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Forum Name: Psychiatric Topics

Question: Panic Attack During Sleep


 ctan - Thu Apr 10, 2008 2:46 am

I've read of a bunch of posts by people who have similar attacks like mine, but i haven't read of any cure..any help would be greatly appreciated. things are getting bad.
in my lifetime i have had 2 panic attacks (or what i perceive to be panic attacks, i am pretty sure though) during the day, both times occurring during the first (and last!) two times i smoked marijuana. in those attacks i would have a severe pounding headache that escalated the more i...thought. imagine not being able to think, every thought, the more complex, made the headache hurt more. I could not even form complete sentences, the pain would be too intense after several words. i remember trying to form words to describe what i was feeling at the time but not being able to because of the pain. after a point i tried to escalate the pain by thinking more complex thoughts because i wanted to pain to be over and i WANTED to die. i'm not suicidal at all normally, the pain was just too great at the time. worst experiences ever. after those attacks, for the next week i would occasionally wake up during sleep with a numb sensation throughout my body, such as not being able to feel my leg. after a week or so it would stop.

nearly two years have passed, and i have not had a single attack. i usually stay away from caffeinated beverages, and rarely drink coffee.
last week i had a glass of fairly strong coffee. the night after i had a dream of being a kind of programmed human in a futuristic world, forced to follow orders programmed in my brain although not wanting to. i would struggle with those orders, and the more i struggled, the more pain i would feel. the pain was very very real, it was an escalating pain that made me think i was going to die. i would then wake up in a high state of alert, and feel.. delayed. Delayed as in i would touch my face and not feel it until a half second later. kind of an Almost-Numb. of course, i attributed this dream to just being a dream. the next two nights the SAME things happened with different dreams (very creative dreams, but i will not go into those). So it has happened 3 times in the last three nights, and i know now something is wrong.

things i have noticed:
these panic attacks during sleep do not occur in REM sleep, i usually wake up from these 2-3 hours into my sleep.
before waking up, i would be *awake* but my body is paralyzed. i would struggle briefly but then i rationalize and try to breathe slowly and come out of it. eventually i do.

i feel like because of the escalating headache, one of these times a blood vessel will pop and i'll just die. either that or become a vegetable. or maybe paralyzed (because of the numbing and delayed sensation). this has got me scared and i need to know if this is a rational fear or what.
 Dr. E. Seigle - Fri Apr 11, 2008 10:29 am

Dear ctan,

Typically panic attacks, which can occur at night, are characterized by a rather sudden onset of intense anxiety or feelings of impending doom or death, shortness of breath, chest pain or tightness, dizziness, numbness and tingling, mental disorganization, trembling, palpitations,feelings of unreality or of going crazy, and hot flashes. They are not typically inclusive as headache as the sole feature or even a prominent feature. People with panic disorder, or those prone to it, can experience their being triggered by caffeine. They can occur during the day or during sleep. Typically, they come "out of nowhere", without a definite trigger, though often there are situations which can trigger them.

Your experience of severe headaches appeared triggered by substances on three occasions. Caffeine and marijuana preceded them. It sounds like you had a couple of nighttime headaches without a chemical trigger. Based upon the description above, if you think you have panic disorder, you should consider consulting a psychiatrist or psychologist. If headaches are the issue, consider consulting your primary care doctor or a neurologist.

By the way, there is a phenomenon known as sleep paralysis. One wakes up, but cannot move. They are, in fact paralyzed, because during REM sleep when you dream, the body is normally paralyzed, allegedly so we don't thrash about during dreaming. Only the eyes can move, hence the name, "Rapid Eye Movement" phase of sleep. The sleep paralysis goes away after a short while, as you have noticed.

Once in a while, a group of three symptoms occurs in people who have narcolepsy (suddenly falling asleep during daytime wakefulness). They are sleep paralysis, suddenly losing muscle tone during wakefulness and falling down (known as cataplexy) and falling asleep muliple times during normal daytime wakefulnss. I mention this on the small chance, very unlikely, that you may have had these symptoms. If not, don't worry about it.

So, thanks for contacting us, good luck!

-Eliot Seigle MD

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