25 answers

Panic Attack in 4 Year Old???

Last night we had a Super Bowl party and my son had a ball. Even with a bunch of people over he still went to bed at his normal time between 7:30-8. Around 10:30 he woke up crying in bed - not calling for us or anything like that, which he would normally do if he woke up during the night. Anyway, he didn't seem to be crying exceptionally hard, but then he started really wheezing and making sounds like he really couldn't breathe.

When I sat down on the couch wih him, he fell back asleep fairly quickly and seemed to be breathing OK. Then, when I put him down on the couch he woke up and it all started up again. We ended up in the bathroom because he thought he was going to throw up. He didn't, but he did gag a few times. Finally, while we were sitting in the bathroom his eyes were closing and I asked if he wanted to go to bed. He did and his breathing was better, but still kind of rattle-y. We set up the humidifier in his room too. I ended up going to sleep on his floor until around 1:30 when he woke up. When I asked him how he was feeling he said "Good"! and sounded totally fine. Then he told me he would be OK if I went to sleep in my own bed.

This morning he is completely fine. A hard cough every now and then, but that could just be a cold starting.

My question is: Could this have been some kind of anxiety or panic attack maybe brought on my a nightmare? He didn't eat anything unusual so I that would rule out an allergic reaction of some kind. He doesn't seem to run out of breath when he's playing hard, so I don't think it would be asthma .

Has anyone else experienced anything like this with your kids?

It was really scary and the only reason we didn't go to the ER was that his lips and fingers looked OK (not turning blue or white from lack of oxygen), but we were sure considering it.

Thank you!

- As a side note, he does remember going through all of it. Does that go along with night terrors or do the kids usually not remember anything? Thanks again!

What can I do next?

So What Happened?™

It really appears that my son did have a night terror. I'm guessing he remembers it because he did wake up during it (because we had no idea what was going on and wanted him to wake up) and that was when it escalated. His preschool teacher said that based on his vivid imagination she isn't surprised it happened with Cal. I also think being tired and on the verge of having a cold - it all came together at once.

Hopefully this is the one and only time it happens, but if it does happen again at least we know what we're dealing with. He does talk in his sleep quite a bit and has been known to sleep walk on occasion, so I guess this just goes right along with that.

Thanks for all the support!

More Answers

You might want to have him tested for asthma. As a person who has it, that sure sounded like an attack to me. If you can rule out allergies, it might have been an attack.

Sounds alot like a night terror! Look into it. 4 and 5 are common ages for them to occur.


It almost sounds like an asthma attack. I have four grown children and they all developed asthma in their early years and then outgre it. He should be evaluated by your pediatrician.


Hi H.,
I have to say that I have a 5 year old and a couple of times when he was sick, stuffy nose, cough, he would panic. I could feel the stress in him and the fear, and it scared me too. His breathing would change and he would panic. It almost caused me to panic too : ). I can't put it past a 4 or 5 year old having a panic attack. Fear flight response is in all of us. I hope this helped a little.
R. F.

Yes a 4 yr old can have panic attacks. My son who will be 20 next month started having them about age 5. We were at our wits end because we had no clue as to what was going on. He would act out incredibly, not just hyperventilate. After a couple of yrs of this off and on we finally took him to a therapist. He was diagnosed with general anxiety. He did take buspar for a couple of yrs and it did help although it didnt totally get rid of them. We even ended up having a battery of test done to make sure he wasn't having anxiety enduced sezier. (dang i can't spell that for the life of me :( )
I would often have to hold him in a "lock" on my lap or between my legs on the floor until he ran out of energy then he would fall asleep in my arms.
It was heart breaking. Knowing there really wasn't anything to do but hold him so he would hurt himself by fit throwing.
He seemed to do alot better so we got rid of the medication but I think that was a bad idea on my part because a few yrs later when he got into high school I tried to talk him back into it and he refused.
Some children are just extra sensitive to things and internalize their worries so much they overload. Made my sons high school yrs very stressful for us all.
But I can tell you he is learning to "talk" himself out of the anxiety before it gets the best of him.
I still wish he would consider the medication because frankly anxiety and depression run in my family for generations and I don't think he will really grow out of it to the point that medication wouldnt be a good choice.
I wish I would have know about the family history way back when then I could have made some quicker and better lasting decisions.
I'm not a pro medicate the kids to quiet them from being normal kids but medicine has made great strides and I believe we should take advantage to better our lives.
K. :)

My daugher at approximately the same age for several years would wake up with a blood curdling scream. The first time scared the daylights out of us. We never really knew what set them off. Most of the time she would saying things that made no sense what so ever. We also made we get out of bed and walked her to the bathroom use the facility and get a drink. Walk her back to bed and she would go right back to sleep. The next day she never remembered anything. We did find out if we did not make her get out of bed that she never seemed to go back to a very restful sleep. However she never seemed to have the breathing problems that you descriped but listening to her screaming and trying to calm her down we as parents did.

