Strange panic attack from waking up

[racingheart77]

Once in a while I wake up abruptly in the middle of the night and it feels like I am going to die. I have a sense of impending doom, racing heartrate, chest tightness, and it sort feels like I cant move my body for a while. It only last a few seconds but it is sooo uncomfortable. Anyone else experience this? I am realizing it happens the most when I take naps instead getting a full night's rest but it can still happen whenever.

[dancer65]

Yes I had this when I was at my worst , it’s horrible feeling . I am pleased to say as I have got my insomnia under some control it has gone away . 
I hope this improves for you. 

[Sarah Tee]

Could it be a bit of hypnagogia/sleep paralysis mixed with autonomic symptoms?

https://en.m.wikipedia.org/wiki/Sleep_paralysis

 

I haven't experienced sleep paralysis, but I did used to often get hypnic jerks (feeling as though you are falling and jerking awake) and exploding head syndrome (hearing a loud noise as you are falling asleep). These are more annoying than anything. Sleep paralysis sounds scary.

 

Edited to clarify:

I didn't mean to imply that dysautonomia and sleep paralysis are connected – sorry! Sleep paralysis is pretty common. A review in 2011 showed about 8% of the general population experience at least one episode. The symptoms of not being able to move, a heavy weight on your chest, and a feeling of doom (!) could perhaps set off dysautonomia symptoms as well.

[Pistol]

@racingheart77 - I have HPOTS and am very familiar with these episodes. I used to fall asleep fast and then wake up in a panic after 3 hours. It was explained to me that this occurs when the adrenaline level fails to drop after 3 hours of sleep ( the amount of time it takes the body to go into REM sleep ). In HPOTS this can not only cause waking up from sleep but also cause the ANS to actually make MORE norepinephrine, resulting in the symptoms you describe. 

For me this stopped happening when I was put on the right medication and treatment schedule. Also - I take Lorazepam sometimes for sleep, it helped me with those symptoms. I think it helps because it takes away the anxiety that comes with adrenaline surges. Whatever the cause - it helped me make it through the toughest nights. 

I agree with @dancer65 - a healthy sleep hygiene can help, but it takes time. Another cause of these attacks can be certain medications, especially in people with HPOTS. Clonidine for example can cause this. 

[Jyoti]

@racingheart77--Yes, this happens to me periodically.  One curious doctor surmised that it might be due to my oxygen levels falling --not to a level that would qualify as sleep apnea, but close--perhaps because I have cervical spine issues and when I curl up, I create even less tracheal space.  She thought that might trigger an adrenaline rush.  It made some sense to me.  I also use Cortisol Manager by Integrative Therapeutics at night, which seems to help, along with intending to keep my neck from curling.  (Which latter probably is not your issue at all, but I thought I would mention the Cortisol Manager.....)

[endless_august]

On 1/22/2021 at 5:33 AM, Sarah Tee said:

Could it be a bit of hypnagogia/sleep paralysis mixed with autonomic symptoms?

https://en.m.wikipedia.org/wiki/Sleep_paralysis

 

I haven't experienced sleep paralysis, but I did used to often get hypnic jerks (feeling as though you are falling and jerking awake) and exploding head syndrome (hearing a loud noise as you are falling asleep). These are more annoying than anything. Sleep paralysis sounds scary.

I have POTS symptoms and multiple dysautonomia symptoms and sleep paralysis preceded them by about 15 years. 

[Crazy Tired]

Tbh sounds like a sleep apnea event.

 

Don't sleep on your back

[racingheart77]

Sleep apnea event? Do these happen to you? Why is it bad to sleep on your back?

[Crazy Tired]

Sleep apnea is when you're stopping breathing. Usually obstructive.

 

Before you wake up your heart rate dramatically increases and adrenaline floods.

 

Sometimes you have nightmares.

 

Consequently by awakening you can feel deathly ill,

 

Also have you considered serotonin.

[halffull]

I get this right as I'm falling asleep, like that feeling where you're falling right as you drift off (hypnic jerk I guess?) but instead it's a jolt of Adrenaline and I wake up with a high heart rate, breathing hard and convinced I'm dying. Then I can't relax enough to fall asleep because it often repeats itself after the first one and I get insomnia. 

They did test me for sleep apnea about 3 years ago and my sleep study came back normal. It was an at home sleep study where I was wired up to a machine that recorded my breathing and heart rate. I'm not sure I had an "episode" the night I was tested though. I also never sleep on my back, mostly on my side or stomach and they still happen. 

It often happens when I'm super exhausted already. On nights I'm not as tired it doesn't seem to happen. I have good sleep hygiene outside of the cycle I can get in when these episodes give me insomnia. 

I'd be interested to figure out how to stop these, it's my worst POTS symptom to date. 

[Chuske]

I had this two nights this week.  I'd had this also a few times last year and some of them were in daytime as well as from sleep. 

Not really sure what triggers them or why they went away for several months. One possible connection for me is my GI symptoms in that I often get trapped burps building up and putting pressure on my diaphragm. Another is hydration. So if I get an attack I try sipping water and doing yoga twists to try and get the burps up.

I also find when awakening from sleep in a pots flare I get brief tachy and then an odd sensation in my solar plexus a little bit like the feeling of being in a car going over a hump back bridge. 

Not yet found how to stop these.  Last time eventually they stopped as it got better.

[UnaOwen]

I get these episodes at times too.  I did a little research (not WebMD and cancer search) and found that it fit more with sleep paralysis than anything else.  There are three types that people can experience, one of them being the falling/suffocating sensation that you may be experiencing.  If you found it difficult or not possible to open your eyes or move, you are probably experiencing sleep paralysis from time to time.  

I don't know if it has anything to do with dysautonomia or if it is related to any other condition associated with dysautonomia.  The unfortunate part about it is that it will (of course) create a sort of sleep anxiety until it resolves on its own.  On the flip side, if your heart rate is dropping while you are sleeping, it could also be an exaggerated response from the sympathetic nervous system.  I reckon the only way to know for sure is to do another sleep study while it is happening again to know for sure.

I'm sorry you both are going through it.  You're not alone.  I hope that you feel better soon and find out what's going on with the sleep disturbances.   Good luck!