Hi, I only get AF when I’m in bed at nighttime. Almost like clockwork after about 10 mins I m off, sometimes lasting all night! During the day I’m absolutely fine and feel really well. Does anyone else suffer this way? Any help or tips would be most helpful. Getting anxious at bedtime, I know this doesn’t help
I’ve just stopped the dilitazem, it was making me feel so bad Just taking Flecainide now. I saw the cardiologist last week and explained this to him. He put me ona 3 day monitor, guess what, hardly any problems till I took it off and it all started again! He changed my meds to Sotalol 80 msg bd. I haven’t changed yet as worried I might feel worse on this.
Anyone else got or had this problem.
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Canariesfan
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Sounds like classic Vagal AF to me. Try some deep breathing exercises to calm the vagus nerve, Nothing ventured. If you search top right for ectopic breathing exercise you should find the instructions.
Perhaps experiment with sleeping position. I found that lying on my left could sometimes be a trigger, I have heard others also say this. However some doubt that it is a trigger and it’s just that you are more aware of your heart when lying on the left. Could be worth a try though.
One of the rules most of us with AF have to follow is never to sleep on our left side.
When your AF starts, change your position in bed. Then start doing deep breathing i.e. deep breath in through your nose and then a fast forceful breath blowing out of your mouth. This is good if you have high BP too. Some people prefer a different breathing technique which is all performed slowly, breathe in, hold the breath and then breathe out. You have to do both for several minutes and sometimes longer. Try and find a way of breathing that works for you.
Remember too that we can't bounce into bed, or indeed out of it anymore, now we have AF. Everything has to be done at a slower pace. Bah, AF is a horrid condition destined to turn us into old people - if we let it!!!! Keep your stamina up with exercise, fresh air and healthy food.
My heart always has a little 'grumble' when I lie flat and occasionally this turns to AF. Maybe try propping yourself up to sleep at a slight angle? If you need to lose weight that might help. Any kind of pressure on your heart is inclined to upset it 😤
Hi Canariesfan. I have the same - AF is always in middle of night although sometimes can last into the Morning if it’s a bad one. As Bob says - classic vagal AF.
Things that help me (I think)
Sleep on right side propped up with an extra pillow - never lie flat or on left side
Never eat late at night and never a heavy evening meal
Keep water by bedside to avoid overnight dehydration
Regular breathing exercises as described by others - I do these most nights just to strengthen the vagal nerve if I can
For me, the triggers are either something I’ve eaten (or eaten to much!) or stress which I try to deal with by mindfulness and meditation.
And if all that fails then i resort to my flecainide pill in pocket and try to stay calm and ride out the episode.
Hi John. I have the same problem at night & it makes you feel exhausted getting lack of sleep which in turn makes AF even worse. So do you not take liquid after a certain time because everyone is always saying how important it is to stay well hydrated. I only have water. No stimulants.
After a couple of years of chiropractic treatments by three different chiropractors, AF at night is much less and often not at all. Pretty much everything people tell you to do affects your neck and back and the nerves that stimulate the heart. In the day, the back and neck are in an entirely different orientation. My present chiropractor says he only wants one hard case like me once a year but his perseverance has resulted in good results. He finally has the vertebrae staying where they need to be most of the time and now soft tissue treatment seems to be the fine tuning needed. I have been his "Lab Rat" since he has not had a patient who gives him the feedback that he needs and challenges him to find a satisfactory solution. I don't take any medication that could interfere with what chiropractic treatments achieve.
So, if you really want an alternative to surgery and drugs, find a very qualified chiropractor to see if this can be your solution. It may be a long frustrating process; but in the end, if it works, it will be worth it. And if nothing else happens, your nervous system will function more optimally. And if you do this and find a willing and qualified chiropractor, I would be glad to offer suggestions.
A corrective chiropractor will tell you if your neck and back need change. The change could take a lot of visits to achieve, especially if your neck and back have been out of alignment for a long time. The brain must be trained to allow a change; and if your brain is like mine, it can be negative on change.
