The aim of this study was to discuss whether NP is a distinct disease category from DP/NP. 12 Thus, the clinical significance of primary NP as well as that of DP/NP remains unclear, although it is possible that the latter is a severe subcategory of PD.Ĭurrent Knowledge/Study Rationale: Many patients with panic disorder experience nocturnal panic attack during sleep time (coexistence of day panic and nocturnal panic attacks: DP/NP), and some patients have panic attacks mainly during the nocturnal sleep period (primary nocturnal panic: NP). Meanwhile, one study that included both primary NP and DP/NP demonstrated no differences between NP and primary DP in terms of frequency of comorbid depression. 11 However, these comparisons were mainly made on patients with DP/NP and those with primary DP. Previous studies have suggested that individuals with NP have more frequent panic attacks, more severe anxiety symptomatology, 6, 10 and higher rates of comorbid depression, which may lead to an increased risk of suicide compared with those without NP. Similarly, the description of PD in the International Classification of Sleep Disorders, 2nd edition, 9 does not address this issue.
#NOCTURNAL PANIC ATTACKS MANUAL#
7 Mainly due to the lack of this information, the Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (DSM-IV-TR) 8 has not clarified whether NP alone should be included within the PD category. However, most previous reports have not mentioned the clinical characteristics of primary NP, except for one report in which the response to pharmaceutical treatment in such patients was discussed. 6, 7 Meanwhile, there are a considerable number of patients who have panic attacks only during the nocturnal sleep period (primary NP). 5 In general, 18% to 45% of PD patients experience both DP and NP attacks (DP/NP). 2 – 4 These nighttime attacks occur without any obvious triggers during periods of sleep-wake transition and are referred to as nocturnal panic (NP) attacks. 1 However, some patients who fulfill the clinical criteria for PD experience panic attacks mainly during the nocturnal sleep period. Panic disorder (PD) is an anxiety disorder characterized by recurrent daytime panic (DP) attacks (primary DP).
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