Nocturnal panic attacks are the type of panic attacks that happen during sleep, the person wakes up abruptly from sleep with strong panic feeling for no obvious trigger or reason. When suffering the panic attacks, the person may feel sweating, fast heart pump, shortness of breath and numbness, flushing or chills, and a sense of insecure.

The signs and symptoms are similar as heart attacks or other serious medical condition. Although nocturnal panic attacks last shorter time, usually less than ten minutes, it may take much longer to recovery and settle down.

Most people who experience nocturnal panic attacks at night also have them during the day. Between 44 percent and 71 percent of people with panic disorder have had at least one episode of nocturnal panic.

It is important to have a complete physical examination to determine whether a medical condition other than panic attacks is the cause of your signs and symptoms. This may include a sleep assessment to rule out an underlying sleep disorder.

Cognitive behavior therapy and anti-anxiety medications are effective treatment to treat nocturnal panic attacks and alleviate or eliminate the occurance for most people.

There are many techniques you can practice to prevent occuring of panic attacks.

An important practice is to train your body and mind to interpret out of ordinary symptoms with normal response, rather than signs of danger.

Another important practice of preventing panic is to teach yourself ways to decrease the physical arousal when your body is in fighting mode, and to  catch  yourself before this emergency system is activated in the first place.

One way to do this is through breathing retraining.

Researches have found that over half of people suffering panic attacks show some signs of over breathing or hyperventilation.  Over breathing can produce initial perception that alarm you and lead you to a panic attack situation.

Over breathing can also make the symptoms worse.  When people breath fast, certain blood vessels become narrower , heart pump faster and the brain may get less oxygen.  This can lead to the dizziness, confusion, and lightheartedness that often occur during panic attacks.  Other parts of the body may also get a bit less oxygen, which may lead to numbness or tingling in the hands or feet or the feeling of cold, clammy hands, and tension of the whole body.

learning the proper breathing control can decrease some of the above reactions or initial triggers for panic, reduce physical sensations during panic attacks, promote general relaxation, and lower overall levels of tension and help break the cycle of panic or stop severe attacks.

When and where to practice breathing exercises. Like any skill, breathing control requires practice. The general rule is practice twice per day for 5 or more minutes. You should find a quiet, comfortable place where you won’t be disturbed. Do not try this technique in specific situations or when you become frightened or have a panic attack at the beginning of your practice.  Practice in a quiet environment to build up your skill level so that you can later use it in time of emergency.

There are the instructions for breathing retraining:

- Find a calm and quiet location that you can concentrate
- Count one on breathing in, and think of relaxation on breathing out
- Focus your attention on breathing and counting slowly
- Focus on normal rate and depth of breathing
- Expand abdomen on breath in and keep chest still
- Count up to ten and back to one
- Practice 2 times per day, 5 or more minutes each time
- Record your practice and keep going

Panic attacks can be triggered by many factors.

Sometimes panic attacks can be triggered by dismay and stressful situations.  For example, an disagreement and argument with your family member at home, a stranger on the street, or a coworker at work can create a stress situation and activate your emergency response system, because your mind perceives it as threatening, even though there is no actual risk to your survival.

But most times, panic attacks don’t seem to be triggered by any particular reasons, they seems coming out of nowhere.  Somehow, the body’s natural emergency fighting response system is activated when there is no real threaten at all.

Why does the body activates to  emergency reaction mode  when there is no real danger? Most of time, people susceptible to panic attacks are frightened or alarmed by the physical sensations of the emergency response system.

Fist, the body experiences unexpected physical sensations, for example, you might feel a tightness in your chest, a heart burn, or short of breath.  This tensed sensation will lead to fearful or alarmed by these symptoms and lead to speculation of some fearful thoughts, like, anything going wrong with me?  am I having a heart attack?  Am I going to faint?  The mind perceives that there is a danger , even though there is no real danger at all.  This combination of body and mind reaction, as a result, activates the emergency response system , leading to a actual panic attack.

Panic attacks are triggered when we misinterpret physical symptoms as signs of impending danger, death, craziness, loss of control, embarrassment, or fear.   Sometimes you may be aware of thoughts of danger that activate the emergency response system, for example, you will thinking about: “I’m having a heart attack” when you feel chest pressure or increased heart rate.  At other times, however, you may not be aware of such thoughts.

After a number of times of being afraid of physical sensations, anxiety and panic can occur in response to the initial sensations without conscious thoughts of danger.  Instead, you just feel afraid or alarmed.  In other words, the panic or fear may seem to occur automatically without your consciously telling yourself anything.

After having had one or more panic attacks, you may also become more focused on what is going on inside your body.  You may scan your body and be more vigilant about noticing any symptoms that might signal the start of a panic attack.  This sometimes leads to picking up on sensations you might not otherwise have noticed and misinterpreting them as something dangerous.  A panic attack may then result.