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What could this be ?

Last 10 days or so every other night when i go to sleep my heart starts to pound "hard" sometimes lasting through the whole night and i dont sleep a wink. I have benign pvc's and pac's for years. Just ironically had a stress echo that was totally normal just before this started. I have a stress echo every 3 years because of family history CAD so i can safely rule out any abnormalities.  It started 10 days ago on a saturday night when i had a couple glasses of wine. I ended up having an elavated heart rate when i went to bed which to me sometimes happens with wine. But now every other night just going to bed my heart really "thumps" and sometimes rate increases. Does this sound unusual ?  My Cardio Doc is scatching his head. I've been on a beta blocker for the past 20 years with no probs. Also....none of this happens at all during the day......thank you for your help !!!!
1423357_tn?1414258965
Sleeping in too warm conditions?
Elevated body temperature from too many blankets will elevate your pulse.

Obstructive Sleep Apnea?
OSA will raise your heart rate as it attempts to circulate oxygen starved blood to vital areas.  I unknowingly suffered from this condition and would awake at night with a pounding pulse.  Warning is often, but not always heavy snoring.  I've read that if you're a male with a neck size of 18 or more, it is nearly guaranteed that you have some degree of sleep apnea.

Low blood pressure?
If blood pressure drops so low that the body cannot receive adequate amounts of blood,  the heart beats faster to deliver more blood. In severe cases of low blood pressure, the heart may beat so quickly that it seems to pound inside your chest.

Low blood sugar?
This is often accompanied by shakiness.


Of these possibilities, I unknowingly suffered from OSA.  I had a very severe case with pulse ox levels dipping in the low 70% range.  I reported awakening with a pounding pulse to my physician, and he responded with increasingly higher doses of the beta blocker, metoprolol.  At 200mg, I was a walking zombie amd it did little to correct my condition. It slowed my heart down a little which lowered my pulse ox even more. I developed a case of secondary polycithemia; blood overly enriched with red blood cells, a condition often found in people who normally live at high altitudes.  A change of my primary care physician led me to a sleep study where my condition was revealed and immediately corrected with CPAP.
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