Are these symptoms typical?

I developed AF four years ago. I woke up that December morning with my heart racing with a terrifying irregular beat. I'd never heard of atrial fibrillation before, four years later I still have questions regarding quite a few really unpleasant symptoms. Hopefully someone here can shed some light.

I am male, 70, still working with my own small business. I'm on 10mg of Bisoprolol and to maintain an average INR of 2.3, 4mg of Warfarin. The worrying symptoms are as follows -

Waking up with a terrible feeling that I'm suffocating or drowning, I am gasping for breath and my heart is pounding. The trigger is always a nasty, unpleasant nightmare. Once I am awake I then feel really unwell, this feeling is difficult to describe but it very frightening coupled with a sensation of a bad stomach upset which wears off fairly quickly.

Another common symptom is waking up bathed in sweat and roasting hot. This can happen on the coldest night, I have to lie on top of the bed and once I have cooled I can resume my interrupted slumbers!

Talking of cold I seem to have permanent cold feet and hands.

I do find that eating less, especially at night, helps. I also have a suspicion that taking paracetamol may be triggering some of these side effects. I do get the well documented symptoms also, that is giddiness and a feeling of fatigue, I can cope with them but I wish I could stop the night time horrors! Not wishing to sound indelicate but since I have had A/F nature's call to go to the toilet is absolutely mandatory now!!

Your thoughts on this would be very welcome.


11 Replies

  • Hi Graham. The cold hands and feet will be the bisoprolol for sure. Ditto any fatigue you have. May I suggest that you talk to your doctor about a sleep study as it could well be Sleep Apnoea which you are suffering from. There is often a link between SA and AF so worth investigating.

    AF triggers an enzyme which causes the body to shed salt hence the need to P a lot.

    The hot flushes I can't explain unless like me you are on hormone implants for prostate cancer.

    Hope that helps.


  • I recognise what you describe, had a couple of really unpleasant dreams about drowning and others where I have a nightmare and wake up feeling terrified. I put this down to sleep apnoea or possibly pauses in my heartbeat which I have had when awake.

    If I are you I would see your GP about the night sweats (apparently doctors are supposed to take them seriously unless there is an obvious cause) and unless you have had one recently a holter moniter for a week might pick up something?

    I have learned not to assume that every new symptom is related to the complaint already diagnosed although doctors often seem to. If you are not convinced make a fuss!

  • I suffered with horrendous nightmares when I was on Bisoprolol which disappeared when my medication was switched to Sotolol

    I to suffer from cold hands and feet and have taken to wearing bed socks in bed!

    Do hope you feel better soon Speak to your GP

  • Same here with sotalol and bisoprolol

  • The bisoprolol was an issue with me causing sleep problems and a general feeling of not quite being in my own body(best way I can describe it) although I did get more used to it. Went onto sotolol which I found a much better alternative, but I still needed to wear socks in bed! I still got the AF, but the sotalol kept the rate down.

  • Thank you all for your helpful comments. I will see my GP as suggested. I really hate the feeling that I am suffocating - I love, though, the idea of bed socks!

  • Yes I have had all the same symptoms as you have for the last two years. The nightmares always seem to trigger the pAF . I went for a period of a couple of years with no pAF but recently had four episodes in three months. As I get a lot of middle chest pain when in an episode one doctor did suggest it might be the vagus nerve starting if off in conjunction with my stomach. I have tried eating lightly in the evening and taking a large dose of Liquid Gaviscon just before going to bed and so far it is working!! I am on a high dose of Sotalol and Warfarin.

  • Your urgent call of nature problem was only too familiar. I remember how awful I felt about having to use a commode frequently and copiously during my first A and E admission with Paroxysmal AT, and feeling very sorry for the person who had to clean it up. The endless need to P was bad enough, without the problem of a hyperactive bowel. I now regard that as a sign of a 'bad' episode. Lesser episodes of night time AF sometimes include the feeling hot and generally unwell. I find a cool flannel around my neck helps. Maybe helping vagus related trigger? I don't have the same drugs as you.

  • Oh, how embarrassing for you! i have to admit that the bladder and bowel urgency has come as an unwelcome surprise.

    Apart from the night sweats and drowning sensation I have been really amazed at the daily fatigue coupled with the exhaustion when climbing stairs or steep inclines.

  • Make sure you drink plenty of water (excluding tea or coffee) - with loosing copious amounts in sweat then you may need more than the usual daily amount.

    Also I was told that if you are sweating a lot then you should reduce the amount of antiperspirant and also not use ones that provide 24 hour protection.

  • Warfarin can also contribute to coldness. The AF itself can cause sweats and coldness. Check your SpO2 levels. After my ablation (even though I went back into AF within 72 hours I don't suffer any where near as much from diahorrea as I did before. Defiantly get checked for sleep apnoea asap.

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