Hi H.,

I seriously doubt it was a panic attack. He might have some upper respiratory illness. You may want to take him to the doctor just to be sure. He may have just been overexcited, but I doubt it was panic.

L. :)

That sounds like Asthma to me, also. My son never gets wheezy, but whenever he gets a cold, he gets a bad cough and has trouble breathing when he lies down. I thought it might be an allergy to something (bedding, down pillows, pet dander, etc.). After numerous atempts to find out what it was, an ER doctor informed me that Asthma generally flares up when the child lies down (for unknown reasons), and makes it hard to breath, which will wake a child and be quite alarming. It can be a wheeze, a cough, a rattle in the chest. It is just best to nebulize him with some abuterol as soon as he has symptoms. I would recommend you check with a good pediatrician.

It sounds like asthma to me. My daughter did the same thing and it was asthma. She never gets asthma when she is exercising; it is almost always at night and sometimes during the day. I have not been able to figure out what may trigger it. I also would get asthma attacks during the night when I was a child. Talk to your doctor. If it is asthma you will want to have an asthma inhaler on hand.

I would say a form of Night Terrors. My 4 year old girl does that. If she is over tired she wakes up crying just like he did. Its not a frantic cry, more like wimpering. We know she is having one because we ask her her name and she just looks at us and doesn't respond. We have to pretty much force her to lay back down...if we try to talk to her its like the lights are on but no one is home. If we make her lay back down, she usually goes back to sleep and doesn't remember it in the morning.
I asked her DR about it and she said it sounded like night terrors. and that she should grow out of it.

Not sure if this helps or not.....Good Luck!!

I have 4 children with asthma. You have just perfectly described an asthma attack. My son does get asthma with anxiety, but normally it's triggered by an allergy. Did your child eat or inhale something that was not normal for him? If so, that would be the likely trigger. My son's triggers are dust, pollen, grass, certain perfumes, and having a cold.

Croup can also manifest in the same way.

The first sign of a night-time asthma attack for my children is usually coughing to the point of throwing up. A rattle or wheeze in asthma is on the exhale. Sometimes there's a sucking sound on the inhale with a rattle on the exhale.

Hope that helps!

I would ask your doctor, but to me it sounds like my daughters night terrors. She only gets them when she has been over stimulated and gets overly tired. Sometimes she remembers them, sometimes she doesn't have a clue what she did. They don't hurt her, but she is 13 and still gets them occasionaly. She started getting them at about 5 years old. It's like sleep walking and we just let her work through them and make sure she is safe.

My experience with night terrors is they do not remember anything about them. My oldest son has asthma (brough on by illness usually) and the wheezing and breathing issues you described sound more like an athsma attack. Could be a bronchial irritaion also or illness. I wouldn't hesitate to call the doctor. Asthma feels very scary and awful. It could lead to a panic attack.

i have heard a lot of people with acid reflux having breathing troubles and feel like they are going to vomit. my girfreinds little boy was three when they firgured it out with him and as long as he took the medicine he was fine. i have heard that the breathing troubles are worse at night when laying down. it could be worth looking into.

My daughter who is now 10 went through this many times when she was younger. She would wake up crying and anything I did to try to soothe her didn't work. I didn't think it was asthma because she never acted like she couldn't breathe. When she was four, however, I took her to the doctor (I think she had a cold), and her doctor diagnosed her with asthma. Her asthma is not severe, and only flares up when she has a cold or is doing a lot of running. I remember thinking that she had night terrors because she seemed so upset when she woke up. I realize now that she was just a feisty kid who couldn't breathe very well. But this may not be the case with your son. I also have a son who is 8 who gets croup from time to time. He wakes up with the barking cough that sounds like a seal, and I usually take him into the bathroom and turn on the shower full blast or take him outside. He also sometimes gets winded when he exercises very hard. He may have a mild case of asthma also. My advice would be just to watch him and to talk to your doctor about it. If he does this again and again, it could be asthma. Otherwise it might have just been a bout with croup. One other thing about asthma (and this may not apply to you at all): when kids who have asthma get upset, it is very important to try to calm them down. Their anxiety and crying makes breathing harder. But it is very hard to do because it is scary if you can't breathe. It sounds like you handled the situation well.

It sounds more like an asthma attack than a panic attack. I would call your sons DR and explain what happened to him. During an asthma attack the lips and fingers do not always change color. My daughter has asthma and has never had any color change to her lips or any other body part.

