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Not sleeping after pacemaker fitted

Five weeks on from having pacemaker fitted for total heart block, taking bisoprolol 2.5mg once daily to control fast heart rates. I just cannot sleep, I lie awake every night for at least two hours before drifting off but only sleep for a few hours. Cardiac clinic suggested Valerian tablets might help but I am so scared to take anything that might affect my heart rate in any way as my pacemaker is working for 85 per cent of the time. I know it is anxiety keeping me awake but don't know what to do about it.

Any advice please friends.

20 Replies

Hi wpw62,

I was surprised that you had a pacemaker fitted as l must have missed your posts ...You seemed do be doing so well for quite a few months post Ablation...

It is only natural that your feel anxious and concerned...This is just a thought but I know from experience that it works...Have you thought of having Hypnotherapy...

There are many reputable therapist around make sure you find one that is accredited to a professional body...They could give you the tool to help you cope through this difficult time...


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Hi wpw62,

I assume you also have AF. The bisoprolol is a Beta Blocker that normally slows down the heart rate. If you have complete heart block then your HR would have been slow which is why you would require the pacemaker. Even although you are now taking bisoprolol your pacemaker will keep your HR from falling too low. I was in hospital 3 weeks ago seeing about getting a pacemaker fitted and the EP I saw was explaining all this to me. He was explaining to me that since I have partial heart block, (LBBB) and am bradycardic then they could not give me beta blockers at present. He then explained that after they fit the pacemaker I will be started on a beta blocker since the pacemaker will prevent my HR from going too low.

If your cardiac clinic is suggesting the valerian then it would suggest that they think it is ok. Perhaps 2 or 3 nights would be enough to help you relax and get some undisturbed sleep. Try and remember that your pacemaker is there to keep your HR where it should be.

Hope this has helped a bit and that you manage to get things sorted out.


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I am not quite sure what you mean by the PM working "85% of the time"? I, too, have a PM on which I am totally dependent, and have total faith in its working in my favour one hundred per cent of the time! After 4 unsuccessful cardioversions, for AF, I had the PM fitted. I was then offered a 5th CV and I said, "No, thank you," I would rather fully place my faith in the PM. So, that is where I now am. I had an AV Node ablation last October and, as a result, became PM dependent.

Because of complications and high pain levels brought about by obstinate ulcers on an old fracture scar on my ankle, I wasn't sleeping at night - I was prescribed Tamazepam, which I started at 20mg when I went to bed, and increased to 30, then 40. I knew that the PM would monitor my heart rate and would not allow it to drop below 60bpm, the prime reason for having a PM in the first place. I certainly slept! Long and hard! The only drawback with sedatives is that you don't get the REM phase of sleep so well, the phase that allows one to wake up feeling refreshed, so there is a lingering sense of lethargy all day. But there is a sort of peace of mind brought about by being knocked for the entire night! In the last few weeks, as the French sunshine has improved the ulcers and the pain level has dropped dramatically, I have gradually decreased the nightly dose of Tamazepam back to the original10mg, my plan being to drop it again to 5mg next weekend, then altogether.

It is all very well to say "Don't worry, and you will sleep better" but, in reality, those are wasted words, aren't they? All I CAN say is that, having had to deal with a double edged sword, I have come out the other side a fully proactive 76-year-old with more zest for life than many women half my age. These pacemakers are amazing things and are guaranteed fail-proof and are, nonetheless, so carefully monitored. There is nothing to worry about, honestly! Clare Weeks wrote a book, many years ago now, but no less valid for that, called "Self-help for your nerves". I was suffering from crippling agoraohobia at the time, brought about (one is always wiser after the event) by undiagnosed panic attacks. As a mother of 5 small children and a previously very proactive life, on many levels, I was desperate to find some kind of help with my problem. In the book, Clare Weeks repeats that the ONLY TING WE HAVE TO FEAR IS FEAR ITSELF. If I could only make you believe how very true that is and what a change it brought to my life to hold that as my mantra, I wouldn't even be writing this reply to you.

I hope it gives you some solace and I include my best wishes!



Hi. I also have undergone AV node ablation and dependant. I notice your post was four years ago. How are you now? My Doc was amazed post pacemaker that my ejection fraction went from 31% to 55% (normal) and normal heart function was restored, so am no longer in heart failure. Love to hear from you. Li


Hi there. I am doing fine in the heart department but the rest of me is falling apart ha ha. November 2016 during a routine yearly scan in my lungs it was noticed that I had a blockage on my kidney. After numerous tests this was operated on robotically in November 2017. The next scan picked up a large nodule in my lung. Had a biopsy last week and get the results next week. Thank God for the NHS and Papworth Hospital.

Hope you are keeping well.


Talk about it never rains..... Glad the ticker is working well. I will be keeping everything crossed for you. Do keep in touch please.



