Frequent waking, pulse rises, sweating

[klezman]

I have been waking up frequently every night - up to 7 or 8 times - for the past 12 months although I have no problem falling asleep. I always wake with a start, my pulse is fast and somethimes my breathing is laboured. My hands are usually hot, puffy and sweaty - and they continue to be so during the day.  I did a self-administered sleep study through the British Sleep Apnea Association which showed I did not have apnea, but their report said I had an "unusually high pulse rise index" (with the pulse rising sharply to a max. of 114 on wakening) which it suggested was the cause of my fragmented and poor quality sleep.
I've seen a cardioligist and an endocrinologist who checked me out and couldn't find anything abnormal. My exercise ECG, 24-hour ECG and blood tests are normal. My heart rate during the day is normal, as is my blood pressure. However, on the few occasions I measured my BP immediately on waking, it was very high and for this reason I have been taking the beta-blocker Labetalol for some weeks. Although I feel exhausted, ill and distressed every  morning and can only work in the afternoon or evening, I try to go for a brisk walk most days (with a few spurts of jogging even!).
Because the symptoms started when my mother died, my doctor feels  anxiety is the culprit. I'm sure the shock of my mother's death played a part initially, and could have been the trigger, but I think the stress and anxiety I experience now is the result of the symptoms that have persisted for so long.  I've had CBT and bereavement counselling but this has not changed my symptoms.  Any suggestions as to how to proceed from here would be greatly appreciated.

[Gregg D Jacobs, Ph.D.]

Your symptoms sound physiologically based or anxiety based since you describe physiological symptoms that are distinct form insomnia. Since your doctors find nothing wrong, follow through on the suggestion of evaluation for anxiety.

Dr. Jacobs