Hi H.,
I don't know if it is the same thing, but my 4-year old son had this happen a few months ago. It was actually the croup. It all started one night when he woke up crying, also not calling for us like usual, but just crying and then when I went up there he started that weird gasping, hard-to-get-a-breath thing. It made me pretty nervous, so I, too, slept with him in his room on the floor that night because he would wake up crying and gasping on and off. He also thought he was going to throw up. It seemed to be Ok during the next day, but then after a couple of days, I ended up taking him to the doctor when his cough turned hard and had this "barky" sound to it. Turns out, it was croup. She said they often wake up crying because it hurts in their chest and they don't want to cough, but they feel like they have to cough, but it just hurts too much to do it, so they gasp for breath, etc. Since there really is no "medicine" for croup, she just had us put a humidifier in his room (we had good luck with the warm-air mist humidifier that you can add the Vicks vapor liquid to) and then we would have to put him in the steamy bathroom, etc. to try to ease his cough. It was a rough couple of days/nights. I felt so bad for him. For several nights, I slept on his floor to give him drinks of water and help him prop up in the night, etc in hopes of relieving the painful feeling for him. I even made the bathoom steamy a couple of times in the night to help him. It always seemed to get worse at night. The "bad" days/nights ended after 5 days. The cough lessened but still held on for a good 2 weeks afterwards before disappearing completely. I don't know if this is what your son is brewing or not, but it sure seems to be a similar situation.
Hope this helps...

um he could be allergic to something take him to a dr and have him checked out. if you had people over make sure no one was smoking cause that could have been an reaction too. i would keep an eye on him and make sure it's not an allergy.
kids can have panic attacks and anxiety it's not unusual. talk to your dr for more info.
hope this idea works.

I agree with the other moms that it sounds like a night terror. My daughter had one at age 2. From day one she was an excellent baby, and always slept well. But, this one time we were on vacation, she woke up couldn't find her pacifier, and that is how it began! She cried uncontrolably for 4 hours--it was awful!!! We had three adults try everything they could--nothing worked, so as a last resort I put her in the shower--it worked like a charm, she then went right to sleep. It never happened again, and now she is 13. I really think it was a night terror that she just could not get out of.

Does he ever complain of reflux symptoms? Maybe if he ate later than usual or had spicier foods he could have been choking from acid reflux? All my kids have it and so does my husband.They cannot eat too close to bed time.When my middle child was younger (before he was diagnosed) he would wake up in the middle of the night choking just like how you described your child.The doctors put him on Zantac because reflux can cause asthma like symptoms.He is better now no meds, we watch what he eats and stop snacking earlier in the evening.You should probably mention what happened to your doctor. Good luck!

Could have been a night terror, the child will seem awake but are really asleep yet.

It was probably all the excitement of the evening. It is hard for a child to process all of that and then just turn it off and go to bed. Some kids have a much harder time transitioning between things. If his normal bed time routine was disrupted that can cause anxiety in children as well. It would be like going to New years in Times Square and at midnight trying to lie down and go to sleep. Children can really enjoy these events while they are happening but feel overwhelmed by all the excitement and energy surrounding them. They are too young to process it all and haven't developed self-soothing strategies to tone it all down. Then when he was alone he may have felt anxious. That is why routines are so important to young children. It helps them to settle down and get ready for the "next thing" (ie. bedtime or whatever)
My daughter used to throw up when ever she was anxious and that was any time there was a new situation in which she felt she had no control. She was typically a very outgoing child however, so I learned to tell to her about things in advance so she would know what to expect and that helped us tremendously. I don't think you have anything to worry about. It seems pretty normal to me. Good luck with things.

I hate to say it, but that sounds just like my kids with their asthma. My kids have never turned blue/white either, but they cough, wheeze, and cry because of lack of air. It does exhaust them and often will fall back to sleep when they settle down a little, because the air flows better when they are relaxed, but the reality of it is that they aren't getting enough to air to start with, so that it what wakes them up in a panic. And the cough today is a pretty big sign that probably is asthma. After dealing with this for over 12 years with 5 kids, I have learned to listen for the cough and start treatments immedietly, so it doesn't get worse. I suggest taking him into the peditritian and telling him about it today.

My kids had (have) night terrors, and it doens't sound like what your guy went through was a night terror (they usually don't remember and it takes a long time to get them settled down in my experience). I think it may have been over stimulation if there were a lot of people over and the game and lots of food. Good luck to you!

I have experienced this same problem with my son. He did out grow it. Just to give you another idea of what it could be I thought I'd share my story. My son suffered these attacks when he was younger and always at night. I did end up taking him to the ER a couple of times and sometimes it was actually the beginning of a cold. It just seemed to be an indication that he was getting one. However, it was very scarey at times. Also when you said he felt like he had to throw up, my son also suffered from this type of thing too, we found it to be that if he didn't eat right or ate too late the night before, then he'd get sick. Acid reflux. But like I said he did out grow it, we just made sure he didn't eat too late and what he did eat wasn't anything too rich or spicey for him. Another thing that I'm familiar with is anxiety in my daughter. She started as young as age 3 if not before. It may be a nightmare that started this for your son but if there is anxiety, I think you will see other signs. My daughter went through a lot of different stages, but night time was more about not wanting to be alone and with your son saying it was ok for you to go back to your room makes me think that it wasn't anxiety. But I'm not a doctor, just thought I'd let you know what I've seen with my kids and maybe it would help. Let me know if you have any questions for me!

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