Cognitive behavioral therapy for nocturnal panic

Nocturnal panic (NP), or waking abruptly from sleep in a state of panic, is a common phenomenon among patients with panic disorder. The purpose of this study was to test the efficacy of an adaptation of cognitive-behavioral treatment for NP. Forty-three participants were randomly assigned to immediate CBT or to a wait-list control condition. The results showed that CBT was more effective than the passage of time alone. The effects of CBT were repeated in the previously wait-listed condition. Treatment-related gains were maintained over a 9-month follow-up period. In addition, symptom improvement was accompanied by lessened subjective and heart rate reactivity to laboratory stressors, as well as lowered arousal and increased cardiac variability during sleep. This is the first controlled treatment outcome trial demonstrating the efficacy of a treatment program for panic disorder patients with NP.