My Year of Nocturnal Panic

I woke at midnight certain I was dying. I stood in the dark bedroom, sweat-soaked in an oversize T-shirt, watching the shadows on the walls. It was August 2020. For years I’d struggled with pelvic pain, which had recently morphed into more severe symptoms: Abdominal bloating. Dizzy spells. Night sweats. I’d started waking up with a pounding heart I imagined better suited to a small, nervous animal, like a rabbit or a shrew.

I should be asleep, I thought. My husband was snoring. Our two-year-old was asleep in her crib—even she, a person who regularly wet herself, had learned to sleep through the night. I felt shame and confusion churning in my gut.

“Jon,” I whispered, shaking my husband awake. “Feel my heart. I’m not okay. Something is wrong.”

His palm to my chest. A pause. Still half asleep, he muttered, “I don’t feel anything.”

“Nothing?” I stood and paced the room, my heart rate soaring. Death, I thought. This feels like death.

I’ve never been more aware of the gap between words and lived experience than when I’ve tried to explain a panic attack to someone who has never had one. It is animal fear, raw and primal.

“Call 911,” I said. “I think I’m dying.”

Not long after, five people in uniforms and industrial masks stood over me in my living room, asking questions.

“Where’s the pain?” “Can you breathe?” “Have you ever had a panic attack before?”

Right here, sort of, no.

I didn’t realize this night would be the start of an intense, debilitating fear of sleep. I didn’t know that it would lead me down a dark hole of research. I didn’t know how much it would change me, in ways that were terrible but ultimately profound.

*

Somniphobia, the fear of sleep, is classified as an anxiety disorder. It’s a category I’m familiar with: Over the years, I’d grown comfortable with my diagnosis of generalized anxiety disorder and PTSD. I understood these conditions well, and I recognized my insomnia as one of their many fun symptoms. For years it had taken me hours to fall asleep. I’d regularly wake early, around 4 a.m, unable to nod off again. It was annoying, but unthreatening, and I’d learned to cope.

After my first panic attack, my ability to deal with my insomnia changed. I stood staring at my bed. You’re not scary, I thought. You’re a bed. Sleep is good and I need rest. Feeling calm and in control, I slid beneath the covers and rolled over, closing my eyes. Within seconds my body flooded with adrenaline. My heart began to pound like I’d run a marathon. If I started to drift off, I jolted awake. Instead of sleeping, I saw violent visions, images of a face that looked like the devil—a fear of mine since childhood, a product of all those hours I spent in a church pew fearing I might go to hell. There were several nights I couldn’t sleep at all. Trying to calm myself only seemed to make things worse.

Each morning my daughter woke early, joyful and energized.

“Mommy, mommy! Come see!”

It didn’t matter how poorly I’d slept; she needed me to wander into her bedroom, to look at the unsteady block tower she’d constructed.

“Wow,” I’d say, “That’s amazing.” I’d force an extra-big smile, hoping she couldn’t locate the fear behind my eyes.

I stood staring at my bed. You’re not scary, I thought. You’re a bed.

In the months before the panic attack, I’d been waking up at 5 a.m. to write before my daughter woke. I was working on a book I hoped to publish someday and had recently been accepted to the Tin House Workshop, a longtime goal. Yet deep down I feared the book would never happen. That all the hours I’d spent on my writing would add up to nothing.

Now when I tried to write, my mind snapped shut. I stared at the blank screen, feeling hopeless. When I did write, I would spell easy words incorrectly. When I later read back what I’d written, I found sentences scrambled, words misplaced. My brain was so fogged with anxiety there was no room left for creativity. I was barely surviving being a mom and a wife, and now I was watching as all my creative goals slipped away.

“I want my old life back,” I told Jon as we stood in the kitchen one morning. He looked at me with sympathy, not knowing what else to say that he hadn’t already said. Just then a noise—maybe a car engine—sounded outside. I jumped, my body on high alert. I covered my ears and sobbed.

