Difficulty breathing at night

   I am a 60 yo male with a long history of heavy exercise, competitive running and cycling. My resting pulse is about 45. I had CABG 6 years ago for a bifurcation lesion bypassed with LIMA and saphenous vein. A recent CT scan shows little flow through the LIMA graft and a patent venous graft. Review of original angio shows only borderline blockage in LAD. The LAD territory was apparently being supplied by an extensive collateral development.
   I am currently taking 5 mg linsinopril, 10 mg Crestor, and 25 mg Toprol XL due to occasional bouts of atrial fibrillation. These come during very heavy exertion during cycling or sometimes during intense emotional incidents. They have always converted back to sinus rhythm within 24 hours.
  Over the last year, I have had several episodes of dreams where I sense that I cannot get a breath, as if my nose were stopped up and my mouth is shut. I struggle and when I awaken, I can breath quite normally with no nasal congestion. It happened again last night but the difference is that the I am on the third day of taking 100mg of amiodarone prescribed to alleviate the Afib. I have worn a Holter recently and it was judged to be normal with occasional PACs and of course sinus bradycardia due to the low resting rate.
   I wore my heartrate monitor the other night when I went to bed and the low limit alarm of 38 bpm sounded before I ever got to sleep.
   I am wondering whether my dream incidents could be due to me reaching too low heart rate during sleep or possibly my heart even stopping. My mother had a similar incident recently and ended up with a pacemaker.
  I don't think I have sick sinus or AV dysfunction as my heart rate climbs quite rapidly to 160+ appropriately during exercise and drops quite quickly when I stop. My low resting rate causes me no problems when I am awake.
   Do my dreams suggest a heart problem? I am becoming afraid to go to sleep for fear of not waking up.

[Michael J. McWilliams, M.D.]

It is relatively common for heart rates to drop into the 30's at night, especially in people that exercise.  If  you are perfectly fine the second you wake up, it is unlikely to be heart failure. I long pause or series of pauses could cause symptoms but I am not sure about the not being able to breath sensation.

Talk to your doctor about your concerns.  They may want to order a monitor to see if  your heart rate is too slow but I doubt this is the case.  The first step is always to talk to your doctor about new symptoms.

[LukeL]

Look up sleep paralysis

[oliverio]

Waking up gasping for breath could be a sign of apnea.  If that is the case it can be diagnosed by a specialist and remedied by a CPAP apparatus.  I find that sleeping on my side and not my back controls this problem.