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Avatar universal

palpitations during sleep

I am 58 years old and sometimes experience rapid palpitations during sleep. I can be doing absolutely nothing but sleeping and my heart will beat faster. I have had echo stress tests, monitors and many other tests. I have had a monitor during the last 2 weeks. There were 7 or 8 episodes that I reported. When the doctor gave me the results, he said I had slight blockages that lasted approximately 0.22 hundreds of a second. He said everything was normal, but I don't understand that why, when I am sleeping, and not doing anything strenuous that my heart will do this. Can you give me any reasons that this may occur?
19 Responses
612551 tn?1450025775
Clearly your doctor is your best chance of getting an informed/expert answer.  Did you see a cardiologist, or was your work prescribed by your primary care doctor?  

As for the slight blockage, I have zero personal knowledge, but I assume you were told that it lasted 22 (not 0.22) hundredths of a second, even that is a very short period of time, so short that I am completely at a loss of how that is measured.  Consider at 60 beats per minute each beat is separated by 1 full second, so "seeing" anything like a blockage at a sub-second time range is very surprising to me.  As I said, I have no knowledge here, but maybe my post will help stimulate input from others.

Best wishes.
Avatar universal
Nice to see your post, I have the same problem with my a-fib. It is called "paroxysmal" -- meaning intermittent.
   I am 65 YO and 10 pounds overweight.
I get a gentle A-fib at 5 or 6 a.m. every day and I usually have to use the toilet at that time and it goes away.
    I think maybe the vagus nerve, which goes between the brain, the heart and the intestines, is irritated by a full bladder or colon. Often I get atrial tachycardia accompanying before or after. And a few PAC's. But they go away when I either get up or lay on my back and breathe deeply for five minutes. This makes me think that I had sleep apnea so I bought a blood oximeter and it showed 98% oxygenation whenever these attacks occured, which is OK.
     It seems odd to me that doctors don't mention this aspect of A-fib. I can't be, we can't be, the only two people to have this symptom.
   I'm getting a slight relief by eating sparingly and early in the evening but it sure doesn't prevent them.
    Anyone else dealing with this regular pattern of A-fib?

  OH, it has a positional aspect to it too. Afibs will start if I lay on either side in the early morning. It decreases when I lay on my back. This is strange. No heart specialist that I've seen understands why this happens. You know, cardiology has a long way to go, I think.
Avatar universal
You're not alone funzleus. I have the very same thing every night, sometimes three or four times a night. That may last for a month, until I think I'm going out of my mind and then for no reason I can explain, it goes away. But, unfortunately, it comes back. By the way it is not A-Fib. I suffer from that too so I know the difference. A-Fib is an irregular, irregular rhythm that you cannot mistake for anything else, although some people do confuse it with PVCs and some don't even know they have it. Let me clarify all this by pointing out that due to having a low heart rate 48-52 while resting, when I'm asleep and my heart rate increases to 80bpm, I feel it as a palpitation. I believe you cannot call a heart rate under 100bpm a palpitation. Nevertheless, it wakes me up several times a night and keeps me from getting a good nights sleep.

The A-Fib I can deal with. That is now occurring every three months and starts with very real palpitation of at least 120bpm gradually dropping down. I guess due to my slow heart rate I also have slow A-Fib. I'm lucky in that it doesn't last long, an hour to two hours and I'm back in sinus rhythm.

I experience the same thing that Navigaiter does in that when I have the increase in heart rate if I empty my bladder it drops down. I believe he/she may be right that it has a lot to do with the vagus nerve. I discovered this simply by accident. Empytying my baldder can and often does stop my A-Fib. It has become my technique for stopping my A-Fib. I drink lots of water and sooner or later while I'm passing it my A-Fib stops. Another thing that convinces me it has to do with the Vagus nerve is that sometimes when I wake up with the increased heart rate I feel nauseas for five or ten minutes.

I too have been through most of the tests. I just finished my second 21 day event monitor  in less than three months, have had the echo, the nuclear stress test and at least a dozen EKGs in the last few months.

I'm not stranger to arrhythmias, have had then most of my adult life and Navigaiter is also right in saying that cardiology has a lot to learn. No cardiologist, and I've seen many over the years, from some top teaching hospitals to my local "take your chances" without any of them being able to tell me why I'm experiencing any of this, electrophysiologists are no better at treating these arrhythmias, at least not for me.

