Afraid to sleep. Most episodes happen at night. What can I do?

Hello- I understand your fear. You are not alone!
Are you taking Flecainide on a regular basis? I think you need your be taking some antiarrhythmic regularly but not just with an episode. Other option is to discuss with your dr ablation.
Arrhythmias are scary but since you are on meds dont be afraid to sleep. I put music on or a fan so there is a background noise before bed and I find it helps me!

Wow! I think I can relate to your fear and anxiety. I developed vtach (mostly nonsustained)
from scar tissue following valve surgery in 2017. I also had assorted PVCs, pacs, svt, bigemi ny, etc. I lived in fear and my life was devastated while they sorted it all out. I thought life as I knew it (I’m active and enjoy backpacking. etc.)was over. They got me onto medication that worked(flecainide), did two ablations that were partially successful, and I was able to continue with life as I knew it, thank God. However, I still had some arrhythmias and continued to be afraid and anxious. Sleep was also a problem.
Right now, it sounds like sleep deprivation and fear are the primary issues. Can you go back to the dr who prescribed the Xanax and see if they will increase the dosage or recommend something else? I am also on Xanax for anxiety 2mg per day as needed and can honestly say it has made it possible to live a normal life. I also note, that it seems to decrease the PVCs, etc.
Have they told you about valsalva maneuvers like coughing? I have frequently broken or headed off a run that way. I don’t seem to have AFIB, but it still might be useful.
Are your drs at all understanding or comforting? My experience has been that some are while others just don’t get it. Maybe get a counselor or someone you can talk to when you are afraid. Most cities have a referral system or crisis line you can call.
Please don’t wait; it sounds like the mental and physical are feeding off each other.
You’ve come to the right place here; welcome. I’ve always found caring and responsive people.
Please let us know how you’re doing.

I hear you! All of my episodes have started at night! I was cardioverted in December, 2024 and was pretty much free of problems until May when I had three episodes about a week apart. Unlike you, mine have never had a pulse over 130 but still! Who lives like this? I went to the ED and cardioverted on my own before they were ready to convert me. I had a 3.2 second flat line, then it went back into a NSR. I saw a EP who listened to me and we agreed to try Flecainide first to see if it would work before we tried an ablation. I think the medical review of Flecainide are scary, but the cardiologist claims it is "safe" for people without structural heart issues or blockages. I am into 6 weeks of taking the med and so far so good. But I really, really understand your anxiety. Hope things will settle down for you.

Please read "The AFIB Cure" and get an experienced highly rated doc to do it.

If you live near and can travel to Raleigh, NC, contact this office to send your test results, especially the latest echo, to the great cardiac surgeon, Dr. Byron Boulton; set up a consultation visit, perhaps by phone. He is Director of the WakeMed Structural Heart Program at WakeMed in Raleigh, NC. Phone (919) 231-6333. I had a serious regurgitation/mitral valve problem and AFIB. He repaired my mitral valve, did an LAAC, and did an ablation to cure my AFIB. That was over three years ago. I am as fine as wine, off all meds too, except for 4 amoxicillin before dental visits. I am an 81-year-old male, just a kid.
Regards,
Sagan

That was so me. I’ve had Afib for years. But it was maybe 1x every 2-3 years. Then in March I reacted extremely badly to Eliquis and Afib came a lot at 1am. With 4 ER visits.
I too was afraid to sleep and didn’t get much sleep. Cardiologist was no help “take more extreme pills for Afib” No!
Now I go to a good acupuncturist. Got a massage. and every night before bed it’s warm chamomile tea, lymphatic massage, tapping with positive thoughts and diaphragmic breathing. After 3-5 breathing cycles I’m asleep and I sleep thru the night now. It’s worked for me.
And not food 3 hours before bed.
My PCP said try TaiChi and yoga too

to - Hope and Faith123 - That’s exactly what is happening to me! About 4:30 or 5:00 am, I go into A-Fib! I’ve only just started on this journey! The first time, that alsrmed me, it was about 10 minutes. I went to see the Cardiologist, and they have a heart monitor on me now! Early this morning, about 2:30 am, I woke up with a headache. I was about to go back to bed, at 4:18, and as I lay down, my heart started racing, and I took an ecg reading on my Apple Smart Watch, It showed 110 heart rate, and that I was in arterial fibrillation! I tried the vagus nerve recommended moves, but that didn’t work. I called the hospital, and asked them to have the Cardiologist on call, to call me. About an hour later, after I took a Propanolol pill, my a-fib, converted back to sinus rhythm on it’s own! The Cardiologist called me 2 minutes later! This is nerve wracking, for sure! Good luck!

