re: suspected panic episodes at night

[fpd3hm]

Dear doctor,



I am a 31 year old white male, 6'2" 180, very active.  For the past 10 years I have suffered from intermittent pacs/pvcs which cause constant anxiety and periodically trigger full-blown panic attacks.  I have significant work-related stress but no real stress outside the workplace.



I have had multiple tests for heart problems done by several physicians with no remarkable findings.  I am on no medication, I do not consume products containing caffeine, I do not smoke nor use illegal drugs, but I do drink alcohol (1-2 drinks daily).



On with my question: For the past month or so, I have been waking up after 3-4 hours sleep with my heart rate elevated to roughly 100-120 bpm, perspiring and feeling very anxious (these symptoms often follow a stressful dream.)  Last night, I suffered from a panic attack during such an episode, replete with heart rate of approximately 180-200 bpm, dry mouth, tremors, feelings of impending doom.



The symptoms resolve themselves within 3-5 minutes after waking up.  My heart rate returns to normal, and I return to sleep with little or no fanfare.  Sometimes, however, I have multiple episodes in one evening.  Needless to say, just going to bed for the evening is causing serious anticpatory anxiety.



Do these symptoms sound consistent with a sufferer of panic attacks, or do you suspect something else is something else at play (atrial fibrillation, inappropriate tachycardia, etc.)?  Also, any thoughts on what to do to reduce the frequency of such episodes.



Thanks for your help, and for this valuable service--



HM

[Roger Gould, M.D.]

HM, thanks for all the good background information..makes my work a little easier. Your description strongly suggests that the dreams are the cause, not an organic disease.  Although every thing seems to be in control on the surface of your life, and you are disciplined re health, something is cooking within you that needs to be addressed, and since it is not addressed during the day, it breaks through in your dreams.  Alcohol may be a contributor, but not the cause.  Alcohol is actually a stimulant and wakes you up three-5 hours after you sleep, or makes that portion of the night's sleep lighter.



If you are not ready to start with a therapist to probe what is going on, you can try a therapeutic alternative I have created at www. masteringstress.com, and I will see whether I can get you started in the right direction.

[ptkg]

My illness started with Panic Attacks at night. I had a baby and my step father died 5 days later and was trying to build a house all at the same time. This put me under a huge amount of stress. The first time I had a panic attack I woke up and didn't know what was happening, I called 911. I would have dreams that I was dying or dreams of having a heart attack or other terrible things.  I also found that I had acid reflux and that was causing some of my attacks especially at night. You might want to look into this.

[fpd3hm]

pt-



thanks very much for your insights.  i, too, wound up at the emergency room one night.  i was sent home the following day, with a diagnosis of panic attacks but no real help.  since then, the attacks have gotten better, but still bother me 2-3 nights per week.  it is good to know that i am not alone, as such attacks seem so random and bizarre.  



hm