Circadian rhythm in panic disorder

Abstract

The relationship between panic disorder and sleep problems has been studied, and possible explanations for this association are discussed in this chapter. So far, the results of polysomnographic studies in PD patients are inconclusive, but seem to suggest that patients with PD have impaired initiation and maintenance of sleep. The presence of nocturnal panic attacks induce an intense fear of sleep, leading to anticipatory anxiety and sleep avoidance, resulting in secondary insomnia and facilitating the development of new panic attacks. Other hypotheses, as the co-occurrence of depression, cortisol levels and anxiety sensitivity are also raised as mec hanisms related to sleep problems in PD pati ents. Treatments are available, as the cognitive behavioral treatment and some novel treatments that may improve panic attacks as well as insomnia.