133 lack of sleep and panic/anxiety
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Welcome to Joy Lab!: [00:00:00] Welcome to the Joy Lab podcast, where we help you uncover and foster your most joyful self. Your hosts, Dr. Henry Emmons and Dr. Aimee Prasek, bring you the ideal mix of soulful and scientifically sound tools to spark your joy, even when it feels dark. When you're ready to experiment with more joy, combine this podcast with the full Joy Lab program over at JoyLab.coach
Henry: Hello, I'm Henry Emmons, and welcome to Joy Lab.
Aimee: And I'm Aimee Prasek. Here at Joy Lab, we infuse science with soul to help you build your resilience and uncover your joy. So today we're talking about lack of sleep and anxiety attacks or panic attacks. This is a very common question and many of us have maybe experienced a time change. So lack of sleep may be sort of amplified for some of [00:01:00] us.
But before we dive in, in episode 111, that's a lot of episodes,
Henry: Yes, it is, Aimee.
Aimee: know if I've said triple digits.
Henry: Oh, but Oh, but I I remember 111
Aimee: And
Henry: we talked about the difference between panic attacks
Aimee: and anxiety attacks or heightened anxiety. So, we're not going to get into all those details in this episode, but if you want to understand more about the difference between those, then head back to 111 and I'll link it in the show notes as well.
All right, so let's dig into this. How do sleep struggles and panic attacks, perhaps anxiety as well, how do they all relate to each other? Henry, do you want to dive in for us? Get us started.
Henry: Sure. Well, as you just said, Aimee, there's, they're not the same thing. Panic attacks are not the same thing as what we usually call anxiety. Although, it is one form of anxiety or anxiety disorders. [00:02:00] So, I think best way to distinguish them is that panic attacks are ~just ~very, very strong, severe anxiety.
Usually it's very short term. So some people will talk about a, you know, a anxiety attack that lasted all day. That's probably not a panic attack. It's just they're having very bad anxiety. But a panic attack is very discreet, very strong, lots of physical symptoms that goes into it. So, what causes them?
What ~what ~causes panic attacks? We don't really know, even after all this, this time, ~you know, ~they've been known about for a long time, and obviously they're quite common, but it's probably a combination of genetics. There does seem to be family, um, patterns with this. Brain chemistry, that's what medications are by and large addressing.
There is also a problem with the autonomic nervous system, which we might think of as the fight or flight system kind of [00:03:00] gone rogue and then the nature of our thoughts. For example, ~if~ if we start to catastrophize it sort of feeds into panic anxiety. So all of those things probably conspire. together in some combination or other.
So we don't really know the cause, but one thing we do know is that panic attacks are related to stress. And some folks will even speculate ~that, um,~ that some of us evolved to be more prone to panic attacks because it might have been life saving for our ancestors. You might think of it as being in fight or flight on steroids.
It's like super intense fight or flight. So in that way, a panic attack is preparing you to do whatever you need to do to survive some life threatening situation. Nowadays, of course, we're not often faced with those true life threatening situations, but our [00:04:00] body is still acting as though we are. So then where does sleep come in? Sleep is also disrupted by stress. So there's a common denominator there. ~Um,~ And it might be that whatever's going on in your life is affecting both your sleep and your internal alarm system. But I think it's actually ~more, ~the connection is more pronounced than that. Because if you are not sleeping well for
just even a few nights, it can impact all of those other factors I mentioned that are related to panic. ~Um,~ Even how our genes are expressed. So, ~you know,~ you're not processing things as effectively in your mind, and what might be a minor problem in real life seems to be magnified. Many times by a poor night's sleep.
Um, and you know, sleep has a direct effect on brain chemistry. So insomnia is shown to, ~uh,~ to impact [00:05:00] the balance of brain chemicals and even our genetic expression, as I mentioned. So, not sleeping well is also a stress, you know, ~it, it,~ it kind of compounds things. It's almost like it feeds on itself.
It just fuels the fire of stress. So it's easy to see how you can get into this cycle of having high anxiety, not sleeping well, being more sensitive even than before, so your anxiety gets even worse and that disrupts your sleep even further. These cycles have to be interrupted somehow. And in the case of panic attacks, the sooner the better, because your prognosis is going to be a lot better if you don't let this go on for very long. So ~Um,~ if you don't yet know that these are panic attacks and nothing more, ~you know,~ like people often think that they're having a heart attack or something, ~um,~ then, ~you know,~ it's really scary because you feel as if you're about to die, which obviously [00:06:00] raises your stress level even more. So, I believe that ~if you,~ if you think you might be having panic attacks, you really should consult with your health professional to try to rule out that it in fact is not something else.
