Anyone’s afib only happened while sleeping? What can be done about it?

[li17]

Anyone’s afib only happened while sleeping? What can be done about it?

[BobD Volunteer]

Sounds vagal so probably beta blockers not a good idea. What does your consultant say about it?

[li17]

I consulted with two EP, both said it’s vagal afib, but both said treatment is the same as any other afib, also both instructed to continue beta blocker. I don’t trust them and had weaned off beta blocker.

I did my research and see that’s vagal mediated afib probably because of high vagal tone and slow heart rate. I always wonder could that be the cause of the afib or just a trigger? And I also wonder if anxiety/panic could lead to high vagal tone while sleeping.

[secondtry in reply to li17]

So, I have Lone PAF vagally mediated with slow heart rate normally between 46-56 resting. I am on just Flecainide 200mgs/day for pills. I am working on my vagal tone by reducing a lot of anxiety causes and I sleep like Wendy above with more pillows above and underneath the mattress to prevent kinking the airway too much and blocking me from turning onto my left side. Supplements for AF prescribed by my Naturopath are Mg (main part of a beneficial compound) and CoQ10; the latter he is suggesting now should be a tad above the top of the normal range, running the argument that if you are susceptible to AF you should have a higher level than the normal person. No AF for 4 years but suspect Flec may cause flutter if I don't wean myself of it.

[li17 in reply to secondtry]

That’s impressive for four years without an episode. I’m not on any daily med but I’m working on gettI got my vagal tone adjusted. Would you think anxiety increases vagal tone? I’m not sure but want to find some study to support it. I think my afib was caused by extended stress and anxiety but I don’t know if these raise vagal tone.

[secondtry in reply to li17]

Almost certainly but you need to establish how much it affects you as an individual. I know anxiety was a key factor I had to reduce and it was a major part of my lifestyle changes. The Vagus Nerve is connected to the brain and then descends going via heart and gut to just about everywhere else; the gut is relevant as if you have problems there (e.g. eating gluten from modern wheats & other cereals) I believe it increases personal anxiety by sending a message back to the brain that all is not well.

The reason I know anxiety is key, I actually tested it revisiting a site where I first got major AF without realising what it was and it triggered it again, fortunately I managed to stop it developing by leaving the site quickly! Good luck.

[Hidden]

I have lately started having an episode most nights since stopping the beta blocker Nebivolol. Oddly enough I also stopped taking Magnesium Citrate at the same time so I am going to reintroduce that before I go back on the Nebivolol

Di

[mwcf]

BB definitely contraindicated for VMAF IMO (vagal-mediated AF in my opinion for all the acronym-haters out there!)

Ask about trying Diltiazem (Ca channel blocker) instead.

All of my paroxysmal AF this last 19 years (2 or 3 episodes per year self-converting (last 10 years 100mg Flecainide BID - ablation now on horizon) has been nocturnal. My resting HR as low as 48 reading in bed late evening/sat at PC in codlins room. On one 24hr Holter in 1999 HR as low as 38 in the night. No bundle branch block or any heart abnormalities - but I am 6' 4" and quite fit and healthy in all other respects other than AF!

[li17]

How did your ablation go? Are you afib free after ablation?

[vaga_v]

Hi! 1 month before my first PAF (vagal?) I had a visit at neurogist due some strange headaches. All test were fine. She wrote that my" trapesious are very tense" and I should start PT asap, masagges and take some Valium before sleep. Wow!!! Normally I didn't take this advice so serious before PAF episode. I am now more than sure I failed to prevent my vagal PAF.

Both times during the night (PAF November 2017, January 2018 - both times self conversion to NSR, vagal?) with initial therapy 2,5 mg bisoprol, rivaroxaban and cordarone. After 2nd opinion all drugs are off (my CHAD score 0-1 max and hystory of hyperthyreosis).

Now, I add magnesium, kalium, walking, cycling, headspace, from time to time even valium to have a good sleep, etc. and feeling much, much better.

[WendyWu20]

Although I seem to have multiple triggers for AF, 50% of episodes began in the early hours of the morning while sleeping. I would get massive ectopics - if they woke me up in time, I could sometimes prevent going into AF by sitting up or walking about. If not, it would be AF that woke me up and then it was too late to stop it.

Notice I used the past tense! For the past 6 months I've been sleeping pretty much sitting upright, or semi upright. I have three ordinary pillows and one big V shaped pillow on top. The V shaped one prevents me from falling off me perch (haha). I know its a bit of pain in the backside, but I'm used to it now and haven't had an AF episode beginning in the night since then. Now all I need to do is work out how to prevent the daytime episodes :o)

[li17 in reply to WendyWu20]

Wow, good for you. So do you think sleeping flat would trigger afib? I guess if I don’t sleep I won’t get another episode

How long you haven’t had afib while sleeping? And what was the frequency before you sleep upright?

[opal11uk]

mine used to be when at rest, not necessarily while sleeping, it seemed to be that when I let go of the days happenings and relaxed.

[li17 in reply to opal11uk]

What do you mean used to be? You don’t have afib anymore or you got it in other time now?

[opal11uk in reply to li17]

After 20 years of suffering I finally had a Pacemaker fitted and that, together with the appropriate drugs, now control my PA/F and after my pacing check last week I was told there had been no PA/F in the past year.

[Bob56]

Lots of sound advice, but not sure anyone has mentioned what you do before you sleep and its effect on AF. I usually found sleeping on a full stomach was AF inducing, and in the early days before I took the pledge, drinking a glass or two of wine late in the evening. I think the deeper my sleep the more likely I was to have an AF episode. That, together with any sort of vivid dream, which might have been anxiety related could also set me off. For many AFers, getting a meaningful trouble free sleep can prove pretty elusive, so I also subscribe to anything which aids a restful sleep such as magnesium, herbal sleep aids ( Any true sleeping pill can be a bit of a slippery slope!) or one of the sleep apps , such as Headspace. Best of luck!

[Steve01]

I definitely think sleep position can cause me to have an afib episode. I invariably get them in the early hours of the morning usually between 4-6am. I always try to sleep on my right side as if I wake up on my stomach that can be a trigger for me. I also agree that having a large meal late isn't a good idea, it seems like anything that is 'pressing' on my innards can cause an episode. I have recently been experiencing a choking sensation which is waking me up and I thought this might be sleep aponea. I have seen a GP but they just prescribed omeprazole for acid reflux which I don't believe it is. I am not keen on going back on omeprazole as the doctor prescribed this for 10 years and it took me ages to wean myself off it. I noticed you suggested magnesium, can I ask what form you are taking this in?

[Hidden in reply to Steve01]

I take Magnesium Citrate. Stopped it because people said it would interfere with my Levo. They forget to tell me it was ok to take them 4 hours apart

Di

[vaga_v in reply to Steve01]

One of the many benefits attributed to magnesium is improved sleep – whether it be simply helping you stay asleep longer, fall asleep faster, or battle insomnia. Spraying magnesium oil directly on the skin is the most common application of the mineral. It's best to apply after a shower, when the skin is clear of lotions or other oils. After spraying, magnesium oil should be thoroughly rubbed in and left to absorb for about 30 minutes. Buy prepared or DIY. Good luck!

[Zacky19]

Hi. I've had af while sleeping often before my ablation, it was usually brought on by Red wine.