Afib triggered at onset of sleep; what to do?
I was diagnosed with Afib May of 2022 and had ablation in October 2022. Five months went by without a single afib episode but in the last month it has come roaring back as I'm getting it 3-4 times a week now.
My afib is almost always associated with sleep. The second my head hits the pillow, afib starts, and lasts about 4-5 hours. I have sleep apnea and have a CPAP. But the afib is getting triggered before I'm even sleeping.
Am on verapamil for afib and atorvastatin to control higher cholesterol. In preparing for ablation, all my blood panels were in great shape and scans of my heart came back perfect.
Am 49 and am worried that another ablation won't help and that I'll have to live with this forever.
Does anyone else have sleep-induced afib and know ways to stop it?
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Yes. But only about twice a month.
AFib wakes me up about 2 hours after I fall asleep.
Even though it is periodic, I worry about it each time I go to bed. Especially when traveling!
Doc says that if I can live with it, just keep taking eliquis.
I understand your worry completely.. I used to get afib at the same time every time I got it. At 12mid night just when I lay down to sleep. I thought maybe I was bringing it on because I worried it would happen but my cardiologist said there is such a thing as night time afib. Also 1 ablation may not be enough for you. You might need a second which has a much higher success rate. I wish you nothing but the best. Its the worry and anxiety about it all can get in on you. I understand.
I also get afib when going to sleep or an hour or so into sleep. I only get afib once a year or so and just went two years before having an episode this week. My afib is dramatic with heart rate around 180, short of breath, chest pain, and I end up in ambulance.
I have done the following things to address afib, but mine is paroxysmal and infrequent so may not apply:
Potassium in the am via low sodium V-8
Magnesium at bedtime
Never eating after 5 or 6 pm, stay upright after eating
Believe it or not, I stopped the episode this week with Gas-X! I usually pop a diltiazem to slow heart rate and aspirin. I burped a lot and the afib stopped. My theory now is that GI gas presses on my heart when lying down. No doc involved at this point. No daily meds. Feel fortunate.
That's makes perfect sense.
You may want to ask your sleep doctor to order a sleep study in the sleep lab to see if your oxygen level drops too low. The sleep study in the lab also monitors your ECG.
My sleep doctor prescribed an oxygen concentrator that connects to my CPAP machine two years ago because a repeat sleep study showed my oxygen level dropped to a low of 71% (hypoxia) during the study, and I felt fine after the study. No symptoms except feeling tired. Hypoxia is damaging to the heart.
After testing many oximeters, I finally found the Lookee Tech Sleep Pro oximeter to monitor my oxygen levels at night, aerobic exercise, and when I have symptoms. It is the only oximeter I have found that will vibrate and buzz if my oxygen level drops below a threshold I set. I have attached screen shots of the report that displays in the phone app.
Low blood oxygen triggers Afib and other arrhythmias in me. My EP doctor has advised me to keep my oxygen level over 90% at all times. My oxygen level is normal at rest (95%) at home and lower elevations. It drops with exercise, traveling to higher elevations, plane travel, and sleep.
I hope you feel better soon.
I also have paroxysmal afib that tends to hit between late evening and within an hour of going to sleep. I’ve noticed it mostly happens when I‘ve had too many carbs particularly sugar. I especially try to avoid chocolate since I’m so caffeine sensitive. My afib tends to last 12-24 hours. I agree, it’s unnerving.
@californiazebra do you go to the hospital?
I went to the hospital when I first had it but not now that I know what it is. I started having issues with afib due to taking Kisqali for breast cancer. I’ve declined taking meds (I took Multaq for 3 days years ago and thought I was going to have a heart attack) or doing any procedures for afib so there isn’t any point for me to go to the hospital. I try to take it easy until the afib passes. Going for a leisurely walk is okay for me.
Hi @windyshores — I wonder why you only get afib once a year? What does the cardiologist think? What do they do for you at the hospital? My heart rate never goes above 125. I feel fatigued. I get afib 2-4 times a month.
The other day a friend was coming over to help me plant new plants. I woke up in afib and stupidly didn’t cancel. When I stated digging a hole I got so dizzy, weak and nauseous it scared me and I stopped. Luckily those symptoms stopped in 2 hours with rest even though the afib kept going. Won’t do that again.
Are you on a blood thinner?
When I have afib it is like a big fish flopping around in my chest, my heart rate goes to 180+, short of breath, chest and arm pain, woozy. My blood pressure is low so diltiazem needs to be monitored in case bp goes too low (I watch the hospital monitors myself). Last time they put me in ICU due to bp issues with meds. It lasted 7 hours so they did an echocardiogram to make sure no clots (and gave me a shot of Lovenox.
I read a study that supported short term anticoagulation. I always ask for that but it isn't in practice yet. With my first episode in 2015 the hospital docs told me to take aspirin for a month but that is no longer recommended as effective, I was told.
I have slowly identified triggers and believe I have both adrenal and vagal triggers. I just went two years without an episode. It is also possible that some cancer drugs I was on started all this, and I am off now.