I wake up at night with tightness in the chest and a

Please let me know if you can provide more information, and I would be glad to discuss it further with you. One possibility to consider, especially if you can check your blood pressure during these episodes and it is very high, would be a pheochromocytoma, which is a tumor that releases adrenaline. This is rare, but can sometimes cause the kind of symptoms you describe. But let me know if you can tell me more and we can discuss it more.

Do you feel like you have anxiety at all? Do you feel like this could be related to anxiety or panic attacks at all?

Do you ever get a headache during these times?

Ok, that sounds less likely like pheochromocytoma then. It might be something worth checking for, it would just involve a 24 hour urine test, which you could discuss with your doctor. But I suspect that it would be negative. So with all the testing you have had, I would suspect anxiety with panic disorder as the most likely diagnosis. There are medications that can help with this, such as SSRI medications, and benzodiazepines, as well as other kinds of medications, can also be used for panic attacks. If you are able to talk with a psychologist, that can be helpful as well.

I hope that helps, please let me know if you have any other questions about that, and I would be glad to discuss it with you further.

Yes, that would be consistent with panic attacks, though pheochromocytoma could potentially act like that too. So I do not think it is a pheochromocytoma, mainly because they are so rare, and panic attacks are relatively more common, but you could discuss testing for pheochromocytoma with your doctor and see what they think.

That is a bit strange, that wouldn't be typical for either panic attacks or pheochromocytoma, though if it is related to dreaming it may be contributing to panic attacks.

It would not be typical for sleep apnea, no. Nocturnal panic, which would be a kind of panic attack, is very possible.