Almost every night 20 min after I fall asleep I sit straight up in bed in an anxious panic and don't know where I am. What's happening?

Answers (3)

Jonathan Lopez, MD (Neurologist) answered (9/21/2012)

There are a few different possibilities for what is happening.

The most likely is a muscle twitch that happens right as you are transitioning from an awake to an asleep state, called a "hypnagogic jerk". This is often accompanied by a sensation of falling. In some people, this causes a feeling of panic that quickly fades as you realize that you are safe in bed. If this occurs a lot, it may be due to lack of sleep or drinking alcohol or exercising too much right before bedtime.

Another possibility that is somewhat rare in adults is a condition called "confusional arousal" (a.k.a. "sleep drunkenness"). Causes include wearing off of sleep medication (unlikely in your case), recovery from lack of sleep, and conditions that cause an abnormal sleep cycle and/or a feeling of being sleepy all the time while you are awake.

Other possibilities that are less likely (but still important to consider) are a psychiatric condition, such as an anxiety disorder, and seizures that occur during sleep.

My suggestion is that you talk with a physician in person about these symptoms so that they can get a full description and examine you. If there is someone who sleeps in the same bed as you, they should join you for this visit to add in any details that you might not remember.

An important question to ask the physician after their evaluation is whether you should undergo a test, such as an EEG (electroencephalogram) or a sleep study (also called a polysomnogram). A thorough description of the event might be enough, though, to make a diagnosis without these tests.

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Michelle Otelsberg (Marriage & Family Therapist) answered (9/25/2012)

Hi Katie -

Sounds to me like you are possibly waking up with a panic attack. I am wondering if this is something new or something that has gone on for a long time? Often times sleep is affected by our daily life. Although you say that you don't have any kind of panic or anxiety disorder, I am wondering if right now there are things in your life that are causing you some stress? And as you lay down at night and start to relax, your mind starts wandering and thinking about these stressful situations - things to do with work, friends, relationships, family, etc.

If you find after talking with your doctor that there is nothing biologically causing you to wake in the middle of the night, I would suggest evaluating the stressors in your life and consider talking with a mental health professional.

Good Luck!
Michelle