First I wake up every night, sometime between 2:30 and 4 and the awful feelings start. Usually am awake for 30 minutes to an hour (thank Cortisol). Then when I wake up for the day, they really kick in, i.e. racing heart, headache, feeling like I've drank 30 cups of coffee, lightheaded, internal tremors, etc. I'll be so glad when I can start treatment soon.