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Does nocturnal panic represent a more severe form of panic disorder?
Michelle G Craske1, Ariel J Lang, Jayson L Mystkowski
1Department of Psychology, UCLA, 405 Hilgard Ave., Los Angeles, CA 90095-1563. Send reprint requests to Dr. Craske.
The Journal of Nervous and Mental Disease
|October 3, 2002
Summary
Nocturnal panic attacks (NP), a form of panic disorder, are not necessarily a sign of more severe illness. Research suggests NP may stem from fear associations with sleep itself, rather than situational triggers.
Area of Science:
- Psychiatry
- Sleep Medicine
- Clinical Psychology
Background:
- Nocturnal panic (NP) affects a significant portion of panic disorder patients (18-45%).
- The underlying mechanisms and clinical implications of NP remain poorly understood.
- Existing research has not clearly differentiated NP from other panic disorder presentations.
Purpose of the Study:
- To investigate whether nocturnal panic (NP) signifies a more severe form of panic disorder.
- To determine if NP is associated with heightened vulnerability to sleep disturbances.
- To explore the relationship between NP and panic disorder severity, comorbidity, and functioning.
Main Methods:
- A comparative study design was employed.
- Patients with NP (n=51) were compared to panic disorder patients without NP (n=41).
- Standardized measures assessed panic disorder severity, comorbidity, interpersonal functioning, and sleep disturbance.
Main Results:
- No significant differences in overall psychopathology were found between NP and non-NP groups.
- Weak evidence suggested a slightly higher degree of sleep disturbance in the NP group.
- Patients experiencing NP demonstrated less agoraphobic avoidance, indicating a reduced association of panic with situational factors.
Conclusions:
- Nocturnal panic (NP) does not appear to represent a more severe form of panic disorder.
- NP may be a distinct subtype characterized by fear conditioning to sleep and sleeplike states.
- Findings suggest a specific cognitive profile in NP patients, with less emphasis on situational triggers for panic.