Your heart specialists and GP will likely be negative on this, but then their solutions are often less than satisfactory and they don't know and have not researched this option. Do some research on what chiropractic does. Chiropractors are nerve doctors and only a very few practice corrective chiropractic methods. So keep looking until you find one.
Google " Heart Arrhythmias- the missed cause" by Dr. John Bergman". It is on YouTube.
Hi, welcome to the select bunch of vagally mediated AFers. Most replies I totally agree with. Re Engmac, I also agree but rather than risk a chiropractor who hasn't got the right skills I do one simple Qigong exercise that strengthens the stomach and particularly the neck muscles (mine were weak as I found in the past when sitting reading I was only comfortable with a cushion supporting my neck).
If you are somebody who flops into bed tired out, try some relaxation exercises before going to bed. The theory (just based on my experience) being the somewhat out of sync Vagus Nerve has more time to adjust that way to the lower level required during sleep; without that it calms you at too higher level in the first hours of sleep providing the right conditions for AF to kick-in. Try it, easy and no side effects. Good luck.
Always in the middle of the night (from roughly 1.30 until about 4.30).
I have been told to stop flecainide after an ablation and at first it was awful, but whether I'm getting used to not taking it I don't know I think it has improved, but I still wake up in the night with either a fast beating irregular heart or just so uncomfortable.
I have recently tried having three large pillows and instead of lying directly on my right side (left side seems to be a no no) I lean slightly towards the right with a little bit on the back and it seems easier.
I still wake up with it, but I get up go to loo and wash my hands and face in cold water and I am able to go back to bed.
However, although I'm tired at bedtime I still dread going..... I have also tried reading a good book when I get into bed and I think it all helps.
I guess once we have these problems perhaps it won't go, but sometimes you find things that maybe help.
When I was taking bisoprolol I sometimes got AF at night. Then the problem was: do I sleep it off, or do I treat? I ended up treating with flecainide PIP. But then I thought a bit. Why at night? Perhaps the bisoprolol was lowering the heart rate too much?? In the daytime, a low HR is easily corrected -- you move around, or consciously start to worry. But at night?? Could it be that the increased irregularities were the body, reacting to low HR? How can the body stimulate a higher HR? Simple. By increasing the irregularities which trigger a faster HR to control them.
Betablockers, and other rate reducers such as Sotolol (which does both rate and rhythm) I theorise, are one of the causes of AF, in some people.
Go figure this. Now I am NOT taking a betablocker regularly, I will take a tiny dose of it, as PIP:
1/ When I get AF at night, or suspect it
2/ After a long tiring day, and the HR gets stuck at walking rate and will not calm down even when resting.
Hi,little confused about your reply! Are you actually taking any medication at the moment or just using pip? I’m just taking Flecainide, however it doesn’t seem to help at night. I’ve stopped taking dilatazem as it made me feel rubbish. I have a new prescription for soltalol, however not started yet as nervous about side effects.
I have taken different regimes at different times. My doctors give me the freedom to experiment with flecainide and bisoprolol, and I know the limits.
For a few years, I was on sotolol, to prevent tachycardia, which it was feared would lead to AF.
I presume that if you take sotalol you will stop flecainide. Interactions can be serious.
If flecainide is not helping at night, then:
1/ maybe a dose adjustment, probably smaller
2/ When I faced that, I started taking the 50mg in the morning only, instead of in divided doses, so that the least amount was in the blood overnight, when the heart rate calms down (except for periods of exited sleep).
Yes, I know from the 24 hour holters over the years that my heart naturally descends to 50/min or less. Probably the bisoprolol makes it worse. I have theorised that irregularities have a natural and desirable biological role (see one of my threads). Rhythm and rate are supposed to creatively and positively counter-check each other. Therefore too low a HR can trigger irrregs which stimulates the HR. Sometimes this battle escalates and gets out of control. I have actually some portable ECG recordings of this actually happening.
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AF at night 
Woken by AF two nights in a Row
AF happening every night...fine during the day
11 nights AF free on 50mg Flecainide 
From a newbie-Night time only problems!
