 23 or so. Even now, doctors often don't notice it unless I mention it. Then they can hear the murmur with a stethoscope.

Also, what I have is more technically described as palpitations than an arrhythmia. Maybe they're the same thing. I don't know.
posted by the young rope-rider at 10:56 AM on February 28, 2011

I was first to shout "apnea", above. But I'd urge you to try not sleeping on your back before resorting to machines, etc. I sleep on my side now (with a thin pillow between my knees and a special "side sleeper" pillow beneath my head), and apnea's all gone.
posted by Quisp Lover at 11:09 AM on February 28, 2011

I used to have a similar reaction to drinking too much caffeine (especially when I was working in Rome and drinking Italian coffee all day) and would spring awake in an utter panic in the middle of the night. It took me far too long to figure out it was related to the coffee.
posted by gingerbeer at 11:19 AM on February 28, 2011

I'll step forward with a non-physiological suggestion (although definitely get the physical stuff checked out with a doctor just to be sure) -- maybe you are just really upset about your school program, romantic loneliness, and the other things you wake up terrified about. Like, really, really upset.

So maybe the thing to focus on while awake, possibly in therapy, is what to do about and how to handle these issues in your life. Do you want to be in this program? What are the alternatives? What is going on in your romantic life? How do you feel about past relationships? Are you meeting the sort of people you like?

You seem to be really good at the "it's not a huge deal, so let's be reasonable about it" self talk, which is really good. (Yay!) But try not to minimize too much. Yes, it's not a huge deal and will probably sort it out...

but it also is a huge deal (it's your life), and maybe the purpose of this anxiety is to give you a huge surge of energy to make some big changes.
posted by 3491again at 11:38 AM on February 28, 2011

Considering the possible explanations for this, based on my research and this thread, include sleep apnea, anxiety, heart arrhythmia, sleep terrors, sleep paralysis, narcolepsy, panic attacks, general ennui and dissatisfaction, nightmare disorder, caffeine consumption, and migraines, I might as well get this one checked out by a doctor.

Thanks, guys!
posted by sock puppet of mystery! at 11:42 AM on March 1, 2011

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