Autonomic Nervous System Dysfunction and Panic Symptoms

Q: Autonomic Nervous System Dysfunction and Panic Symptoms

Hello： The autonomic nervous system shows moderate to severe dysregulation. <br>It may be important to understand the relative changes between the sympathetic and parasympathetic nervous systems in order to determine where adjustments are needed. <br>Generally, the autonomic nerv

Consultation for Autonomic Nervous System Symptoms

Hello, Dr.
Jiang.
Last year, I experienced palpitations and discomfort, and after seeing a cardiologist, I was diagnosed with mild benign arrhythmia.
A subsequent evaluation by a psychiatrist revealed moderate to severe autonomic nervous system dysregulation, which later led to panic disorder.
During episodes, I experience trembling, numbness, rapid and forceful heartbeats, and a feeling of impending doom.
Since starting medication, most of my symptoms have alleviated, but I have a question about a recent symptom.
Thank you!
I used to experience this occasionally, but it has become more pronounced lately.
Specifically, when I am on the verge of falling asleep at night, I suddenly wake up, feeling very anxious, with a slight increase in heart rate.
Sometimes, I notice my heartbeat more distinctly (palpitations), and I feel involuntary body shaking (like an earthquake), along with a sensation of muscle tightness.
I would like to know if this could be related to the autonomic nervous system still being unregulated.
Thank you, and I wish you peace and happiness.

Niming, 20~29 year old female. Ask Date: 2020/02/18

Dr. Jiang Junyi reply Neurology

Hello: The autonomic nervous system shows moderate to severe dysregulation.
It may be important to understand the relative changes between the sympathetic and parasympathetic nervous systems in order to determine where adjustments are needed.
Generally, the autonomic nervous system is regulated by the sympathetic and parasympathetic nervous systems, with one acting as the accelerator and the other as the brake.
The sympathetic nervous system is responsible for stimulating the "gas pedal," driving the body into action, while the parasympathetic nervous system is responsible for engaging the "brake," allowing the body to rest.
For example, during exercise, the sympathetic nervous system is activated, leading to increased heart rate, faster breathing, and increased sweating.
Once the exercise stops, the parasympathetic nervous system begins to take effect, slowing the heart rate, reducing breathing rate, and decreasing sweating.
In addition to medication, lifestyle adjustments are necessary.
It is recommended that you consult with a neurologist or a psychosomatic medicine physician for discussion and treatment.
Wishing you good health, peace, and joy.
Dr.
Jiang from Taoyuan Medical Center cares about you.

Reply Date: 2020/02/18

More Info

Hello! Thank you for your detailed question regarding autonomic nervous system dysfunction and panic symptoms. Based on your description, it seems that you are experiencing a range of symptoms that can indeed be associated with autonomic nervous system (ANS) dysfunction, particularly in the context of panic disorder.

The autonomic nervous system is divided into two main branches: the sympathetic nervous system, which prepares the body for 'fight or flight' responses, and the parasympathetic nervous system, which promotes 'rest and digest' functions. When there is a dysfunction in this system, it can lead to a variety of symptoms, including those you mentioned: palpitations, trembling, feelings of impending doom, and even physical sensations like tingling or numbness.

Your experience of waking up suddenly at the brink of sleep, feeling panic, and noticing an increased heart rate can be indicative of a hyperactive sympathetic response. This is often seen in individuals with anxiety disorders, including panic disorder. The body may misinterpret normal physiological changes associated with transitioning to sleep as a threat, triggering a panic response. This can lead to the symptoms you described, such as heart palpitations, muscle tension, and a sense of impending doom.

Moreover, the phenomenon of waking up in a panic can also be linked to sleep disturbances, which are common in individuals with anxiety and panic disorders. The body’s inability to transition smoothly into deeper sleep stages can lead to a state of heightened arousal, making it easier to wake up startled or anxious.

In terms of management, it is crucial to continue working closely with your healthcare provider. Since you mentioned that medication has helped alleviate many of your symptoms, it may be beneficial to discuss any adjustments or additional therapies that could further support your recovery. Cognitive-behavioral therapy (CBT) is particularly effective for panic disorder and can help you develop coping strategies to manage panic attacks and anxiety symptoms.

Additionally, lifestyle modifications can play a significant role in managing autonomic dysfunction and panic symptoms. Regular physical activity, mindfulness practices such as meditation or yoga, and ensuring adequate sleep hygiene can help regulate the autonomic nervous system. It’s also essential to monitor your caffeine and alcohol intake, as both can exacerbate anxiety symptoms.

Lastly, if you continue to experience these symptoms, it may be worthwhile to explore further evaluations, such as a sleep study, to rule out any underlying sleep disorders that could be contributing to your symptoms.
In summary, your symptoms of waking up in a panic and experiencing autonomic dysregulation are indeed interconnected. Continued collaboration with your healthcare provider, along with lifestyle adjustments and therapeutic interventions, can significantly improve your quality of life. Please feel free to reach out with any further questions or concerns. Wishing you peace and health on your journey to recovery!

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