Hi there.
Happened to me, too! A Fib needing cardioversion in hospital 4 times - all in the middle of the night over the past year.
Cardiologist ordered sleep study - I have sleep apnea and started on a CPAP machine about 4 months ago.
I've been on my CPAP machine and I LOVE IT! I had so much anxiety about going to sleep - but this machine gives me confidence and I haven't had a middle-of-the-night A Fib incident since I've been on it. I feel so much better.
I have a great medical supplier who worked with me on getting just the right mask - this is the 3rd or 4th one I've tried - but we finally got it and I look forward to bed time now.
Just something to think about.
(And I totally understand the anxiety about going to sleep - it's terrifying to wake up in the middle of the night with your heart going over 160 bpm.)
Good luck!

Very interesting about the CPAP machine. I never knew it would help with AF at night while sleeping. My heart rate is in the low 40s during the day while resting and at night while I am asleep, it goes down to the 30s. At this rate, I may just not wake up in the morning. My wife gets very concerned because at times she does not hear me breathing when I am sleeping and gives me a nudge to get me back to breathing. But she can't stay awake all night just to see if I am breathing.

I have been diagnosed to have sleep apnea but have never bothered to look into getting a CPAP machine. The 3 Cardiologists that I am seeing, not one of them has ever informed me that a CPAP machine would help me with my AF. I have had 2 Ablations, 2 Cardioversions, 3 cauterizations, and the last one being a Cardiac Cauterization.

My AF went away for a while, but I feel it during the day and at night. I have a Kardia apparatus that I purchased, and I monitor my EKG at home. Most of the time it gives me a reading of "Possible AF" or "Unclassified". My last EKG reading was normal since August 1st.

So, I don't really know what to do. I have asked my Cardiologists if a CPAP machine would help my AF and they said it would not. I asked them about a pacemaker, and they said it would not help my AF. And 2 are the top Cardiologists that I am seeing from Austin and one is from my local area who is supposed to be the best in my area.

I have other severe issued with my heart and lungs which is severe pulmonary hypertension, pooling blood in my veins, and the right and left upper chamber valves of my heart are not shutting properly and leaking blood so my heart is not pumping all the blood it should into my system.

So, as you can see, my heart and lungs are not in the best of shape, but I am not going to worry about it because it would not do me any good. I will just continue to go to my follow-ups with my Cardiologists and Specialists and just hope and pray for the best. I am at peace, and I have left everything in God's Hands.

I, too, was diagnosed with severe OSA and have used a PAP machine ever since. Just a correction: CPAP won't help with atrial fibrillation if it was the original cause. Once your heart is disordered electrically, that's it...for life. What CPAP can do is to reduce the nocturnal strain on your heart that caused the AF in the first place. By keeping your airway splinted, you keep your optimal range of O2 saturation. The constant severe reductions in O2 in your blood during sleep apnea, with its constant threat of 'dying' , is what makes your heart disordered.....it can't get any rest at night. The CPAP keeps your blood oxygen levels up, and your heart can beat calmly, even down at the low rate of 34 BPM if that's what your O2 demand is and your heart is fit and strong.
So, your cardiologist is partly correct. CPAP won't make AF go away. AF is a progressive disorder (all the modern research makes this quite clear), and left unmanaged it can get worse progressively. The CPAP machine, apart from improving your quality of sleep by allowing you to STAY ASLEEP....not waking up gasping for air sixteen times each night... and therefore going through each successive stage of sleep properly..., will reduce the constant strain on your heart and possibly decelerate the progression you don't want. You have the disorder and it is permanent. It can be reduced in severity with CPAP, but also it needs strict management via drugs, lifestyle changes, catheter ablation (The Gold Standard of care for AF for most patients, especially early), or a pacemaker.
I said your cardiologist is partly correct. He's right on the face of it, as stated. But CPAP is necessary for longevity if you have moderate or severe sleep apnea. Not only will OSA cause sleep disruption, which is very unhealthy (weight gain, metabolic syndrome, kidney and lung problems, dementia, etc), but it causes your heart to continue, even more quickly, to deteriorate. CPAP is essential if you want to live longer, with or without atrial fibrillation.