Once again in talking about positional aspects, Navigaiter has touched on what works for me in reducing the intensity of my heart rate increases. I'm learning to sleep in an almost sitting up position and instead of the rates being above 80-or over 90 beats pm, I have them down to 70 and 80. Now I'm not sure of any of this but when you lay down flat your diaphragm moves up towards your chest where most of the vagus nerve is located from the larynx to the esophageal plexus. When your in a sitting position your diaphragm is down. Why this should work for me is quite beyond me. But my A-Fib was, as I said above, occurring every three months. Since I started sleeping sitting up it's been almost four months and I haven't had an A-Fib episode. Now don't get me wrong I don't believe for a moment that I've found a cure for my A-Fib or the increase in heart rate that wakes me up. It just makes it a little better that's all---so far. All the best and remember you're not alone or without those who understand what you're going through. God bless.  
376186 tn?1219283105
I tend to get PVC's every night when I go to bed..sometimes they start up after I have been lying there for an hour or they might come in a few min but I can count on episodes every single night. My cardio has not given me any reason why this happens. I am going to ask him the next time I go in for a check up if I can take 25 mg of Toprol and see if that helps. I am currently taking 50mg of Toprol XL in the morn. He had wanted me to increase my dosage anyway to 75 mg but when I tried that, the PVCs did not decrease and I had 0 energy so I went back to taking 50 mg. The PVC's at night are so bothersome and these started like this several months ago. I also get them throughout the day....fun!!!!! They really do affect my sleep tho and would love to take something for sleep but hate taking any RX's...I have tried the natural sleep aids but they did not help at all.
612551 tn?1450025775
I think some (all?) of the modern sleeping pills are safe.  My wife, also a Barb, doesn't have any heart problems that I/we know of, but she's not symptom free and regularly takes a sleeping pill.  Here doctor says there is no problem with taking them every night.  She's now on a generic form of one of the patent meds advertised on TV.  

I think if I were loosing sleep on a regular basis I'd take a sleeping pill.  That's not to say I sleep through the night, but my wake-up call isn't my heart, its my bladder.  
47427 tn?1238442851
I think the blockage your doctor was referring to is a slight lengthening of the "PR" interval on your EKG.  The PR interval is the time between depolarization (contraction) of the atria and the depolarization of the ventricles.  Normally, this interval is between .12 and .20 seconds.  Technically, a PR interval of .22 would be a 1st degree AV block, which means the electrical impulse between the atria and ventricle is very slightly slowed during sleep.  Many things can cause this, including medications (e.g., verapamil) and sleep itself.  If it is transient and only occurs during sleep - and if your heart has been thoroughly checked out - then I'd bet everything is A-OK.  One thing that can cause your pulse to accelerate during sleep is dreaming.
376186 tn?1219283105
I googled Lunesta which is what my primary care doctor game me 2 yrs ago..samples which I had never used. Well, I read some of the side affects and tossed them just the other day. Maybe I should have kept them and given one a try. When I go back to my doctor, I will ask her for an RX b/c I know that lack of sleep causes all kinds of problems.
Thanks for your reply.
Avatar universal
Regarding sleeping problems:  have you tried vitamin Melatonin?  Also I had to take prescription Amitryptalin(sp?) for couple months to get me back into healthy sleep pattern.  They started me on 5mg, then found 10mg to work best w/no sideaffects.  Take hour before bed (doesn't really make you sleepy, but once you're asleep-helps you STAY asleep).  When you figure out the correct dose for you, you don't even feel drowsy in the morning (25mg was too much for me).  Dr said safe enough to stay on for whole life if necessary.  It is NOT addictive either.  Once I got into good pattern (4 months) I dropped dose down to 5mg for 2 wks, then stopped.  Sleep is such a critical requirement to our physical and mental health.  If you are interested check w/your Doctor.  It might just serve as a temporary aid for you.  Hope this helps.
Avatar universal
Nice to hear awlright chime in with their afib symptoms and agree that there are positional aspects to afib events. A top cardiologist at the VA Miami hospital didn't have anythibng to tell about this aspect of the disease. He, and another local cardiologist doctor treat afib with ablation, [ burning scars into the heart tissue], or  with prescription drugs which haave side effects..
    But I feel sure that the paroxysmal type of afib is caused by some condition in the body and the cure would be to find out what is the cause of them, not to just mask the symptoms for a while. That is why I say that cardiology has a lot to study and learn.
637910 tn?1454710180
I am convinced that the vagus nerve plays a major role in irregular heart beats. One evening, after a very unusual meal (raw cabbage salad, very acidic I think), I bent down to pat my dog, then went to bed. Immediately after lying down, my heart started skipping like mad. When I sat up, it stopped. This continued the whole night, lying down, skips, sitting up, stop (needless to say I didn't sleep a wink!). I took a beta blocker, didn't help with the skips, I took a Zantac, not sure if it helped, but in the morning, the skips subsided. I often have pvc's, when I eat the wrong stuff. I also believe that once your vagus nerve is really irritated, it will need a while until it calms down again, so taking antacids might help a bit, but not always. Remember, everyting is connected, stress (brain), tiredness (brain), food (stomach), alcohol (stomach/brain). vagus nerve = brain-heart-stomach! I don't understand why most cardiologists seem to ignore this fact and tell us it's a mechanical/benign problem of the heart. If that's the case, why don't we have the skips all the time? Why do we have periods where all is fine?
Avatar universal
Hi Skippy,  I found it interesting that you get some results from fish oil.  As you probably know fish oil (omega 3, 6, and 9) can have anti-inflamatory properties.  This makes me wonder if your problems have anything to do with an inflamed nerve or tissue.  I take fish oil also and believe it helps but have not had complete sucess.  I am also taking adrenal support suppliments and thyroid supplements and things have improved but not eliminated yet.  I have PAC's constantly but the severity of them has changed.  The supplements I am taking are pharmaceutical grade nutraceuticals.  I think exploring our endocrine systems (thyroid, adrenal, pituitary, and hypothalamous), is another avenue for us sufferers.  Many cardiologists though do not use a more complete testing system.  They only test for T3 and T4 thyroid hormones.  These can give a false reading because you need to know the TSH , anti-TG and anti-TPO levels.  So if you go this route ask for complete comprehensive testing.  Good luck!
Avatar universal
Have you ever had a sleep study? Do you snore? I woke up in the early am with episodes of Afib several times. It was a mystery to me why it always happened while I was asleep. A cardiologist referred me to a sleep disorder specialist who had a sleep study done and it was found that I have sleep apnea. I started on a CPAP and it got much better. I didn't need sleeping pills anymore. Be careful. The newer sleep meds that claim to not be addictive do produce dependence that causes one to face loss of effectiveness over time or having to increase the dose and are readily abused.