Desperate to claw back some control, I began reading about neuroscience. The research into nocturnal panic attacks is limited, and scientists don’t know for sure why some people experience them. What I was able to learn, though, was this: My fight-or-flight response was being triggered at night. I was also experiencing an oversensitivity to my bodily sensations. Due to years of unresolved trauma, I likely have an overactive amygdala, which can result in a heightened fear response. My health issues—the bloating and pelvic pain—may also play a role. Doctors have suggested that it may be endometriosis, though I was recently diagnosed with small intestinal bacterial overgrowth (SIBO) as well.

Eventually, I found the work of Dr. Andrew Huberman, a Stanford neuroscientist whose lab studies neuroplasticity and brain states like fear, focus, and stress. I went on long runs, putting headphones in as I listened to the Huberman Lab podcast. I ran for miles, trying to remember my strength as I listened to an episode on the brain’s plasticity. I began to understand that my brain had been trained to fear sleep—but that there are ways to begin to rewire the brain.

This discovery gave me a new, vital sense of hope. I walked around the house like a motivational speaker, muttering, “We can rewire our brains. We can rewire our brains. We can rewire our brains.”

I just had to figure out how.

*

Exposure therapy, a behavior technique where the patient confronts the source of their anxiety, is one of the most frequently recommended therapies for intense fears, like my husband’s terror of heights and mine of open water. If we wanted badly enough to overcome our fears, we could do so by gradually exposing ourselves to their sources.

But when you fear sleep, you have no choice. A body has to sleep eventually. (Doesn’t it? I thought, staring at the ceiling at three in the morning.) So each night, I faced my fear. Again and again, I went to bed. This felt like a curse, but it wasn’t. I had no alternative but to confront the physical and mental symptoms of my terror. I became interested in interoceptive exposure—a practice of inducing symptoms of panic. I learned to sit still and imagine going to bed, feeling the sensations of panic in my body without reacting to them.

I didn’t do this alone. I saw several doctors, who performed everything from simple blood tests to extensive hormone testing. I saw a behavioral health therapist, who referred me to a psychiatrist, who referred me to another therapist. I saw an acupuncturist in a tiny building across town, one of the few places where I, strangely, fell asleep regularly, tiny needles sticking out of my abdomen. That I was able to get this help is a privilege, and I often thought about where I would be if I didn’t have access to this treatment.

I heard the words sleep hygiene so often the phrase eventually set me on edge. “Yes I know!” I said quickly to the last therapist who once again recommended having a nightly routine. “Brushing my teeth at the same time every night is not going to save me!” I wanted to but did not scream. Still, I did everything they recommended. I set my clock for the same wake time every morning so that I had a predictable schedule. I started going to bed earlier. I made sure I got sunlight in my eyes in the morning. I cut out alcohol and caffeine and began sleeping with an eye mask and earplugs. I became boring, and perhaps more than a little strange. I began meditating regularly, having read studies on how meditation changes the brain. I started practicing yoga nidra, which can be beneficial in training the body to sleep.

At first, none of it seemed to help, but over time I saw how the effects compounded. When I meditated in the morning, I imagined my brain shifting, the amygdala shrinking. I’d become a sort of scientific mystic, a person prostrating on the altar of the prefrontal cortex. I gained a new respect for my fear, for my brain, for all the many ways it has tried to keep me safe. Understanding the science of it empowered me to take steps that led to real changes.

Eventually, slowly, I began to sleep.

*

For six months, I slept like a blissful child—one with earplugs, a black satin eye mask, and a weighted blanket. I fell asleep easily, weaning entirely off the sleep medication I’d started taking on an as-needed basis. Most times, I slept through the night. I was thrilled, stunned, and I believed I’d conquered my sleep issues.

I gained a new respect for my fear, for my brain, for all the many ways it has tried to keep me safe.

Until they came back. It was March 2021. I was still parenting during COVID, while once again trying to focus on my writing and other ambitions. I’d stopped meditating regularly and had fallen back into some of my old habits: ruminating, procrastinating, eating chips and salsa close to bedtime. No surprise that the bloating and pelvic pain were back too. I began seeing a new doctor, hoping to get answers beyond sleep hygiene. I also found a new therapist, one who specializes in EMDR, eye movement desensitization and reprocessing.

