Night time anxiety upon waking

[Kris72]

Ok, I am 33 years old and for the passed 8 months  I have been waking up on/off in the middle of the night with a rapid heart rate, anxiety, shortness of breath.  I have seen cardiologist who has done echo, stess test, holter, ect and claims this is anxiety.  I dont feel like this is just anxiety and have been researching the internet trying to find an answer.  

My question is....could this be a symtpom of hypoglycemia?  I have done some reading, and it sounds like it might be.  Could sugar and white flour or alcohol be causing this?  The rapid heart rate and anxiety last about 15 minutes....usually I take an ativan, but have in the passed had raisans and that seems to help?  I think?  I am so concerned and confused.  I also have a nervous/tremor feeling and do feel hungry a lot and crave carbs....this past week I have been doing the no sugar and no flour diet and I do feel better....not so anxious and mood swings better.

Any advice?

[Johnny Alpha]

I have a similar non-diabetic problem. For the last 20 years (I am now 38) I have always had a good appetite, feeling hungry 3 hours after a meal. I have been cycle racing for the last 6 years which has brought on similar effects to what you are describing.

After an event or long, hard training ride I would feel confused and lethargic, and during the night I would wake with very noticable heart beats, not always fast but enough to keep me awake for some time. I would sometimes have 'the shakes' and any sleep during this time would be light with many dreams. The following day I would be tired and physically drained and the heart papitations persisted. This would last for 2 to 3 days. I saw my doctor who gave me an ECG (Cardiogram) and gave me the all clear. This took away my concerns but the problem persisted. My moods were also erratic during these periods, and I would refrain from training until I felt recovered.

I started to investigate on the net and bought a blood sugar meter which indicated a reasonably low level (4-5mmol/l) most of the time, even 1/2 hour after a meal. Further web browsing indicated the posibility of post-prandrial or reactive hypoglycemia. As I understand it this is an overreaction to a rising blood sugar level either by too much insulin release or excessive response by the liver causing a low sugar increase after a meal.

I went back to my doctor who referred me to a dietician who helped me with my diet. To cut a long story, er not so long I have now had a significant improvement and hardly ever have the night time problems. My meals are smaller and more frequent to help prevent fluctations of sugar levels. They are of low to middle glycemic index. I believe the main solution to the night time episodes is a low GI meal immediately before sleeping, I have some dry fruit (not much), nuts and sugar free cereal. If I wake up in the night with any of the previous symptoms I have a small bowl.

I have the requirement of a fairly high carbohydrate
diet so my weight is more or less under control but I did put on a few pounds when I first started the more frequent meals. You tend not to feel as satisfied after a small meal.

Even the dietician had little knowledge of this condition although he researched it prior to the consultation. I don't even know if I am a bad sufferer but what he has suggested has made a difference. I've just had my best racing season so far.

I hope this has helped.

[JDRF-Team-JW]

Wonderful advice from GG. I'm also a volunteer here and have had diabetes for 11 years. The symptoms you describe are pretty much what I experience with hypoglycemia, especially waking up in the middle of the night (which is the worst!). It sounds like you do need to have your blood glucose checked with your doctor. And not just a finger stick but an A1C blood test to check how your sugar has been in the past 3 months. Good luck to you!

[JDRF-Team-gg]

Hey Kris!  I am not a medical professional, so I can't offer you medical advice and my experience with this forum is with type 1 diabetes so I can only share with you my experiences with hypoglycemia in relation to that.  Have you had your blood glucose level checked?  I think that is where you need to start to determine if your blood sugar level is causing these symptoms.  It's good news that it isn't your heart though.  You may want to monitor your caffeine intake to see if that helps with the daytime nervousness.  Recently, a friend of mine, who thought she had hypoglycemia for the past 10 years or so, stopped caffeine altogether and her shakiness disappeared. Just something to consider.  If you need advice after having determined if diabetes is the cause, please post again.  Good luck to you.