AF episode starts during sleep: Hi all, Does... - AF Association

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AF episode starts during sleep


Hi all,

Does anyone else have this issue where there episodes start during sleep .Around every 5 days or so I go to bed then wake in the night with AF,then the usual routine is flecainide 50mg ,which I use prn. Has anybody found any interventions that they may use to prevent an episode starting . I suppose I need to look at what I've had /done during the day or evening prior to the night I have the episode more in more detail in an effort to try and prevent it.



12 Replies

Yes, most of my episodes would start at night, no nothing seemed to help - tried not sleeping on my left side - not my right side - being propped up by pillows - diet etc and nothing helped.

AF starting in sleep can indicate vagal AF so look up and watch the Dr Sanjay Gupta's video on vagal AF. Improving vagal tone will help.

Other thoughts - sleep apnea can be big cause of AF - easily treated with CPAP. I had 2 ablations and no AF for over 2 years, then several episodes - but not at night. My EP referred me to sleep clinic after successful ablation saying that would be the biggest threat after successful ablation for AF returning.

AF is such a mongrel disease that what works for one, doesn't for another. Knowledge and self-awareness and working out what is best for you takes time and practise.

agree with CDreamer about AF and Dr Gupta's video- only thing I would add is that mine has responded to having more food high in Potassium- I started this after seeing was below range in A and E blood test- normally am in range. It's worth a try- bananas, salmon, loads of fruit and veg jacket potato is very good for potassium.

Hope all goes well

in reply to rosyG

If only Rosie

I eat banana and fresh fruit every day, salmon and jacket potatoes every week - no luck sadly


Yes for me it now happens on more than 50% of the episodes either during sleep or as I wake up. This can be when I wake during the night or in the morning. This has not always been the case.

I try my best to stay still for as long as possible as I wake to try and avoid the AF starting.

These days I am actually scared to go to bed.

So whilst I empathise I have no reliable solution.


Thanks for your reply's. Pete,I feel the same with regards going to bed at night thinking am I going to have an episode,which isn't good to promote a good nights sleep is it!


in reply to whiststev

My strategy was distraction - plug earphones in and listen to an audio book - that way couldn't hear the thump, thump........thump,thump,thump.

It didn't worry me, I got used to it, it was just very tiring,

in reply to pottypete1

Like you I don't look forward to going to bed. What is so frustrating is that during the day I do 2 mile power walks in 30 minutes and I ride an exercise bike taking my pulse up to 120 and I'm hardly out of breath and not a sign of AF or an ectopic. Yet, as soon as lay down in bed (propped up I might add), I get these ectopic feelings. I can fight off impending AF by doing deep breathing but it can take over an hour of doing that before I feel totally normal and ready to go to sleep. Ironically, I actually get more sleep if I do go into AF quickly because then I know there's nothing I can do about it and I just go to sleep. The downside is that it can be a number of hours before I return to NSR. It's so infuriating.

Always through night with me - take Flec at 5pm and 8pm and unless have something else wrong am ok.

My AF is similar and my Consultant thinks it is vagal affected.

Eating a heavy meal late at night (especially hard to digest food such as red meat) / drinking caffeinated drinks etc and stress appear to be the triggers for me.

I have lost weight, I no longer drink any caffeinated drinks or alcohol and I walk as much as I can. I am taking Flecainide (taken at least one hour after and one hour before food), Diliazem and Warfarin. Events seem to have settled down (at the moment).


Yes! My 90 yr old mother has had a-fib for over 25 yrs and much of her a-fib occurs at night. There are times when she thinks she is not having episodes, but her ekg and her pacemaker reading says differently. The doctor says that much of it is occurring when she is sleeping. I guess it doesn't wake her up every time. Sometimes it does, but sometimes it doesn't.......She has had it for so long, with no relief, that she just accepts it now. There are certain mess and procedures she cannot have because of her age.

I would try Breathright Nasal strips.

My diet/digestion is not quite right, creating too much moisture (according to chinese medicine) and I quite often blow my nose and am stuffed up at night, hence poor oxygen when sleeping, headache on waking or before daily Flecainide AF. The strips have helped a lot.

Firstly, are you sure you are in AF? Do you check it with a Kardia? IMO, if you are actually in AF more than once a week, then using the flecainide as a pill-in-pocket regimen may not be the best way to go.

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