“Panic itself is a trauma,” he said confidently on our introductory phone call. It was 6 p.m. and I was sitting on the end of the bed, the site of my traumatization. I watched the light through the window, knowing it was just a few hours until bedtime. My chest tightened.

“Do you think you can help me?” I said quietly. I wanted to say, “Did you know I wasn’t always like this? I traveled the world alone. I lived overseas. I ran half-marathons. I’m a writer. I used to be . . .” But I didn’t. I held the phone to my ear as I waited for his response.

He told me he couldn’t make promises, but he had a good success rate working with people who had experienced trauma. “Are you comfortable sharing what sort of trauma you’ve been through?”

The multiple assaults. An ex-boyfriend’s serious car accident. My childhood. As I talked about my trauma, I felt a stirring of deep sadness, exhaustion, and relief that someone was listening.

“I think you’d be a good candidate,” he said.

Over the next several months in EMDR, I confronted deep fears I didn’t previously realize I had—ones of losing my mind, of letting others down, of failing. I began to see the ways the panic stemmed from my fear of not being a good mother (if I didn’t sleep at night, what if I couldn’t parent?) and how this related to my own childhood. I was facing my fear of sleep, but I was also confronting deeply held beliefs about myself.

Bigger changes started to take hold. I started sleeping again, sure. But I also noticed another shift.

*

It’s not my fault.

I woke one morning with the phrase playing in my mind like a refrain.

One of the more difficult aspects of my nocturnal panic was the shame. I told friends I was having trouble sleeping but felt embarrassed to share the details. I didn’t understand why this was happening, why I couldn’t outsmart it or be “better.” Those thoughts, in turn, left me feeling even more out of control.

My pandemic-induced setback forced me to see it differently. I couldn’t control every aspect of my body and mind. I needed to loosen my grip, while still recognizing the agency I had over my own life. For the first time, I forgave myself: for the panic, for stopping meditation, for the heartache I’d inflicted on myself, for the nighttime chips and salsa, for my failure, for that thing I said that one time in sixth grade, for all the ways I felt like a bad mom, a bad wife, a bad person, and a failed writer.

Panic brought me to my knees and into a new understanding about my life and about who I am beyond my anxiety. I replaced my old hobby of ruminating for hours with a new practice of feeling my emotions in my body. I embraced self-compassion and gratitude. I learned to access positive memories, flooding my body with oxytocin. I was surprised how well this worked. Eventually, I was able to look at the night of my first panic attack not as a failure but as a success. Seeking help, as I did that night, is a form of strength rather than weakness. This understanding was a turning point.

I don’t know if I will ever be completely free of nocturnal panic. But I am free of shame and, mostly, of self-loathing. I am full of gratitude and love for myself. I could not have said that before.

On good nights, which are most of them now, I fall asleep within twenty minutes. Of course, the story isn’t over. Even in researching this essay, I became afraid. What if digging up all of this brought me back to the place I’d once been? What if I experienced more panic? And it did. Sort of.

I had a few days of more intense fear, slightly more rumination and physical symptoms. I also had one bad night where I began to sweat and sensations of panic rushed in. But this time, I didn’t panic about the panic. I let the sensations exist, knowing they’d pass. It took me several hours and I didn’t sleep well, but eventually I did sleep.

The following night, I lay in bed, holding my hands to my heart. Let it go, I told myself. I’d practiced this enough times in meditation. One bad night did not mean another was inevitable.

I fell asleep easily. It felt like a miracle, but I knew it was not. It was all the training I’d done, all the ways I’d cared for myself. In the morning I woke, rested and only a little afraid. I stayed in bed for a while, listening to all the noises I wouldn’t have noticed before. The birds outside, the trash truck, my neighbor going to work. Eventually I could hear my daughter playing quietly in her bedroom. I got out of bed and went in to say good morning.

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