People do have heart attacks after all and ~you know~ panic attacks also don't easily go away on their own and so it's just a good idea to get some help
for them and again the quicker the better.
Aimee: Yeah. So, ~um,~ encouragement there to get support. ~Um,~ And then you're highlighting Henry this reciprocal, ~this,~ this feeding cycle between sleep, struggle, stress and panic attacks, how they all can influence each other. ~Um,~ And there's a specific type of panic attack that I think could also be helpful ~uh,~ to discuss when we're talking about these types of sleep problems and panic and anxiety.
And those are called nocturnal panic attacks. So a nocturnal [00:07:00] panic attack is abruptly waking from sleep with a panic attack. So during the nighttime.~ And it, you know,~ there's sort of this terrifying experience, just like a panic attack would be. It rips you out of sleep. And there's some research here that's found that ~um,~ there isn't really a reliable dysfunction in sleep architecture either.
So, the common pattern of moving through the stages of sleep ~uh, ~during the night is not perhaps the issue. It doesn't ~seem to,~ seem to be a sleep disorder. You know, this is a panic attack that wakes you up. ~Um,~ Not to dismiss the relationship of sleep with it, um, but with this nocturnal panic attack, you might fall asleep fine, actually.
You might sleep pretty well and then bam, a panic attack comes out of nowhere. And then, sleep can become, ~um,~ rough as a result of that. So ~there's, you know,~ you know, falling back asleep after a panic attack in the middle of the night.... that would be very difficult, right?
Your heightened [00:08:00] system, the last thing your body wants to do then is just fall quietly into slumber. So on top of that, it can be common to start to get uneasy about sleep because, ~you know,~ you've had a panic attack in the middle of the night while you're sleeping. That context ~sets, um, uh,~ sets some stress around falling asleep.
Am I going to have another panic attack? So can really have some avoidant behaviors around sleep after experiencing a nocturnal panic attack. ~Um,~ They might, ~you know, you might~ want to go to bed late, you sort of stretch it out and end up going to sleep really late, sort of avoiding sleep and not getting sufficient sleep.
So now you see how sleep can then start another cycle. So do you want to talk a little bit about this as well, Henry, and how these things play out?
Henry: Sure. So I've never had this happen to me, but I can easily imagine that having a panic attack in the middle of the night would be really tough. But oddly enough, as a clinician, [00:09:00] it's kind of helpful information. It helps us ~to~ to think about this differently from a diagnostic standpoint. So, you know, I mentioned earlier ~that,~ that some people will think they're having a panic attack when they're, in fact, ~they're just,~ their anxiety is just really high.
~And it,~ It's sometimes very hard to distinguish those two, just from the description of them, but they are different. And,~ um, You know, panic,~ true panic attacks tend to have more of a life of their own. Whereas really bad anxiety tends to be triggered by something going on. Some stressful thing going on.
Now that's not a hard and fast rule. You know, stress obviously affects panic too. But they are not exactly the same thing. And I think that ~um,~ having a nighttime panic attack is sort of, by definition, is coming out of the blue, ~you know.~ you're not doing anything at the time. You might be having a dream that triggered something, which could be a different thing, [00:10:00] by the way.
That's worth exploring. But if it's just an outright panic attack that wakes you from sleep, that's kind of a helpful question to ask when I'm seeing someone as a client. ~You know,~ Does it ever wake you from sleep? Because if, if it does, you, you do first want to make sure it's not some kind of a sleep disorder, like, ~you know,~ you get panicky because you can't breathe if you have sleep apnea.
Sleep terrors are a very discreet thing, but ~it's,~ it's important to rule those out. But if it does seem to come out of nowhere and it seems to be, ~you know, ~pure and simple anxiety, that is a very clear indicator that, yes, these are panic attacks, this is panic disorder, and it really helps us then to think through the best kind of treatment for that. ~ ~
Aimee: Yeah, that makes sense. ~So I'll link to our other show notes. No, I won't.~ So I will link in the show notes our earlier episodes that relate here as well, which will add some strategies to [00:11:00] consider ~um,~ in addition to seeing your primary care doc and knowing that there is ~um, ~support for panic attacks, for sleep struggles, for anxiety, ~um,~ that these things can be ~um,~ dealt with, that we can find some healing here.
So, ~um,~ also to close, I just want to bring some levity to what can be these monsters, really, of panic attacks, sleep struggles, anxiety... tough stuff that we can work on, but it is, it is tough. So here's perhaps a way to reframe those monsters. Anxiety is a lot like a toddler. It never stops talking, tells you you're wrong about everything, and wakes you up at 3 am. So true.
That's very good.
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