Severe nighttime panic attacks?

I've been experiencing progressively more intense panic attacks over the past couple of years, and almost always at night. They usually begin around 9 or 10 pm, and usually it's when I'm just sitting on the couch trying to unwind. They're negatively impacting my relationships and my ability to do work, and I keep missing out on things I want to go to because I'm so tired. They scare and exhaust my partner because they're so intense, and I never ever want to do that. These panic attacks last hours. We're talking hyperventilating from 10 pm to 5 am straight. I cannot identify a trigger. It just seems like, no matter what, I will experience horrific panic attacks at night that are so severe that I can't talk, move, or sometimes even hear. Grounding techniques, breathing exercises, and going for a walk to calm down are fully out of the question. Nothing I've found can reliably reach me or shock me out either, including but not limited to ice, cold water dumped on my head, and electric shocks. These panic attacks are incredibly painful because of how long I end up hyperventilating in the fetal position for. I feel the physical effects for days afterwards, and lately I'm having as many as four of these attacks a week.

I am not on a daily anxiety medication. I've had severe side effects or reactions to every daily medication I've tried, and it's been quite a few daily medications by this point. My doctors agree that medicating me is complicated, and most of the medication options left are not very favorable for me specifically. I've also been in therapy for years, but it hasn't really helped. I have a trial as-needed prescription for hydroxyzine, which surprisingly does seem to help, but it also tends to put me to sleep immediately. This is a problem when I'm trying to get work done late at night. I'm also worried about taking it too much and building a tolerance, or growing dependent on it, or developing serious side effects like I have with every other medication I've tried. And, all of that aside, often the attack is too severe for me to even be able to physically pick up the pill bottle by the time I decide I need medication.

I'm exhausted and desperate, and I just want to reliably be able to enjoy my evenings, get enough sleep, and properly maintain my relationships and life. I don't want to be afraid of hanging around once the sun goes down anymore. My life would be pretty good if this would just stop.

Has anyone else experienced anything like this? Does anyone have a single idea of anything that might help? Preferably something out of the box? I would be so grateful if anyone were able to suggest something that could make this even a little bit more manageable. I feel like I've tried everything.