Why Did Sleep-Onset Timing Matter in a Case With Repeated Panic Attacks?
A frightening experience at bedtime can be described simply as a panic attack. Asking what happened first can reveal a separate symptom worth evaluating.
The symptom that preceded the fear
Kaneko and colleagues described a woman who perceived sudden loud noises inside her head only while falling asleep. The episodes were painless. As they became more frequent, she began to fear going to bed and later experienced nighttime panic attacks. The authors identified the brief sleep-onset experiences as exploding head syndrome, a parasomnia.
Why the sequence is informative
The perceived sound, the later fear of recurrence and the panic episodes were distinct parts of the history. A timeline can preserve the sleep state, duration and sequence of those experiences. This case illustrates how a detailed history informed the authors’ interpretation. It cannot establish that every nocturnal panic episode has the same cause.
Source
Kaneko et al., case report of exploding head syndrome and panic attacks (full text) · DOI
