Why Panic Disorder and Anxiety Cause Sleep Issues

woman checking phone from bed in the dark

Adam Hester / Blend Images / Getty Images

People with panic disorder, panic attacks, and other anxiety disorders are often susceptible to sleep issues. These can include insomnia (difficulty falling asleep or staying asleep, or both), panic attacks, or other sleep problems. Since lack of sleep may exacerbate symptoms of anxiety, it is important to try to treat these sleep problems.


Many people with anxiety disorders have a difficult time managing negative thoughts and worries. People with panic disorder are often all too accustomed to the uncomfortable feeling of frequent worrying. Perhaps you worry about events that have passed, your current situation, or what is ahead in your future. You may worry about your career, relationships, and other responsibilities in your life.

Regardless of the source of your worry, these feelings of uneasiness can also be a source of stress that prevents you from getting a good night’s rest. Worrying at night can make it difficult to shut off your mind and get the rest you need.

Troublesome thoughts can lead to insomnia, making it difficult to fall or stay asleep over prolonged periods of time.

Nocturnal Panic Attacks

Panic attacks are the main symptom of panic disorder but can also be associated with other mental health conditions, including agoraphobia, depression, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and specific phobias. These attacks may also be linked to a medical condition, such as irritable bowel syndrome (IBS) or gastroesophageal ​reflux disease (GERD).

Panic attacks are often experienced through a combination of physical, mental, and emotional symptoms. Typical somatic sensations that occur during a panic attack include:

  • Chest pain
  • Dizziness
  • Excessive sweating
  • Feelings of numbness and tingling
  • Heart palpitations
  • Nausea
  • Shaking
  • Shortness of breath
  • Trembling

You may become frightened and have symptoms of depersonalization and derealization, experiencing a sense of disconnection from yourself and reality. When panic strikes, a person may also fear losing control, going insane, or even possibly dying from these symptoms.

Nocturnal panic attacks share the same symptoms as panic attacks that occur during the day, but they occur when a person is asleep.

Waking from a panic attack can heighten fear and anxiety, potentially leading to sleep issues. When awakened from a panic attack, a person may find it difficult to fall back to sleep. If this occurs regularly, the person may become prone to sleep deprivation.

Related Sleep Disorders

Nocturnal panic attacks have been linked to other sleep disturbances.

Sleep Apnea

Sleep apnea, one of the most common sleep disorders, causes a person to have a sudden break in breathing or extremely shallow breath while asleep. Some of the symptoms of sleep apnea, such as shortness of breath and feelings of suffocating, overlap with that of nocturnal panic attacks.

Sleep Paralysis

Sleep paralysis occurs when a person becomes consciously awake but cannot move, speak, or gain control over the body. When sleep paralysis occurs, a person may become afraid of being moved or fearful of never waking up.

Sleep paralysis often sets in as a person is either falling asleep or waking up and is caused by a disruption to the sleep cycle. This condition includes sensations of choking and fears of losing control.

Sleep paralysis may be a sign of narcolepsy, so it warrants a sleep study if you are experiencing it.

Some studies have found a significant co-occurrence between sleep paralysis and anxiety disorders, including panic disorder.


Scary or upsetting dreams may occur with the onset of nocturnal panic attacks. A person may awaken from a nightmare and begin experiencing the uncomfortable symptoms of a panic attack, such as excessive sweating, accelerated heart rate, or overwhelming fear and anxiety.

Night Terrors

Night terrors are more common among children but can be present in adults, too. Much like nocturnal panic attacks, night terrors involve intense feelings of fear and apprehension, trembling, sweating, shaking, and feelings of fear and dread.

Night terrors are different from panic attacks in that they occur during a severe nightmare and often involve screaming, thrashing movements, and crying. A person experiencing night terrors is often unaware of their symptoms, which subside once they awaken.

It is important to note that night terrors occur outside of dream, or REM sleep and that is what distinguishes them from nightmares.

Treatment for Sleep Issues

Sleep disturbances and anxiety can form a vicious cycle. People with panic disorder and those who experience anxiety often have trouble sleeping and the resulting sleep deprivation can result in more anxiety and exacerbated symptoms.

If you believe you have developed a sleep disturbance and/or are experiencing the symptoms of panic disorder, anxiety, and panic attacks, consult with a mental health professional. Medications for panic disorder, such as antidepressants and anti-anxiety medications, may help ease the severity of your nocturnal and daytime panic attacks.

If you think you might be experiencing sleep apnea or sleep paralysis, you should talk to your doctor about having a sleep study or multiple sleep latency tests to rule out those conditions.

If you or a loved one are struggling with anxiety or panic disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. 

For more mental health resources, see our National Helpline Database.

Attending in-person and online anxiety support groups and psychotherapy can also help you learn ways to stop worrying, acquire good sleep hygiene, and learn effective strategies for getting through panic attacks.

7 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Mellman TA. Sleep and anxiety disorders. Psychiatr Clin North Am. 2006;29(4):1047-58. doi:10.1016/j.psc.2006.08.005

  2. Cackovic C, Nazir S, Marwaha R. Panic disorder (attack). In: Statpearls [Internet]. StatPearls Publishing.

  3. Levitan MN, Nardi AE. Nocturnal panic attacks: clinical features and respiratory connections. Expert Rev Neurother. 2009;9(2):245-54. doi:10.1586/14737175.9.2.245

  4. Su VY, Chen YT, Lin WC, et al. Sleep apnea and risk of panic disorder. Ann Fam Med. 2015;13(4):325-30. doi:10.1370/afm.1815

  5. Allen D, Nutt D. Co-existence of panic disorder and sleep paralysis. J Psychopharmacol (Oxford). 1993;7(3):293-4. doi:10.1177/026988119300700310

  6. Llorente MD, Currier MB, Norman SE, Mellman TA. Night terrors in adults: Phenomenology and relationship to psychopathology. J Clin Psychiatry. 1992;53(11):392-4.

  7. Anwar Y. Tired and apprehensive: Anxiety amplifies the impact of sleep loss on aversive brain anticipationJ Neurosci. 2013;33(26):10607-615. doi:10.1523/JNEUROSCI.5578-12.2013

Additional Reading
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: DSM-5. American Psychiatric Publishing, 2013.

By Katharina Star, PhD
Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness.