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Atrial fibrillation when falling asleep (Read 10869 times)
FloppyHeart
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Atrial fibrillation when falling asleep
Nov 17th, 2010, 10:19pm
 
I am a 51 year old male, 5'10" in good physical condition, and have been having bouts of Atrial Fib for 3 years now.
I have had an ultrasound done on my heart after the 1st episode, and my cardio doc told me it was ok. They put me on low dose aspirin, and told me I had low B12, so i have been on 1000mg b12 as well. I also foumnd out recently I have a low form of celiac disease, but nothing serious. I am on a gluten free diet, and eat a very balanced low carb meal plan. Lots of fruit, veggies, fish, and lean meat. NEVER no junk food. I do not drink or smoke. (how boring eh!)
I have had the 24 hr holter monitor done, as well as the king of hearts monitor.
Lately, i have been slipping in to atrial fibrillation just at the momemt of sleep.
You know, the moment when you just doze off from that conscious state to the unconscious state, well at that moment, I will be completely calm and
relaxed and just as I doze off, my heart starts to fribillate and wakes me right back up.
I MUST stand and walk about in order to get out of A-fib. And if it wont come out right away, within 1 to 2 minutes, then I know I am stuck in A-fib
for 1 to 2 hours or so. I can usually get it to stop after about 1 minute. But if I just lay there and let it continue, I will slip into Atrial fib for about 1 to 2 hours, and must walk around calmly to get my heart back to normal sinus rhythm.
This happens all night now, every night just at the point of sleep. And I cannot get to sleep because of it. It has been quite a while since I have had a good nights sleep.
I do not have any palpitations during the day or any other time at all.
It usually takes me until 6am before I can finally slip into sleep without any atrial fib. I have tried eating, and NOT eating, I have check my glycose,
but its normal. I'm at a loss, and have scheduled another appointment with my cardio doc, but the waiting list is long.
The only vitamin supplements I take are C & D, 500mg each.
The first thing I will need to do is get tested for my current levels of magnesium and potasium.
I'm not even sure what blood tests to ask my doctor for, but I will ask.
I wouldn't want to start taking Potassium without know what to take and how much, as I know to much Potassium is very dangerous as well.
I've kept a journal of notes, its long, of all my episodes over the past 3 years, and one thing I do notice is most of the episodes happen during the winter months... as a matter fact, I have no episodes from May until September each year. I figured I may be low in vitamine D, as the reason I am taking it. Maybe 500mg is not enough.
In the summer months, I do spend alot of time out in the sun on my boat and such, so maybe the sun plays a big roll.
I did have a sleep apnea test done a few weeks ago and it showed I was ok in that department and no signs of problems there.
I also should mention that when they did the 24 heart monitor, my resting heart rate averaged between 46 to 51 bpm, and hit lows of 36 bpm.
During the day it averages 60bpm, unless i'm working out or something.
I have a slow resting heart rate as I was kept fairly fit when i was younger, and try to do as much as I can for cardio nowa days as well.

What is really strange, is that I can lay down after supper, and take a nap for 30min or 1 hr, and never have any problems. No palps, nothing.
But during my regular sleep, It's a whole different story.
Like this morning, I spent 4 hours trying to get to sleep fighting with A-fib, right at the moment of falling asleep... at 6am I was finally able to get to sleep, but was woken at 7:30am in A-fib, I sat up immediately, and was able to get back into normal sinus rhthym within a couple of minutes. Then fell back asleep right away, and was woken at 9:30am again in A-fib, and sat up again, and was able to get out again within a few minutes. Then laid back down, and as far as I know, I was able to sleep another 3 hours in NSR. Its hard to tell when your fast asleep if your having an episode or not, but it usually wakes me, because I am very sensative to it. I know of a person who has A-fib even during the day, but never knows when she is going in and out of it. I am completely different and feel it very prominent.
Another thing I should mention, is when I do slip into A-fib, it is a very relaxed fribillation. My heart rate while in a-fib averages between 60-70 bpm, but very irratic. one minute it can be 90bpm, then the next 60bpm, as it is flopping around like jello.
When I first got diagnosed with it 3 years ago, I was in it at the hospital with 180bpm, so they converted me with the shock. I suppose at that time, I was horrified by the condition, my nerves played a big roll and I thought I was having complete heart failure. But now that I'm a little more educated on this, It doesn't play with my nerves as much, therefore when I slip into A-fib now, its a more "relaxed a-fib" so to speak.
But in anycase, the a-fib attacks are always at the trime of sleep, usually between 2am and 6am and mostly right at the "MOMENT" of dozing off.
I'd really like to know what the experts can conjure up on this one!
Thanks for listening and will enjoy any and all input....
Frank
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RLR
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Re: Atrial fibrillation when falling asleep
Reply #1 - Nov 18th, 2010, 6:49pm
 
Hello Frank,

I am a retired neurologist and host of the forum. I've read your complaint. This problem, while less common, does occur in a similar manner in other patients. You can read about the underlying causes here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1852524/

and here:

http://circ.ahajournals.org/cgi/content/full/110/4/e32

and here:

http://circ.ahajournals.org/cgi/content/full/105/23/2753

You can read through the articles for a better understanding of what is taking place with respect to your condition. Realize, however, that these articles are purely targeted to the medical community. They will, however, provide you with some insight into the fact that the condition is not as strange as you portend.

As for deficiencies in vitamins, I'm a bit perplexed why a fellow your age would demonstrate a B12 deficiency and I'd be interested to know precisely what levels were documented. Realize that this sort of deficiency rarely produces symptoms above levels of 200. Deficient potassium and magnesium levels are rarely demonstrated as well, only arising in patients with underlying disorders such as diabetes in the case of potassium.

When you say you underwent a "sleep apnea test" are you referring to a formal sleep study?

Also, just to inform you, there is no such condition as a "low form" of celiac sprue. Unless you underwent direct gastro-biopsy of the small intestine, then any concerns about celiac disease are purely speculation. In other words, the disease cannot manifest in the manner being suggested. Simply because a change in diet may reduce symptoms in no way suggests that it is due to the presence of celiac disease. If you've underwent biopsy and have a positive result, then ignore my comment here.

If you don't mind, please describe in detail what GI symptoms you were or are experiencing that led to evaluation and a diagnosis of celiac sprue.

We'll talk more once you've looked at the articles and can provide me with answers to my questions.

Best regards and Good Health
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Best Regards and Good Health
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FloppyHeart
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Re: Atrial fibrillation when falling asleep
Reply #2 - Nov 18th, 2010, 10:37pm
 
Hi RLR, thanks for the reply... I apreciate all the information provided... and I did skim through it as they are very long and complex... I didn't go to medical school for 10 years, which is pretty much is whats needed to understand what they are talking about. I did however work very hard all my life , mostly farming, and back breaking work, and can tell you alot about that! I'm also quite an emotional person, which probably has something to do with the vagal nerves. All that information in your links must all lead up to a summary.. in your professional opinion, what would you summerize it as in simple english?
As far as my B12 levels.. I think the doctor told me it was below 200 and that I defanelty needed either B12 injections or supliments, I opted for the supliments as I hate needles.
I am guessing my b12 was low because of the celiac disease, which a gastro doctor told me I had... he said I was 95% certian of it because of blood tests showing this, and wanted to do an endoscopy, I told him I would wait, and and just try and go gluten free for a while with more tests later... so 6 months later, the blood tests showed better, and he also said he 99% sure by these tests... I didn't want to bother with the biopsy, as I was having such a better health without the wheat , rye and barley, and me and my wife just decided to cut the gluten out of our life, as its probably much better health wise anyways.. When I used to eat whole wheat bread, my heart used to jump around like a jelly bean. Pasta would do this as well... it would send my heart into over drive, with tons of palpitations... now a days, I eat rice bread or sorghum, millet, or tapioca bred... and I have no heart palps of any kind at all. So when I said a low form of celiac, I meant it effected mostly my heart when I ate wheat, barley or rye. I am not like some people who can not even eat a crumb without having massive bloating and diarhea. I know of a couple people with this form of celiac disease since birth. They have to be very very careful... where as I could eat a slice of bread, but I wont get the diarhea, but will get all kinds of ectopic beats, and sometimes pasta would make my stomach bloat right up real bad.
As for the sleep apnea test, I was wired up with 3 belts on my body and a hose in my nose and a pulse thingy on my finger for a recording machine while I slept through the night. I don't know what kind of test this is called, but It did show tachycardia while I slept, thats all I know at this point, I have to see the doctor who ordered the test next month. Seeing doctors is sometimes a long drawn out affair around here... sometimes the wating lists here are 6 months to a year.
The gastro doctor said if the celia's or little fingers or whatever they are called, are flattened in my lower intestine, from all the years of gluten, then that would explain being vitamine deficent. Maybe why b12 was low? Anyways, I was told I need to be on B12 1000mg for life now by both my family doctor and cardio doctor. The cardio doc also told me to eat small meals several times a day, and I have hypoglycemia, and will be doing a G.T.T test within the next few months sometime... when ever they can get me in. When I was 17 years old, I remember being told by a doctor that I was borderline diabetic, and will probably have to deal with it later on in life. I guess i've been maintaining it fairly well, but might be a problem now... we'll see once more tests are done.
Once again, I appreciate your help, and I hope I don't have to undergo ablation, I know of a guy that has had 5 ablation surgerys, and is on his way for his 6th next week.. but he has superventricular tachicardia... which none of the ablations have worked as of yet.
I'd really like to stay away from invasive procedures, until i've absolutely exausted all other optoins.
Thanks, Frank
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« Last Edit: Nov 19th, 2010, 8:16am by FloppyHeart »  
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FloppyHeart
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Re: Atrial fibrillation when falling asleep
Reply #3 - Nov 19th, 2010, 7:22am
 
I would like to add something else about this that seems to play a role in having these attacks when I fall asleep. "Gravity"
It seems that as soon as I am laying down, and falling asleep and the attack starts, or ectopic beats set in, I am usually laying on my back, and I will, by instinct, sit up for a bit, then if they don't stop immediatly i'll stand up right away, and allot of times it will stop. Then I will walk around for several minutes to make sure it has completely stopped, and when I walk around, if it does stop, it will never start again, UNTIL I lay down, but, sometimes I will lay back down on my stomach, not sideways at all, but completely on my stomach, and the attacks will NOT happen again. I remember a couple times I tried laying o my LEFT side, and the attacks would happen even before I fell asleep.
It seems that gravity plays a big roll somehow.
Is something pressing against the heart muscle that triggers it off?
Or is the heart muscle pressing against something that triggers it off?
Why when I stand up, the heart stops erratic beats usually?

And also, I remember when this first started to happen to me, (I kept a journal of every episode I had, its 9 pages long, dates, times and the lengths of the A-fib), the 1st several times I used to go into the hospital and they would make me lie on my back with ecg monitors and things on me, and I would stay in A-fib for 5 hours or more.... but after the 3rd time of going in, the doctor told me I didn't need to come back in UNLESS I was A-fib for more that 24 hours... ( God help me if it does! )so I stopped going into the hospital. (Btw, my wife is a 17 year ER nurse)
And ever since then, I have never had an a-fib session last more than 2 hours, Because I always stand up and walk around! It seems to bring the heart back to normal sinus rythem much faster. The average time of these a-fib sessions would be approx 90 minutes.... sometimes it would last 30 minutes, sometimes 1 hour... and thats IF AND WHEN it doesn't stop erratic beats right away if I sit up. If it stays in it for 3 or more minutes, then I know I'm stuck in it for at least 30 minutes to 2 hours. But as I said, I can always get out within 2 hours by walking around. If I lay on my back and stay there, I will stay in it for hours and hours. SO, gravity does have something to do with this in the body somehow. Especially laying on the left side, thats a huge NO NO!
Its pretty bad when you can't sleep a certain way!
I mention all this now, because this just happened to me last night, so I got up this morning and wanted to let you know... I was falling asleep last night on my back, I sat up, then stood up as soon as I felt the bad beats, then it stopped within 2 minutes, it was a looooong 2 minutes! it always is... lots of swearing involved!@!@!@! Then I layed down on my stomach and went to sleep with no problems. And whats more strange is, I can lay down during the day and take a nap or sleep for 20 min to an hour, and not ever have a problem at all! Not 1 skipped beat! NEVER! This all always happens during what I now call, "The witching hours"! between 2am and 6am.
thanks for llistening...
Frank
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« Last Edit: Nov 19th, 2010, 9:13am by FloppyHeart »  
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Re: Atrial fibrillation when falling asleep
Reply #4 - Nov 19th, 2010, 8:37am
 
hi floppy heart ,i have read your posts and something similiar happens to me .Though i have never been diagnosed with a fib .I like you get these attacks when lying down and im either sleeping or falling asleep ,i am woken by a very eratic heart rythm but because i panic about it mine goes in to sinus tach up to 180 per minute the hospital always says it a panic attack but i want to know why my heart goes very irregular just as im getting off to sleep.My partner has actually felt my heart rate go mad as i was sleeping and he said i sat up out of a sleep and by then my heart was in sinus tach.I also get ectopics and eratic beats when i lie on my left side i have for years and still dont know why they happen.I  do also get scary beats when im sitting or out and about but they are worse at night .Well at least you have found this site and you are not alone .Rlr is great and will always get back to you .kind regards molly
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Re: Atrial fibrillation when falling asleep
Reply #5 - Dec 17th, 2010, 3:59pm
 
Hi Floppy heart. I am 47, male and experience the exact same thing. I think my problem is related to my lower back(herniated discs). Usually, my back pain is aggravated in some way. Then as I fall asleep, within 30 minutes as my body is totally relaxed I suddenly wake up with either an erratic or fast heart beat.  Sometimes I have to get up and walk it off. It seems to be vagus nerve aggravation. I had my first bout of atrial Fib. when I was 41. I had back to back Tetanus Boosters and the second one was about 8 years too soon. It just about killed me. My body(muscles) were sore and Afib was converted by IV . I get palpitations every once in a great while.
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