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. Worrisome thoughts or fears may keep you from falling asleep at night. While troublesome symptoms of panic and anxiety can wake you from your sleep. Are persistent fears, anxiety symptoms, and panic attacks preventing you from getting the rest you need?

The following describes some common sleep issues for people with panic disorder, along with ways to cope and treat them.

Is Worry and Anxiety Keeping You Up?

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. You may find yourself worrying about many aspects of your life. 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 even lead to sleep disturbances, such as ​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:

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

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, including:

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.

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

Nightmares

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.

Treatment

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.

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.

Was this page helpful?

Article Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy 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). Treasure Island, FL: StatPearls Publishing. Updated July 3, 2019.

  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 anticipationThe Journal of Neuroscience. 2013;33(26):10607-10615. doi:10.1523/JNEUROSCI.5578-12.2013

Additional Reading

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: DSM-5. Arlington, VA: American Psychiatric Publishing, 2013. 124-125, 156. Print.

  • Cervena K, Matousek M, Prasko J, Brunovsky M, Paskova B. Sleep Disturbances In Patients Treated for Panic Disorder. Sleep Medicine. 2005; 6(2),149-153. doi: 10.1016/j.sleep.2004.08.008.

  • Papadimitriou GN, Linkowski P. Sleep Disturbances in Anxiety Disorders. International Review of Psychiatry. 2005; 17(4), 229-236. doi: 10.1080/09540260500104524.