Doctors Answers (6)
Anxiety disorders are very common psychiatric disorders, and are often associated with sleep disturbance. In fact, anxiety and problems sleeping have a bidirectional relationship. Evidence suggests that effectively treating anxiety should also include evaluating and treating sleep problems. Thus, symptoms of disturbed sleep should be discussed with a physician.
If you hadn't had a sleep study, I would strnogly recommend that as if you have sleep apnea, it is known to cause similar symptoms or exacerbate symptoms of panic and anxiety attack. Once ruled out or treated for sleep apnea, cognitive behavioral therapy can also be considered for managment of panic and anxiety in sleep. There are not alot of therapist who do that, nor insurances cover the cost, but if it helps, it maybe worthwhile.
It sounds as though you have a complicated psychiatric problem that will require many facets of therapeutic intervention to help solve. You are taking medicine, but psychotherapy as well may also be of benefit. As far as the panic episodes at night with sleep, this may represent a parasomnia sleep disorder- sleep terrors or nightmare disorder. The other medical possibility is seizures, in particular a frontal lobe epilepsy. Referral for extended EEG monitoring as well as a sleep study would be to your benefit to help find the best medicines to treat each identified disorder. Any self stress reduction techniques that work for you should also be part of your daily regimen.
Both anxiety and medication used to treat anxiety can affect sleep. Evaluation with a sleep specialist to correlate your medical history with your symptoms is recommended to determine the proper course of treatment.
Anxiety is caused by or results in an over stimulation of the sympathetic nervous system which is mediated by excitable neurotransmitters such as dopamine. Adrenalin levels are high or the end organs (heart, for example) are overly sensitive to normal levels. Treating anxiety and panic attacks is often dependent on the frequency and timing and triggers. Your psychiatrist may be correct as a different part of our brain is more active while sleeping. However, you should investigate triggers for anxiety such as sleep disordered breathing which is well known to trigger anxiety attacks. A sleep study would be required. If you suffer an anxiety event in the sleep lab and no obvious triggering mechanism is detected, then I would recommend cognitive behavioral therapy (CBT) which includes imaging techniques and biofeedback training. Along with some medication your fairly predictable anxiety should be controlled.
Your problem is a common one, and one that I see a lot of people have: Anxiety. Anxiety arises when there is a disconnect between what you are feeling and the thoughts whirling around in your head. What you are feeling is pointing you in the right direction that you need to let go of the thoughts whirling around in your head. So how do you do that? Here are a few techniques: a) be the observer of your thoughts but do not reply or comment to the thoughts in your head; and b) let go of the story that is whirling around in your head. If this sounds too deep and difficult, the reality is that it is not. Yet it does require lots of "practice". I call this living in the NOW and recommend you read two books written by Eckhart Tolle: first "A New Earth" and after you have mastered the teachings in that book, read "The Power of NOW" to take you to the next level. If you do this it will change your life. I have recommended these books to many patients and friends; and can tell you that it changed their lives dramatically for the better, and it will change your perspective on your "life situations" and enable you to sleep at night peacefully, awaken in the morning with excellent energy and enthusiasm, and also allow you to feel better during your awake hours. The final bit of advice I give to everyone is that you need to read and live the messages in these books; and it requires multiple readings of the book and passageways in the book until it becomes part of your way of living. Good luck and do not give up!