I have just seen all this. I had completely forgotten that I had written that message 4 years ago. I am still OK, except that my legs are suddenly swelling badly. I look like a prize rugby player in the evenings, and that is definitely not me. So, the efficiency of my pacemaker is now being checked. I am awaiting the answer. Apart from that, I cannot complain. I am now 80 years old and still have a lot of energy and am about to have an art exhibition which has taken a huge amount of effort in arranging. So, I cannot really complain. However, nothing less than perfect is acceptable in my books, so watch this space. I had blood tests done last week and await the results. The ONLY thing wrong with a pacemaker is that, if something goes slightly awry, one cannot tell because the heart still beats, at least on the face of it, at a very regular beat.


If I can't sleep I use Andrew Johnson relaxation/sleep recordings.


Even if you don't get back to sleep straight away ,it is something calming to do. Hope this issue settles quickly for you.Wendy B


If it anxiety is keeping you awake. Then you need to deal with that. The longer you leave it the more established it will become, Suggestions:-

Worry thoughts - use CBT (cognitive behavioural therapy). Best to see a counsellor but there is plenty of freebies on the net.

Bach Flower Remedy Night Time

EFT. (Emotional Freedom Techniques). Uses tapping on acupuncture points on the body - again plenty on the net to get you started but a trained energy therapist can help. See AMT website.

When I saw a sleep specialist l was told the following:-

Go to bed later

Do NOT nap at all during the day, however tired you are

Establish a routine going to bed

I found fresh air and exercise (as much as you can do) really helps me sleep.

I also used to listen to a sleep meditation tape until I got into a routine, now sleep 6-8 hours - makes such a difference to my energy and feel so much better,

The impact of Sleep deprivation on health is vastly under estimated. Everything improves after a good night's sleep.

Any meds you take will have an effect somehow, somewhere. There are plenty of teas on the market which contain Valarian, only prob with those is they make me want to pee just after I got to sleep! I think you would be pretty safe with Valarian if your cardiology nurse advised.

There are also some heart based meditations on sleep on the HeartMath page, I have found those very helpful.

Best wishes CD

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PS - I was referred for investigation for sleep apnea - I have mild sleep apnea but because of another condition the treatment for which is using a CPAP machine - supports my breathing when asleep, has also helped enormously. The service I received from my local hospital was excellent and very thorough. Sleep apnea can wake you up in the night but it does sound more like worry thoughts,


I use a lavender pillow spray - available at Boots - which is supposed to aid sleep. "The soothing scent .. can help to relieve the day's stresses, leaving you feeling relaxed and ready to unwind."


I am back on maybe for a Pace and Ablate (Long Story), the way it was explained to me is that it will control my HR so will be acting 100% of the time. However even though they zap the sinus node it will not stop the sinus node working completely. So if the PM stopped working which is highly unlikely! The heart would still work to a fashion. My last 24 hour test I had a low of 32 BPM and high of 160 BPM. Waiting for another to once more decide if they will Pace and Ablate?

As for sleep I use Zopeclone maybe once or twice a month. I have not slept well since 2008.

Be Well

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Thanks everyone for your kind words and advice. Plenty to think about there and try out. I think because it all happened within seven days I Didn't have time to adjust. Had to put on a brave face for my family. Will try to be more positive from now on.


I had the same problem .Not keen to take sleep medication even herbal.

I was advised to try Magnesium Oil spray and rub in before bed. I could not believe how effective this is. No more cramps in legs either.

I use alt nights.



I read reports on forums about Melatonin and asked my GP for it. He was reluctant as he is also a doctor for sports teams and they had tried it without success after flights back from Australia and South America.

I took it for over three weeks and it did not help.

Abroad you can buy it over the counter but in UK it is only on prescription and should only be taken for up to three months.


I. To are having this problem it wakes me up every morning about three o'clock after l had my pacemaker fitted it getting better it wakes me up at four o'clock now so l am getting there Gordon


Thanks Gordon. I have been taking Kalms with valerian. I still wake up a couple of times during the night but dont feel so stressed about it.

I wake up around 3 or 4 o'clock in the morning too now and feel wide awake. Have to sit and read.

Hope we can both sleep a bit longer soon




What you want is a portable CD player that's what I use I never see the end of the film as I always drift back to sleep so at least I get some sleep in the end all the best Gordon ps l sleep on my own

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I have one of those. Will give it a try. I usually read until I fall asleep but that keeps my husband awake with the light on.

We will get there in the end


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So many great tips already but just wanted to say my brother had to change to a different beta blocker because he couldn’t sleep with bisoprolol. I only took it for 3 weeks at the minimum dose and suffered terrible terrifying nightmares. So maybe it Could be having some impact on your sleep alongside the anxiety?

Hope you get it sorted out soon, take good care 😊


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