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[Quiz](https://www.psychcentral.com/quizzes/anxiety-quiz) - [Symptoms](https://www.psychcentral.com/anxiety/anxiety-disorders) - [Causes](https://www.psychcentral.com/anxiety/causes-of-anxiety-disorders) - [Treatment](https://www.psychcentral.com/anxiety/generalized-anxiety-disorder-treatment) - [Find Support](https://www.psychcentral.com/program/how-to-find-mental-health-support) # Understanding Mini Panic Attacks When Falling Asleep  Medically reviewed by [Nicole Washington, DO, MPH](https://www.psychcentral.com/reviewers/nicole-washington-do-mph) — Written by [Janelle Cox](https://www.psychcentral.com/authors/janelle-cox) on March 31, 2022 - [Jolting awake?](https://psychcentral.com/anxiety/mini-panic-attacks-when-falling-asleep#jolting-awake) - [Causes](https://psychcentral.com/anxiety/mini-panic-attacks-when-falling-asleep#causes) - [Symptoms](https://psychcentral.com/anxiety/mini-panic-attacks-when-falling-asleep#symptoms) - [Tips to cope](https://psychcentral.com/anxiety/mini-panic-attacks-when-falling-asleep#tips-to-cope) - [Summary](https://psychcentral.com/anxiety/mini-panic-attacks-when-falling-asleep#summary) Hypnic jerks or nocturnal panic attacks could jolt you awake in a state of panic. Whatever the cause, there are ways to manage anxiety at night. If you wake up at 2 a.m. in a panic (and it’s not because you had too much caffeine before bed), you may be experiencing a nighttime or nocturnal panic attack. Nighttime panic attacks can feel incredibly similar to daytime [panic attacks](https://psychcentral.com/anxiety/panic-attack-symptoms) — with rapid, short breaths and a racing heart rate. When you wake up from sleep in a state of panic, it could also be caused by other things like hypnic jerks. No matter the cause, you can take steps to relieve distress and symptoms. ## [Jolting awake from sleep anxiety or hypnic jerks?]() Hypnic jerks are involuntary muscle contractions that some people experience as they’re falling asleep. They usually occur during the transitions between your sleep-wake cycle. These twitches or “[hypnic jerks](https://www.medicalnewstoday.com/articles/324666)” are pretty common, often mild, and even unnoticeable. However, sometimes these spasms may be strong enough to startle you or jolt you awake. A [2016 study](https://www.sciencedirect.com/science/article/abs/pii/S1389945716301198) found that hypnic jerks are “highly sporadic and affect all ages and both sexes with prevalence between 60% and 70% in the general population.” There’s a good chance these “jerks” or “twitches” have happened to you, and you may not have known it\! ### More than hypnic jerks If your nighttime jerking or jolting is accompanied by feelings of distress, there may be more at play. [Panic disorder](https://psychcentral.com/anxiety/panic-disorder-overview/) is an anxiety disorder that’s characterized by repeated panic attacks and a fear of having them. Authors from a [2013 study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629320/) noted that 18% to 45% of people with panic disorder had [nocturnal panic attacks](https://psychcentral.com/anxiety/panic-attack-in-sleep). Though panic attacks during your waking hours can develop quickly, they usually don’t jolt you awake in a second like the ones during sleep. ## [What causes anxiety attacks during sleep?]() Experts are still unsure what exactly causes someone to have panic attacks. However, there are a few things that may contribute to someone having nocturnal panic attacks. This includes: - having a family or personal history of panic attacks - living with certain conditions, such as [anxiety](https://psychcentral.com/anxiety/anxiety-disorders/) or [depression](https://psychcentral.com/depression/depression/) - experiencing traumatic life events - changes to your brain chemistry (hormonal or from certain medications) - feeling stressed ## [What are the symptoms of a nocturnal panic attack?]