Night Anxiety Can Impair Day Performance

Vijai P. Sharma, Ph.D

Many people tend to "come alive" as the night approaches and get livelier as the night advances, often called, "night owls." For the majority of people, night is a time to wind down and relax and feel sleepy as the night falls.

For some, night is nothing but bad news! They may feel more worried, anxious or agitated. Some dread darkness because of the heightened feeling of personal loss, loneliness and depression.

For people with severe and persistent pain, chronic illness, symptom "flare ups," insomnia, agitation, nightmares, obsessive worries and anxiety the night seems to add the "witches brew" to what is already a potent dose of torture. Why does the night make mental and physical health issues worse?

Let me tell you about a middle-aged man who has suffered for years with chronic anxiety and panic attacks. We will call him, "Mr. Payne." Mr. Payne takes his concerns, frustrations and worries to bed and starts ruminating over them while trying to go to sleep.

He is a smart man. He figured out on his own that when he "thinks" he is asleep, he is actually awake! I agree with him. During the process of falling asleep, his mind is increasingly gripped with anxiety. His nervous system as he describes it, "almost shuts down." He feels his heart is hardly beating and lungs barely working.

Many nights, within half an hour of going off to sleep he jumps out his bed to get his "heart going again." I believe that at some point he misses a heartbeat or experiences an irregular hear beat pattern called, "cardiac arrhythmia."

The abnormality in the heartbeat pattern wakes him up. He finds himself in the middle of a panic attack with racing heart and rapid breathing. At this point, he is somewhat hyperventilating, breaking into a cold sweat and his body is shaking from inside and outside. It is scary for him. He feels his breath is totally out of control and he is losing control over his own mind.

What He described to me is a classical description of a "nocturnal panic attack." The term, "nocturnal" means that the panic attack occurs in the night. Some people only experience a panic attack in the night while some experience them during the day as well as night or only during the day. Mr. Payne experiences such panic attacks three to four nights a week.

When Mr. Payne goes to work, he feels extremely fatigued and anxious, which impairs his attention, concentration and memory. It is affecting his job performance. He worries about losing his job.

At night he often doesn't want to go to sleep because of the fear of nocturnal panic attacks. So, now he has one more thing to worry about and his anxiety level is already high as the night progresses.

Don't worry about Mr. Payne any more because he has got over those nocturnal panic attacks! He basically did it by understanding the relationship between what he does during the day and what happens to him at night.

While reviewing the origin and history of his panic attacks, it dawned on him that the first panic attack occurred when he was trying to cope with all kinds of pressure. There were office deadlines, his wife was pregnant and his mother, around the same time, was hospitalized. He had bought a new house but the old house was still not sold, which required him to pay two mortgages.

He had earlier failed to see the relationship between the panic attacks and the anxiety and stress he was earlier experiencing. He thought he was too busy at the time to take the time to sit and worry.

But his brain and his nervous system constantly sensed pressure and danger. As a result during the day, he would under breathe or over breathe and his heart would miss a beat or beat in an irregular pattern. Such body events, whether we notice them or not, can result in panic attacks.

While he was oblivious of the irregular body sensations during the day because of the tasks at hand, the nervous system by night was totally wound up. The stage was set for a panic attack.

He learned to monitor his body sensations and regulate his breathing and calm his nervous system during the day and practice relaxation and deep breathing several times a day, which put an end to nocturnal panic attacks.

In some cases, stress and pressure caused by pain, shortness of breath, and discomfort caused by physical symptoms, can cause panic attacks. You, too, may benefit from the techniques Mr. Payne utilized.

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Copyright 2004, Mind Publications 
Posted October 2004