Hi there
Once again I have woken up and got a racing heart. What triggers that? It is getting really frustrating because I am so tired with anxiety, I get to sleep at a reasonable hour and then once I am woken up by the racing heart soon after I have gone to sleep I am left wide awake for a couple of hours while it calms down.

And also I have a new thing happening - well it feels new. As I was sitting at my desk earlier my heart suddenly just started going boom boom boom boom for about four or five beats - really fast and hard before reverting to normal. What is that and why did it happen? I wasn't doing anything other than sitting checking my emails.

In general my ectopic heart beat is slightly less in frequency in this past week - ie. it is not every seconds - if I was to think about it in the past there would always be one but this last week I might not get one for or a run for five minutes or more sometimes.

There are several causes for this phenomenon, the most common of which are night terrors (similar to nightmares) and sleep apnea. It's important to realize that anxiety disorders continue to exert their influence on the body and its physiological processes even during sleep. Most times, patients are already experiencing a reduction in quality sleep, which leads to a pattern of fatigue and changes in the brain's function during sleep. Many patients have terminal insomnia, or in other words awaken regularly throughout the night or at certain times. The brain undergoes several phases during sleep and it is often at the junctures between REM or Non-REM sleep patterns that patients awaken and note the time of their awakening seems to mysteriously be roughly at the same point each night. This continues and patients will then find a more restful night's sleep on about the 3rd or 4th day due to overwhelming fatigue that generally overcomes the anxiety's ability to reduce sleep.

Sleep apnea is the restriction of air by the soft palate and changes in respiration that together cause mild reduction in oxygen exchange during sleep. Patients are often found to snore, gasp for air, awaken with a sore throat, hoarseness, fatigue and lethargy and other symptoms. Research has demonstrated a link between cardiovascular conditions and sleep apnea in certain persons.

Pounding heart is typically the response by the body subsequent to benign palpitations which cause slight changes in blood pressure that must be compensated. Increased cardiac force raises blood pressure to normal and it's an entirely normal physiological process.

You're going to be just fine.

Best regards and Good Health