Expanding Fear of Loss of Vigilance: Intolerance of Uncertainty, Responsibility for Harm, and Fear of Sleep for Predicting Nocturnal Panic

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Objective/Background: Nocturnal panic involves experiencing panic attacks out of a sleeping state without obvious causes. Roughly half of patients with panic disorder will experience nocturnal panic in addition to panic attacks while awake, or daytime panic. Like daytime panic, nocturnal panic also occurs in other disorders such as PTSD. The Fear of Loss of Vigilance theory is currently the only model available to explain nocturnal panic. It suggests nocturnal panickers fear states in which they cannot easily react to or protect themselves from danger. The current study sought to expand upon the existing theory by including constructs from the broader anxiety literature. Nocturnal panickers were expected to report higher scores on these measures when compared to daytime panickers and non-panickers.

Participants: A sample of 166 participants were screened for panic history.

Methods: Participants completed self-report measures regarding panic attacks, fear of sleep, intolerance of uncertainty, responsibility for harm, and fear of loss of vigilance.

Results: Measures of fear of sleep and responsibility for harm successfully differentiated nocturnal from daytime panickers, whereas measures of intolerance of uncertainty and fear of loss of vigilance did not.

Conclusions: These results provide partial support for the Fear of Loss of Vigilance theory. Modifications to the theory to incorporate additional constructs are suggested.

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Behavioral Sleep Medicine



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