Poor sleep. Should I change Bisoprolol time?

Hi All,

I think my first attempt at posting question may have gone boo-boo.

In Feb I was diagnosed with AF (with irregularities) - rate 165.

I had thought it was early morning anxiety attacks but docs insisted no anxiety, def AF. Bisoprolol 5mg prescribed and Warfarin. At pre op rate was stil 140, so Bisoprolol increased to 7.5mg.

Successful cardioversion on 31 March. Week long monitor showed 3 ver short blips and ave rate at 70. Told to stay on Bisoprolol to stopr AF returning.

Due to caring for partner (his health and my other conditions) bedtime is 2am.

I wake after only 3-4 hours (toilet noo 1 only) and struggle to get back to sleep.

Been taking Bisoprolol around 8-9am. Should I take at 2am when I go to bed (my 7.5mg dose is in form of two tablets, 5mg & 2.5mg)?

Very tired (especially if I exert myself a bit) as not getting enough sleep. Also making weight loss harder.

I just want 7-8 hours deep quality sleep, so any advice would be great :-)

Thank you,


(Additional info, pre diagnosis, my body must have been under a lot of stress caused by AF, as menstrual went irregular, weight loss big struggle and other probs. Since cardioversion, body has menstrually settled into monthly rhythm and I'm not so stressed out). With Bisoprolol I no longer feel heartbeat, which is kind of relaxing too :-)

11 Replies

  • Hiya DD,

    When I was diagnosed with AF (heart rate 160 bpm) in Jan 2010 I was put on Bisoprolol 5 mg (and other meds but they aren't relevant to your post) and told to take in the morning at breakfast. Did this and started having side effects, lots of random and often lengthy nose bleeds. Complained to GP and she looked up in her book of Witches Magic Potions and Brews and said - take it at night at bedtime. I did this and have never had a problem with Bisoprolol since - coming up for 6 years now.

    I have had, and still have, sleep issues but blame these on lifestyle and job. I usually get 8 hours sleep but it is broken - when I'm not working I just pace myself.

    By the way, Bisoprolol has been and still is, holding my heart rate at around 65 bpm.

    Just an observation but I'm surprised they didn't put you on another drug to drop your heart rate to 100 or well below AND THEN put you on Bisoprolol or some other beta blocker. Seems like they are expecting the Bisoprolol to do a job that it wasn't intended for. Alternatively, maybe Bisoprolol isn't the best for you, maybe your GP could try another. Just a thought. Try night time first - the logic is that if you take it at daytime then the forces of daily living are acting against the Bisoprolol and hindering it doing its job. If you take it at night (bedtime) then it will be working with your resting body during the night -even a night with undesirable sleep patterns. These days my sleep patterns are similar to yours. If I can't get back to sleep I get up, read, cuppa tea, chill out then go back to bed and sleep. But I have to say I am not in a carer situation as you are.

    Hope this helps.

    Happy New Year


  • Try a little Magnesium supplement - not the cheap Mg oxide as most is not absorbed but Mg citrate (from Klare Labs was recommended to me), say 125mg per day.

  • Careful, me thinks this interacts with Waefarin if you are taking Warfarin that is. J.

  • It has to be always check with your medics but I thought it was CoQ10 that is an issue with warfarin.

  • Fortunately I was taken off Warfarin months ago :-)

  • I was once on 10 bisoprolol having worked my way up from 2.5, 5 and 7.5. Post-ablation I am on 2.5 which reduces my heart rate from 80ish to 65ish.

    Monitors have shown that I am not always aware of fibrillation. I have often woken up at 5am in full blown AF. ( I can sleep for England ) I decided to take my bisoprolol at night and this has proved helpful. From posts on here others have also found this to be helpful too.

    You say that you have 5 and 2.5 tablets. If I were you I would try taking the 5 at night and the 2.5 in the morning.

    Best wishes for 2016.

  • DD101. Certainly ask your EP or cardio or GP as to what is appropriate. I am not medically qualified but but gut feeling from logical perspective is 5mg in morning and then 2.5 at night. The logic is that when you are rushing around during the day the Bisoprolol is doing what it is supposed to do and limits the HB. Then at night when that effect is starting to tail off you give it the 2.5mg to top it up to take you through the night. For over 99% of people taking it in the morning as it was designed to do works, but for the remainder it doesn't. Another option to ask about is to reduce the bisoprolol and add an ACE inhibitor. EPs are normally the best to ask.

  • Thank you all, I'll be speaking to GP asap and will talk about your suggestions, which all make sense.

    I suffer additionally with S.A.D. (supplement with vit D and get out every day), fibromyalgia, restless legs (main painkiller/muscle relaxant is Co-codamol).

    Working on the weight loss too, so sleep would be helpful :-)

    Partner does have sleep apnea, snores and struggles to use cpap machine, also gives off lot of heat when sleeping.

    Not sure if my body gets too warm (despite heating off, window open). Maybe invest in a fan???

  • I found my beta-blocker (nebivolol) caused similar sleep problems if taken at night and so I take all of mine as soon as I wake up. bisoprolol may have a different length of time to react with the body so maybe a change of beta-blocker might be worth trying.

  • Hi , interesting set of posts . when first given the bioso a single dose did not last 24 hours and was put on two lots of 2.5 to take in the morning and at night. Seems reading posts it was a lowish dose but still felt rough on them.

    Am now on one dose of 1.25 which on advice of chemist , I take at bedtime.

    Posts left me wondering what is best .

    A couple of nights was really hot but put that down to a cold.

  • I tried 5mg about 4 hours before bed (10.30pm - bed is 2am)), and 2.5mg in morning (about 6.45am). Still didn't get a lot of sleep, but felt generally more settled in my body. Getting a GP call back on Monday to discuss with her.

    Someone mentioned a term called Middle Insomnia (you can get to sleep just fine but can't stay asleep for long)?

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