() As with the more well-known daytime panic attacks, nighttime attacks can occur without any reason or warning. But there’s one different symptom. Unlike waking panic attacks, sleep terrors, or [nightmare disorder](https://psychcentral.com/disorders/nightmare-disorder-symptoms), in a nocturnal panic attack, you’re awoken from sleep every time. Other common symptoms may occur during waking or nighttime panic attacks, including: - a fast or racing heart rate - shaking or trembling - sweating - [difficulty breathing](https://psychcentral.com/anxiety/can-anxiety-cause-shortness-of-breath) - tingling - dizziness - [chills](https://psychcentral.com/anxiety/anxiety-chills) or [hot flashes](https://psychcentral.com/anxiety/hot-flashes-anxiety) - fear of losing control - fear of dying - [chest pain](https://psychcentral.com/anxiety/can-anxiety-cause-chest-pain) or discomfort - feeling like you’re choking ## [How to cope with nighttime panic attacks]() Panic attacks and anxiety — whether during the day or at night — can feel frightening, but they’re not dangerous. One of the most stressful things about nighttime panic is that you just don’t know when it’s going to happen, so you feel like you can’t prepare. There are actually several things you can do to help manage your anxiety before and in the moment, so you can get back to sleep. ### Practice mantras A mantra is a helpful saying you use to affirm yourself when needed. When nighttime panic arises, you could try saying mantras to help calm down so you can go back to sleep. [Dr. Kathy HoganBruen](https://www.districtanxiety.com/about?msclkid=f0da42ffab9211ec90022ba0e4f37bff), clinical psychologist and founder of District Anxiety Center, suggests the following mantras: - “Panic is uncomfortable but not dangerous.” - “This is my body’s hardwired reaction to stress, but just like a faulty or very sensitive smoke detector, the alarm going off doesn’t necessarily signal any true danger or emergency.” - “Now is the time to sleep, and tomorrow is the time to address any pressing issues.” ### Try mindfulness [Mindfulness](https://psychcentral.com/health/everyday-mindfulness) is a technique where you’re aware of what is presently happening in your body and mind without any judgment. “Do a body scan from head to toe to notice and feel sensations and thoughts, but without deeming them troubling. Like a fly on the wall, just observe,” says HoganBruen. Instead of letting your mind spin out of control, you can mindfully focus on the present moment without worrying about things that just happened or haven’t happened yet. You may want to try a [meditation app](https://psychcentral.com/health/online-meditation) that has sleep meditations, which can mindfully guide you back to sleep. ### Focus on your breath If you’ve ever had a [panic or anxiety attack](https://psychcentral.com/anxiety/panic-attack-vs-anxiety-attack-whats-the-difference) before, then you know that regulating your breathing isn’t easy when you’re panicking. But by leveraging [deep breathing exercises](https://psychcentral.com/anxiety/reduce-your-anxiety-this-minute-3-different-types-of-deep-breathing) for anxiety, you can get your nervous system back to a state of calm which can help with that fight-or-flight response you’re going through and thus help you sleep, explains HoganBruen. ### Try CBT [Dr. Bryan Bruno](https://www.midcitytms.com/about/), medical director for Mid City TMS in New York, suggests [cognitive behavioral therapy (CBT)](https://psychcentral.com/lib/in-depth-cognitive-behavioral-therapy), a type of talk therapy. He says, “This form of psychotherapy helps patients confront their fears and anxieties in a controlled environment.” “Therapists may also offer [tips for better sleep hygiene](https://psychcentral.com/lib/tips-for-a-good-nights-sleep) and coping mechanisms to control or de-stress after a nocturnal anxiety attack,” he explains. ## [Let’s recap]() Experiencing nocturnal panic attacks can be just as intense and scary as daytime panic attacks, but with the added suddenness of waking you up. But whether awake or asleep, panic attacks are not dangerous. You can use several coping tools to get through the panic and get back to what you were doing — like sleeping. You could: - practice mantras - try mindfulness - focus on your breath If nighttime panic attacks are affecting your quality of life, you may want to consider speaking with a [mental health professional](https://psychcentral.com/health/find-help) or [sleep specialist](https://www.healthline.com/health/sleep/how-to-choose-a-sleep-specialist). Their knowledge and experience can help you find tools and treatments that will work best for you. 6 sourcescollapsed - Answers to your questions about panic disorder. (2008). <https://www.apa.org/topics/anxiety/panic-disorder> - Bruno B. (2022). Personal interview. - Chiaro G, et al. (2016). Hypnic jerks are an underestimated sleep motor phenomenon in patients with parkinsonism. A video-polysomnographic and neurophysiological study. <https://www.sciencedirect.com/science/article/abs/pii/S1389945716301198> - HoganBruen K. (2022). Personal interview. - Nakamura M, et al. (2013). Is nocturnal panic a distinct disease category? Comparison of clinical characteristics among patients with primary nocturnal panic, daytime panic, and coexistence of nocturnal and daytime panic. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629320/> - Park J, et al. (2021). Awakening from sleep with numbness and indescribable odd feeling: Nocturnal panic attack or sleep-related epilepsy? <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7911585/> [FEEDBACK:]()  Medically reviewed by [Nicole Washington, DO, MPH](https://www.psychcentral.com/reviewers/nicole-washington-do-mph) — Written by [Janelle Cox](https://www.psychcentral.com/authors/janelle-cox) on March 31, 2022 ## RELATED - [Anxiety Worse at Night? 4 Ways to Calm Down and Sleep Better](https://www.psychcentral.com/anxiety/anxiety-at-night?utm_source=ReadNext) - [Sleep-Wake Disorders](https://www.psychcentral.com/disorders/sleep?utm_source=ReadNext) - [Panic Attacks While Sleeping: Causes and How to Cope](https://www.psychcentral.com/anxiety/panic-attack-in-sleep?utm_source=ReadNext) - [How to Stop Stressing About Work and Finally Fall Asleep](https://www.psychcentral.com/stress/stress-related-insomnia-how-to-stop-stressing-about-work-finally-fall-asleep?utm_source=ReadNext) - [11 Ways to Shut Off Your Brain Before Bedtime](https://www.psychcentral.com/lib/ways-to-shut-off-your-brain-before-bedtime?utm_source=ReadNext) ### Read this next - [Anxiety Worse at Night? 4 Ways to Calm Down and Sleep Better](https://www.psychcentral.com/anxiety/anxiety-at-night?utm_source=ReadNext) Medically reviewed by [Karin Gepp, PsyD](https://www.psychcentral.com/medical-team) [Anxiety can be especially bothersome when it happens at night. You can try these tricks to calm your mind and get a better night's sleep.](https://www.psychcentral.com/anxiety/anxiety-at-night?utm_source=ReadNext) [READ MORE](https://www.psychcentral.com/anxiety/anxiety-at-night?utm_source=ReadNext) - [Sleep-Wake Disorders](https://www.psychcentral.com/disorders/sleep?utm_source=ReadNext) Medically reviewed by [Nicole Washington, DO, MPH](https://www.psychcentral.com/medical-team) [You're not sleeping well — or at all — but symptoms are starting to spread to other areas of your life. Get intel on sleep-wake disorders here.](https://www.psychcentral.com/disorders/sleep?utm_source=ReadNext) [READ MORE](https://www.psychcentral.com/disorders/sleep?utm_source=ReadNext) - [Panic Attacks While Sleeping: Causes and How to Cope](https://www.psychcentral.com/anxiety/panic-attack-in-sleep?utm_source=ReadNext) Medically reviewed by [Matthew Boland, PhD](https://www.psychcentral.com/medical-team) [Various factors may cause nighttime panic attacks. But you're not alone, there are coping strategies available to help you reduce panic attacks in…](https://www.psychcentral.com/anxiety/panic-attack-in-sleep?utm_source=ReadNext) [READ MORE](https://www.psychcentral.com/anxiety/panic-attack-in-sleep?utm_source=ReadNext) - [How to Stop Stressing About Work and Finally Fall Asleep](https://www.psychcentral.com/stress/stress-related-insomnia-how-to-stop-stressing-about-work-finally-fall-asleep?utm_source=ReadNext) Medically reviewed by [Vara Saripalli, Psy.D.](https://www.psychcentral.com/medical-team) [Stressing about work can affect your sleep in different ways. But healthy sleep habits can help you stop worrying about work and get to sleep.](https://www.psychcentral.com/stress/stress-related-insomnia-how-to-stop-stressing-about-work-finally-fall-asleep?utm_source=ReadNext) [READ MORE](https://www.psychcentral.com/stress/stress-related-insomnia-how-to-stop-stressing-about-work-finally-fall-asleep?utm_source=ReadNext) - [11 Ways to Shut Off Your Brain Before Bedtime](https://www.psychcentral.com/lib/ways-to-shut-off-your-brain-before-bedtime?utm_source=ReadNext) Medically reviewed by [Joslyn Jelinek, LCSW, ACSW, RDDP](https://www.psychcentral.com/medical-team) [Does getting to bed feel like that mad dash shopping for presents the eve before a holiday? Does it sneak up on you before you're ready? Learn to wind…](https://www.psychcentral.com/lib/ways-to-shut-off-your-brain-before-bedtime?utm_source=ReadNext) [READ MORE](https://www.psychcentral.com/lib/ways-to-shut-off-your-brain-before-bedtime?utm_source=ReadNext) - [Science Says: Do These 6 Things to Sleep Soundly](https://www.psychcentral.com/lib/tips-for-a-good-nights-sleep?utm_source=ReadNext) Medically reviewed by [Nicole Washington, DO, MPH](https://www.psychcentral.com/medical-team) [It's not a commercial: It's years of research and compiled data. Learn what tips studies show will guide you into sleeping deep and waking refreshed.](https://www.psychcentral.com/lib/tips-for-a-good-nights-sleep?utm_source=ReadNext) [READ MORE](https://www.psychcentral.com/lib/tips-for-a-good-nights-sleep?utm_source=ReadNext) - [Podcast: Cobra Kai Actress Discusses BIPOC Representation in Pop Culture](https://www.psychcentral.com/blog/podcast-cobra-kai-actress-discusses-bipoc-representation-in-pop-culture?utm_source=ReadNext) [Cobra Kai actor discussing her always having to “represent” for a larger group and of BIPOC representation in pop culture](https://www.psychcentral.com/blog/podcast-cobra-kai-actress-discusses-bipoc-representation-in-pop-culture?utm_source=ReadNext) [READ MORE](https://www.psychcentral.com/blog/podcast-cobra-kai-actress-discusses-bipoc-representation-in-pop-culture?utm_source=ReadNext) - [The 10 Best Teas for Stress in 2022](https://www.psychcentral.com/health/tea-for-stress?utm_source=ReadNext) Medically reviewed by [Jillian Kubala, MS, RD](https://www.psychcentral.com/medical-team) [If you're feeling stressed, drinking a hot (or cold) cup of tea may help. 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Hypnic jerks or nocturnal panic attacks could jolt you awake in a state of panic. Whatever the cause, there are ways to manage anxiety at night. If you wake up at 2 a.m. in a panic (and it’s not because you had too much caffeine before bed), you may be experiencing a nighttime or nocturnal panic attack. Nighttime panic attacks can feel incredibly similar to daytime [panic attacks](https://psychcentral.com/anxiety/panic-attack-symptoms) — with rapid, short breaths and a racing heart rate. When you wake up from sleep in a state of panic, it could also be caused by other things like hypnic jerks. No matter the cause, you can take steps to relieve distress and symptoms. Hypnic jerks are involuntary muscle contractions that some people experience as they’re falling asleep. They usually occur during the transitions between your sleep-wake cycle. These twitches or “[hypnic jerks](https://www.medicalnewstoday.com/articles/324666)” are pretty common, often mild, and even unnoticeable. However, sometimes these spasms may be strong enough to startle you or jolt you awake. A [2016 study](https://www.sciencedirect.com/science/article/abs/pii/S1389945716301198) found that hypnic jerks are “highly sporadic and affect all ages and both sexes with prevalence between 60% and 70% in the general population.” There’s a good chance these “jerks” or “twitches” have happened to you, and you may not have known it\! More than hypnic jerks If your nighttime jerking or jolting is accompanied by feelings of distress, there may be more at play. [Panic disorder](https://psychcentral.com/anxiety/panic-disorder-overview/) is an anxiety disorder that’s characterized by repeated panic attacks and a fear of having them. Authors from a [2013 study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629320/) noted that 18% to 45% of people with panic disorder had [nocturnal panic attacks](https://psychcentral.com/anxiety/panic-attack-in-sleep). Though panic attacks during your waking hours can develop quickly, they usually don’t jolt you awake in a second like the ones during sleep. Experts are still unsure what exactly causes someone to have panic attacks. However, there are a few things that may contribute to someone having nocturnal panic attacks. This includes: - having a family or personal history of panic attacks - living with certain conditions, such as [anxiety](https://psychcentral.com/anxiety/anxiety-disorders/) or [depression](https://psychcentral.com/depression/depression/) - experiencing traumatic life events - changes to your brain chemistry (hormonal or from certain medications) - feeling stressed As with the more well-known daytime panic attacks, nighttime attacks can occur without any reason or warning. But there’s one different symptom. Unlike waking panic attacks, sleep