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Nocturnal Panic Attacks
Q.
Sometimes, at night, usually when I go to bed on the early side, I
can wake up with a full blown panic attack--short of breath, feeling
unreal, and knowing that this is the big one. It is so scary and
sometimes I think I will not make it through one more. Are these
nighttime attacks common? Also, my chest and neck seem to be red and
flushed all the time. Is this normal?
A. We can't diagnose, but from the sound of your letter it
does appear as if you are having nocturnal panic attacks. There is
no doubt they can feel very violent. They are very common in people
who have spontaneous panic attacks and some people do go onto
develop Panic Disorder as a result of the fear of them.
It is very important for you to have had a full medical check up
to ensure there is no physical cause for the attacks. Once you have
been diagnosed as having nocturnal attacks, it then becomes a matter
of learning to manage them. There is research which suggests (and
with which we agree with 100%) that the nocturnal attacks happen on
the change of consciousness--as we either move into sleep, known as
the hypnogognic state, or as we move from REM sleep to deep sleep or
deep sleep back to REM. The attacks are not associated with dreams
or nightmares, but happens, as we said, on the change of
consciousness. One research study (again, with which we agree) says
it is the magnitude of the change in consciousness which can create
the symptoms.
People who develop this type of attack usually have a history of Dissociation.
That is, they have the ability to self-induce various trance states,
though they may not be aware of their ability to do this.
We do understand what the experience is like, because we also
experience them ourselves. Although the attacks can feel like the
'Big One', the one which we feel it is going to cause 'massive'
physical problems. They don't. Personally, we have now learned that
when we wake up from them to say to ourselves, 'ok I'm having an
attack,' and simply turn over and go back to sleep!
They can manifest in many different ways and it is very common
for people to have a red face and/or neck as a result. The secret is
to lose the fear of them.
Bronwyn Fox's book, 'Power
over Panic' is, as far as we are aware, the only book about
Panic Disorder on the market which deals with the nocturnal panic
attack and dissociation and teaches people how to manage the
attacks.
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