panic when falling to sleep

on a few occasions i start to drift off then suddenly have to sit up my body feels all strange like im panicing , im on dagabatran , bisoprolol and flecinide ,does anyone else get this problem , i suffer with paf , also if i sleep on a certain side , i usualy have to prop myself up then try to sleep

13 Replies

  • I started a similar thread about two weeks ago and received many interesting replies. Have a look at them. I had similar symptoms before my AF was diagnosed and wasn't on any medication. Therefor It may be a symptom of AF itself. Someone with more knowledge maybe be able to add to this

    Best of luck

  • Hi Duckpopper,

    A couple of times or so a week, with no warning, as soon as I lie down to sleep my heart starts what feels like fluttering, but according to ECG proof it's lots of ectopics. If I ignore it, it will then go into AF, but if I sit up it stops. This is a B... nuisance because all I want to do is sleep but I have to sit up because I don't want to allow the AF to continue. I stay sitting up and gradually slide down and then lie on my right side, because during these irritable times turning on my back or left side starts it up again. A few weeks ago it was particularly bad and I had several nights when it didn't seem to want to settle. My pulse was very slow and kept going below 50 bpm. When I moved and my pulse went over 50 everything was fine, so for a few days I cut my Bisopralol (7.5 mgs) down to 6.25 and this has done the trick. I've now gone back up to 7.5, as I was having the odd pip and squeak during the day, and am just back to the 2 or so night time episodes. I have just seen the Cardio, well, I saw his registrar who was lovely and easy to talk to, she hadn't a clue why this is happening, just called it positional PAF and could only suggest upping the Bisopralol to 10mgs, not a good idea I decided if my pulse has a tendency to go slow, or the other suggestion was to change to Sotalol. I've read that vagally mediated AF doesn't do well with Bisopralol because of slowing the heart rate too much, but at the moment I am otherwise doing so well that I am reluctant to change to Sotalol. I've looked at triggers and don't eat late or overeat so I have no idea why some nights I'm OK and others I'm not. Funnily enough during the day if I lie down it never happens. I'm just back from an R and R holiday in Greece and have lounged lots with my book and even after a large lunch not a blip occurs.

    Does this sound similar to your episodes? Hope it helps. If anyone else out there has any ideas please do let me know.

    Stay as well as is possible, Liz

  • Hi, My first (and only so far) AF episode started when falling asleep after taking a sleeping tablet. sudden feeling of panic jolted through my body.

    But I had panicky feeling at night before AF as well. Now on rivaroxaban and bisoprolol 1.25mg and was asked to reduce and stop bisoprolol altogether. best wishes. Eva

  • Hi Sqirrel, Thanks for your reply. Lets hope your one and only episode stays that way, stay well, Liz

  • I get panic attacks when I am falling asleep all the time. I'm on 5mg bisoprolol but I think it's to do with being nervous about an attack starting when I'm asleep (so far they always have done). Some nights I barely sleep at all.

  • Hi Eatsalottie, I've just replied to your message and it seems to have vanished, must have forgotten to send it!! My attacks always start at night too when I am lying flat. I've even managed to fall asleep sitting up but then I end up with a stiff neck...there's always something! Sorry you are having trouble sleeping especially as tiredness doesn't help either...a vicious circle. Do hope you can get to manage the anxiety as time goes on. Stay well, Liz

  • Me to its very scary I listen to my Walkman but still cannot get to sleep which does not help for the next day .

  • I often have the same sympton where i wake in the early hours of the morning with heart thumping and it feels as if it trying to break out the beats are so strong and more often very low heart rate. This is useally preceeded by AF which wakes me up, i have to sit up in bed and eventualy it settles down and i can get back to sleep. on more than one ocasion its been so bad with chest pains comeing on i have ended up in hospital. i am on 5mg of bisoprisol 100mg of flecanide i have tried different doses of the drugs but this seems to suit me best. i am now waiting for ablation

  • Hi Johnw, Ahh!! this sounds similar to me although I haven't had any chest pain thank goodness. I am sure it's something to do with my pulse dropping too low and allowing a breakthrough of AF, but I do seem to need 7.5mgs of Bisopralol most of the time. Did think about swapping to bedtime to take it but decided that might make things even worse. Things settle down immediately as soon as I sit up or go for a wander round the house. Hope the wait for the ablation isn't too long. All the best, Liz

  • There has been some recent published studies linking AF with sleeping disturbance both apnea and non apnea.

    If anyone has AF and has developed sleeping pattern problems it could be worthwhile asking your doctor to refer you to a sleep clinic to investigate sudden awakening or disturbed sleeping. Sleep apnea can be quite problematic and would benefit from being investigated.

  • I have experienced similar symptoms to Lizily and agree that it can be brought on by positioning and yet doesn't happen if I lie down in the day. I also know (from a visit to my dentist when she gave me a local and I had an ab-reaction to it) that adrenaline is a very strong trigger for me, hence my interest in anxiety. Strangely enough I used to get what I called an adrenaline rush with palpitations whenever I drove down a steep hill, this is way before I was diagnosed with AF.

    So I wonder if we could suggest that a) sitting up may help? b) thinking about other triggers for you and avoiding them generally + relaxation techniques may help.

    I think I would also re-visit my GP and discuss


  • Loquitir what you say is so interesting - do you know who did the studies and if we can get a copy.

    I also think the link between sleep apnea is interesting and may very well be connected in some way - good idea to ask for a referral to a sleep clinic.

  • I know all about the panic that occurs just as I want to settle down and s-l-e-e-p, as that dreaded adrenaline rush begins - even if AF doesn't follow! It doesn't seem to matter whether I try to sleep on my left or right, I'm aware of my heart beat on either side. I guess I'm just super-sensitive these days...

    One thing which seemed to help last night was the "smile" technique (sorry to appear flippant!) Working on the basis that if you smile your brain tells you you MUST be happy, I gave it a shot. And, surprise surprise, my heart rate came down slowly but steadily and I drifted off to sleep. Can't prove that this distraction technique was the cure, but at least I must have looked a cheery chappie.

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