A cardiologist I saw when the hospital once following an episode of Afib that required electrocardioversion to stop, told me that such events that seem to occur during sleep are related to change in vagal tone when relaxed. I tend to get PAC/PVC's when I am resting. If I get up and pace, it usually stops until I sit or lay down and relax again.
Avatar universal
hi everyone...not sure if anyone will ever see my post.  but i feel relief while i'm typing this...
i'm 29 and just diagnosed with a-fib as of tuesday.  i feel terrified because the only thing i've ever really experienced for the past year or so was palpitations and i learned to live with it, not knowing it was a-fib at the time.  but lately it has gotten louder and terrifying at times (usually at night after dinner).  i have chest discomfort everyday.  not quite painful, but just enough to let me know i'm not right.  

other than a year of waking up to frightening conscious convulsion-like activity during my sleep, which i can't tell are a-fib episodes or possible sleep apnea, and the milder palpitations i was doing okay.  but i think it's all caught up to me now.  
i went a year to doctors, cardiologists, and was only diagnosed tuesday when i had to move and find a new family doctor.  

i'm blabbing....can anyone tell me what a-fib episodes at night during sleep are like so i can eliminate the possibility of seeing a sleep specialist?  i sometimes wake up drenched in sweat with my heart racing and what feels like my entire body jerking around.  it wakes me up and scares the hell out of me.  and sometimes, i feel my body startle and jerk around quickly and i wake up, but no sweats.  i live alone right now and am afraid everytime i go to bed.  

how do i get through it.  i don't think i can.  

637910 tn?1454710180
thank you mel48 for your interesting observations. I have been tested so many times for thyroid malfunction, all ok of course! But yes, probably not tested the full range! But I must admit, one gets sick of doctors after a while, telling us it's all benign and live with it. So I'm trying to just do that, live with it, accept it, and listen to my body and look after it. Hard at times, but reading other's posts, I'm still lucky as I do have periods where I hardly have any skips :)

to mis211: I don't have a-fib but know how it feels, when the heart skips away and when suddenly, the heart starts pounding and racing. VERY SCARY! We probably all go through these stages, and get stressed so more easily, no wonder. Stress can cause the sweating/racing of your heart (believe me, I've been there too). Try and go for some slow walks in the sun everyday, and read up on stress and how to combat it. I hope you feel better soon. Take care.
Avatar universal
I have something slightly different, in early am, between 2-5, i woke up feeling like my heart has stopped, almost no pulse, my limbs are weak, and i had a doom feeling that is hard to explain. When i then sit up and move around, i feel better. This happens few times a week. Appreciate any comments/advice
Avatar universal
I was told, after it scared me badly ( I'm 55) that it is a type of heart burn. This is why you feel it with certain types of food later in the eve and why it's positional. I realize what I did wrong after the fact now. But watching what I eat and when, going to the gym and taking Q10, seems to help alot.
Avatar universal
I was told, after it scared me badly ( I'm 55) that it is a type of heart burn. This is why you feel it with certain types of food later in the eve and why it's positional. I realize what I did wrong after the fact now. But watching what I eat and when, going to the gym and taking Q10, seems to help alot.
968809 tn?1288660510
I have atrial flutter and almost always have svt when I am sleeping or just relaxing (doing nothing like watching tv). I'm guessing that a slower heart rate must allow for more ectopics and an ectopic always starts my svt.
Avatar universal
I'm a 41 year old female, diagnosed with MVP at the age of 14. I take no medications. I had the first episode of an extremely fast heartbeat in the middle of the night some 7 years ago. I have learned to help myself. I take granulated magnesium and I tap along accupuncture points on my face and collar bone (EFT technique). But last april it stopped working. It took me a month or more to realize that at the same time I started using magnesium I also bought a radiation protection for my cell phone. I had it for 5 years and last march it came off. I also realized that my problems 7 years ago started with the use of a cell phone. Here you go! I don't use a cell phone any more and it's under control. I don't know whether it's all in my head, but the cell phone messed up  my hormonal cycle right away, which was the reason I put that radiation protection. And it worked right away. Best luck to all of you!
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