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Panic Attacks While Trying to Fall Asleep

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I've always had a strange love/hate relationship with sleep. I need a lot of it, but I almost always wake up anxious. No matter what is going on in my life, I can almost always count on waking up with anxiety.

Lately (as in the last two weeks), my brain has thrown a new trick into the mix.

Now when I try to lay down, either to nap or go to bed at night, I start having a panic attack after about two minutes of laying down. My heart races (102 bpm last night). I start to hyperventilate and then get really restless. I also start to feel emotional, like crying.

I've stopped taking naps, even though I'm completely exhausted, b/c I can't stand the panic. I do my best to ignore it at night b/c I'm trying to keep my sleep routine as normal as possible. And I am able to fall asleep, probably, from the sheer volume of sedating meds.

Anyone else ever have this trouble? Its really hard to fall asleep when you're panicking. FWIW, I take 500 mg seroquel, 15 mg abilify and 1 mg klono before bed, so I fall asleep whether I want to or not. But the meds don't touch the panic.

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Posted · Report post

PR,

Just from a physical perspective, are you always compliant with your CPAP equipment? If so, is the pressure of your machine still therapeutic for you? There is a big link between sleep panic attacks and sleep apnea.

An apnea episode "feels" to the body a lot like a panic attack. Heart rate increases, breathing becomes difficult, some people feel like they are going to suffocate. It can be very emotional.

It's possible that your apnea isn't totally being treated. It's possible that your love/hate relationship with sleep could be because for however long you had the apnea and didn't know it - going to sleep was in a sense "suffocating" you because you couldn't breathe. In some people that starts an association where sleep becomes something bad or even frightening.

Also possible is that you've had this tendancy toward sleep+panic for a while but one of the meds you used to be on was supressing it (since psych meds are often used for this).

If all is good with your apnea treatment, is could just be your anxiety disorder. Proper sleep hygiene and perhaps making yourself a relaxing ritual to do before bed can help you calm down. In a sense your logical side needs to tell your emotional side that there's nothing to fear, you've got nifty gear now that should keep you breathing all night long.

That's all I got for now. Be glad I didn't open a textbook. It would be the post that never ends!

*May*

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PR,

Just from a physical perspective, are you always compliant with your CPAP equipment? If so, is the pressure of your machine still therapeutic for you? There is a big link between sleep panic attacks and sleep apnea.

. I am 100% compliant with the CPAP, but haven't had the pressure on the machine checked in about 1.5 years. I guess it is possible I need a higher pressure.

It's possible that your apnea isn't totally being treated
. I think this is quite possible. I also think I may not have my mask on tight enough and air is leaking out around my nostrils. I've woken up with my mouth wide open (and trying to breathe through my mouth). My throat is totally dry, so I know I've been sleeping that way for a while.

Also possible is that you've had this tendancy toward sleep+panic for a while but one of the meds you used to be on was supressing it (since psych meds are often used for this).
Very good point, May.

If all is good with your apnea treatment, is could just be your anxiety disorder. Proper sleep hygiene and perhaps making yourself a relaxing ritual to do before bed can help you calm down. In a sense your logical side needs to tell your emotional side that there's nothing to fear, you've got nifty gear now that should keep you breathing all night long.
My logical side is fighting a tough battle right now. I can make myself lay still while having the panic attack, but it really sucks.

I'm going to try tightening my mask, having the pressure checked and then contact my sleep doctor, in that order.

That's all I got for now. Be glad I didn't open a textbook. It would be the post that never ends!
Thank you for all the great advice, May!

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Posted · Report post

Tossing out ideas, the position related part of this strikes me and the fact that you aren't asleep. It could be some sort of vaso-vagal nerve thing. The vagus nerve runs thru the torso and can cause blood pressure and heart rate changes. One more commonly hears stories about problems people have with fainting.

I would suggest seeing your family doctor who can start with a good physical checkup. It's always best to rule out physical problems before chasing the mental.

best, a.m.

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Concur re apnea possibilities. I remember coming back from having my wisdom teeth out before the sleep apnea dx. I woke up strangling and it very much felt like a panic attack.

If your CPAP machine is like mine, there is a place to put in a little card which takes records from the machine which can be sent to the company that provided it. In a week or so, they can generate a report showing how much of the time you are experiencing apnea. (Or even hypoapnea.) Generally they send it to the doctor, but I can get them to send it to me too. It's not patient friendly, but it's pretty easy to figure out anyway.

Or if you have someone you feel comfortable around when you're dropping off, you can have them listen. The mask probably makes it much easier to hear the rhythmn of your breathing. If you stop for a long time and then wake up with the panic, maybe apnea is the problem. But of course that report is probably more accurate.

There are masks you can get which cover your mouth as well. I got one in case I had nasal congestion, though that hasn't come up in the 6 months I've had the machine. Still, I've tried it and it works fine. You can get them mail order, and it might only cost the same as two or three office visit copayments if you're in a hurry. I've also heard that people sometimes use some kind of elastic strap to gently hold their mouth shut, but I don't know if this is a good idea or not.

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A.M. :

It could be some sort of vaso-vagal nerve thing
If it doesn't resolve itself in a few days (I quit taking abilify two days ago. The attacks started when I started abilify), I'll definitely contact my GP.

Ido: Thank you for reminding me about the card in my machine! I had forgotten that you can get data off of it. The attacks don't happen at night, only when I'm laying down to go to sleep.

Lately, the anxiety kicks in as soon as I start thinking about going to bed. I'm really hoping that abilify is the culprit and getting rid of it will get rid of the panic attacks.

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