Dear Patient, Thank you for submitting your question. Panic attacks can be happened as you described above at night during sleeping without any particular or obvious reason. Also, you have to remember that panic attacks are the sudden expressions of build up anxiety over the time in your life. Before confirming these episodes as panic attacks, first I would highly recommend you to see your family physician and explain all your complaints to him or her. Also, please remember If you have experienced any family problems such as a divorce or death of a loved one please remember to tell about it to your doctor because such happenings in your life can obviously raise your anxiety level that will be expressed as panic attacks. Furthermore, there can be other diseases and conditions which share the same symptoms and sighs of a panic attack. Hyperthyroidism, mitral valve prolapse, some types of cardiac arrhythmia, withdrawal of certain medications are some of them. So, my advice is to see your family physician and explain all your complains and she will refer to you certain laboratory testing such as TSH, T4 and ECG or Echocardiogram to find out the underlying cause of your complaints. Also, if you were on certain medications and recently you stopped taking those medications, please do not forget to tell your doctor about it. If underlying cause for your complaints is anxiety, your doctor may prescribe you SSRI drug such as Fluvoxamine, Sertraline and direct you to cognitive behavioral therapy. Again, it s all up to your doctor to decide upon your complaints and results of laboratory and other testing. I hope that I answer your question. Good luck! Dr. Dinesh Nuwan Weerasinghe, MD.