Sleep in Panic Disorder and Nocturnal Panic Attack / 수면정신생리

Sleep disturbance is a one of common complaints among patients with panic disorder. However, clinicians and researchers did not give much attention to the sleep symptoms of panic disorder yet. Several previous studies suggested that the sleep disturbance in panic disorder is mediated by nocturnal panic attack. In terms of the pathophysiology of panic disorder, nocturnal panic attack seems to be closely associated with the sleep problems in panic disorder. In this article, the authors reviewed various previous studies about sleep of panic disorder and intended to give importance of evaluating sleep disturbances and nocturnal panic attack in panic disorder for both clinical and research purpose.

Sleep and Panic / 수면정신생리

Nocturnal panic involves sudden awakening from sleep in a state of panic characterized by various somatic sensation of sympathetic arousal and intense fear. Many(18-71%) of the spontaneous panic attacks tend to occur from a sleeping state unrelated to the situational and cognitive context. Nocturnal panickers experienced daytime panics and general somatic sensation more frequently than other panickers. Despite frequent distressing symptoms, these patients tend to exhibit little social or occupational impairment and minimal agoraphobia and have a high lifetime incidence of major depression and a good response to tricyclic antidepressants. Sleep panic attacks arise from non-REM sleep, late stage 2 or early stage 3. The pathophysiology and the similarity of nocturnal panic to sleep apnea, dream-induced anxiety attacks, night terrors, sleep paralysis, and temporal lobe epilepsy are discussed.