terrors, or [nightmare disorder](https://psychcentral.com/disorders/nightmare-disorder-symptoms), in a nocturnal panic attack, you’re awoken from sleep every time. Other common symptoms may occur during waking or nighttime panic attacks, including: - a fast or racing heart rate - shaking or trembling - sweating - [difficulty breathing](https://psychcentral.com/anxiety/can-anxiety-cause-shortness-of-breath) - tingling - dizziness - [chills](https://psychcentral.com/anxiety/anxiety-chills) or [hot flashes](https://psychcentral.com/anxiety/hot-flashes-anxiety) - fear of losing control - fear of dying - [chest pain](https://psychcentral.com/anxiety/can-anxiety-cause-chest-pain) or discomfort - feeling like you’re choking Panic attacks and anxiety — whether during the day or at night — can feel frightening, but they’re not dangerous. One of the most stressful things about nighttime panic is that you just don’t know when it’s going to happen, so you feel like you can’t prepare. There are actually several things you can do to help manage your anxiety before and in the moment, so you can get back to sleep. Practice mantras A mantra is a helpful saying you use to affirm yourself when needed. When nighttime panic arises, you could try saying mantras to help calm down so you can go back to sleep. [Dr. Kathy HoganBruen](https://www.districtanxiety.com/about?msclkid=f0da42ffab9211ec90022ba0e4f37bff), clinical psychologist and founder of District Anxiety Center, suggests the following mantras: - “Panic is uncomfortable but not dangerous.” - “This is my body’s hardwired reaction to stress, but just like a faulty or very sensitive smoke detector, the alarm going off doesn’t necessarily signal any true danger or emergency.” - “Now is the time to sleep, and tomorrow is the time to address any pressing issues.” Try mindfulness [Mindfulness](https://psychcentral.com/health/everyday-mindfulness) is a technique where you’re aware of what is presently happening in your body and mind without any judgment. “Do a body scan from head to toe to notice and feel sensations and thoughts, but without deeming them troubling. Like a fly on the wall, just observe,” says HoganBruen. Instead of letting your mind spin out of control, you can mindfully focus on the present moment without worrying about things that just happened or haven’t happened yet. You may want to try a [meditation app](https://psychcentral.com/health/online-meditation) that has sleep meditations, which can mindfully guide you back to sleep. Focus on your breath If you’ve ever had a [panic or anxiety attack](https://psychcentral.com/anxiety/panic-attack-vs-anxiety-attack-whats-the-difference) before, then you know that regulating your breathing isn’t easy when you’re panicking. But by leveraging [deep breathing exercises](https://psychcentral.com/anxiety/reduce-your-anxiety-this-minute-3-different-types-of-deep-breathing) for anxiety, you can get your nervous system back to a state of calm which can help with that fight-or-flight response you’re going through and thus help you sleep, explains HoganBruen. Try CBT [Dr. Bryan Bruno](https://www.midcitytms.com/about/), medical director for Mid City TMS in New York, suggests [cognitive behavioral therapy (CBT)](https://psychcentral.com/lib/in-depth-cognitive-behavioral-therapy), a type of talk therapy. He says, “This form of psychotherapy helps patients confront their fears and anxieties in a controlled environment.” “Therapists may also offer [tips for better sleep hygiene](https://psychcentral.com/lib/tips-for-a-good-nights-sleep) and coping mechanisms to control or de-stress after a nocturnal anxiety attack,” he explains. Experiencing nocturnal panic attacks can be just as intense and scary as daytime panic attacks, but with the added suddenness of waking you up. But whether awake or asleep, panic attacks are not dangerous. You can use several coping tools to get through the panic and get back to what you were doing — like sleeping. You could: - practice mantras - try mindfulness - focus on your breath If nighttime panic attacks are affecting your quality of life, you may want to consider speaking with a [mental health professional](https://psychcentral.com/health/find-help) or [sleep specialist](https://www.healthline.com/health/sleep/how-to-choose-a-sleep-specialist). Their knowledge and experience can help you find tools and treatments that will work best for you.