Hello everybody, I would be very grateful for any recommendations (experience?) regarding best sleeping position for PAF. I have slept on my back but have read that it is very bad for heart and could trigger AF. It seems that in my case it’s true because all my recent episodes of AF (30+ hours) happened at night about 4-6 am. 😊
Best sleeping position for AF - Atrial Fibrillati...
Best sleeping position for AF
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Kittyca
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Have you had a sleep test? There is a close link between AF and Sleep Apnea
Not yet. I have read about sleeping apnea but it seems not my case. Sometimes I have nightmares and feel chocking but it isn’t often and never caused AF
My EP organised for a sleep test in hospital because they can can monitor things better than they can in home tests. Most of my sleep was good but I had a number of apneas in REM sleep which is the dreaming sleep when your body is basically paralyzed so you don’t act act your dreams. My oxygen levels dropped and the CO2 increased. My overall diagnosis was mild and the sleep specialist said if I didn’t have AF he wouldn’t worry about treating it but because of my arrhythmias it was wise to treat so I’ve had a CPAP for a couple of years now.
And I was on my side for my entire sleep test.
Thanks a lot, ! I have been scheduled to see cardiologist soon and will ask about sleeping test. The only problem is that it’s done in hospital and I can’t sleep in hospitals at all! Usually spend all nights without dreaming
I managed about 3 hours. I fi d listening to talk back radio or podcasts helps me get to sleep. It helps take the mind somewhere else. Music keeps me awake.
You have said you use CPAP now. Do you wear it every night? Do you feel comfortable in it?
Yes I do. It’s a very comfortable soft mask that sits below my nose. I’m really claustrophobic so wouldn’t be able to wear a mask that covers my mouth and nose.
Could I ask please , as I’m struggling to adapt to using new CPAP machine due claustrophobia , which sort of mask do you have ? Is it a nasal pillow mask ?
I had it too! Awful at first but I just pretended to be a fighter pilot until I got use to it. Full face mask. Now welcome it every night as I sleep. Mind over matter I guess? Worth a try.
How do you find you feel now you’ve been on CPAP for a couple of years Kaz? I’m the same, if it wasn’t for the AFIB they wouldn’t have treated me. I’ve had issues with finding the right mask. Started with a full face mask and discovered I had an allergy to silicone. I tried the Air Touch face masks with foam but still didn’t get on with them. Tried the nasal pillows, they are better and finding my way with them. But as a shift worker I cannot take my CPAP machine into work every night, so I’ve managed to get a fitting for a mouth advancement device to use when I can’t use my machine.
I’m the same if I didn’t have AF the cardio doctor would not have ordered a sleep apnea test, she asked if I snored I replied terribly! Turns out she was right sleep apnea.
Kittyca find if I try to sleep on left side I can feel my heart hammering so sleep on right side.
All good. I use it every night and haven’t had any dramas. I didn’t bother trying any other type of mask as I knew I wouldn’t cope with them.
Very interesting thread. I just started using a CPAP. life changing for me. Sleep 8 blissful hours. I use the Resmed 10 and nasal pillows. Mine has heated water device attached so like a warm kiss. Minimal adjustment and now won’t be without it.
I had an NHS sleep test done at home which showed mild sleep apnea not sufficient for a CPAP machine. Instead I use Breathright nasal strips at night and since last summer a thumbnail piece of tape keeping my mouth closed; the latter has stopped me waking suddenly with a choking splutter and made me feel much fresher in the morning, for more information on mouth taping/breathing see mrjamesnestor.com/breath
Call me a cynic but I've had my fill of books/blogs that charge and are always ' amazing ' only for me to find time and again that they aren't. What would make me trust this one ?
I know there is a lot of useless information out there. It is trial and error I'm afraid. I believe this one as it has helped me. Can't guarantee it will do the same for you.
Ok Thanks
Whew, I think this is life, try a heat pack, put your electric blanket on full and warm up, read a bit of fiction, we really have to overcome this, there is no magic fix for anyone. I sleep very poorly most nights get over it, all is not lost. Cheers.
Sorry not wired to 'get over it' have a need to understand and help myself
I have been trying 50 years out of 77 so I wish you luck, sorry to offend but for me it was to "get over it" Dosen't mean I like it XX
I had sleep issues for years. Paul.McKenna's book helped me and I'm doing much better now. It's a discipline in itself.
I have AF but haven’t been tested for sleep apnea .I have tried the nasal strips but don’t seem to be able to keep them on, it might be the shape of my nose, they just peel off after about 5 mins . I also tried a plastic thing which goes in your nostrils but that kept falling out as well. I wake up choking and spluttering as well about once every two weeks and never feel as if I have had a good nights sleep.
If you are in the UK request your GP for a Home sleep apnea test or if this is difficult pay privately if possible. Have you tried the Breatheright brand of nasal strips (nb I have no commercial connection with them), they were recommended by Bob on this Forum and I have never had any peeling problem; the plastic thing you mention didn't work for me either.To get a better nights sleep and to feel fresh again in the morning, I first read James Nestor's book Breathe & listened to Patrick McKewan Oxygen Advantage on YouTube. I then practised keeping my mouth closed during the day to only use the nose for breathing; at night I put a very small piece of tape, thumbnail size, over my lips in the middle to continue nose breathing. Done this for 9 months, no known side effects and feel much better.
I have the same, where you wake feeling like it are choking and quite vivid nightmares. On top of that I was feeling exhausted to the point where I was falling asleep playing with my kids! I had a sleep test and found I had moderate sleep apnea. I’m now on CPAP which I’ve had trouble getting used to, but I’ve persevered with it and starting to see the benefits. But I still get the nightmares, but since CPAP I’ve even noticed a reduction in ectopics.
My advice would be to speak with the GP, get a sleep questionnaire and see what that comes back with. Sleep quality is important for everyone, but especially for us cardiac misfits!
I didn't snore, but my EP sent me for a sleep apnea test all the same as I was lethargic and tired a lot of the time. I blamed it on my permanent A Fib. To my surprise I was found to suffer from sleep apnea. So don't dismiss it out of hand. I now sleep with my head raised on a wedge and feel so much better, but the A Fib is still there.
I found sleeping slightly upright on my right side works to keep things calm...
My heart doesn’t like me lying on my left side (goes a bit wobbly) - so on my right side for me. 😴
Same here, left is the most AF inducing side, right better and on my back is best.
Agree for me it is right hand side slightly raised....left hand side causes issues. You might also consider your pillow I stopped using firm bounce back and switched to soft low pillows where no pressure was being put on vagal nerve.....it helped.
I bought an adjustable bed which helps to rise up the position while sleeping and bought a special support neck memory form pillow. Are they good for vagus nerve?
Sounds like a good idea anything to reduce physical pressure on vagal nerve.....I think everyone is unique in what works best for them, its taken me 4 months to find a solution that works to help improve sleep. When it comes to the heart it literally is about doing everything that works for you personally to allow time for heart to heal and for things to settle things down. I would try everything. Hope things improve for you soon, it's not good having heart out of control.
Yeah me too. My heart can get irritable sleeping on the left side.
Hi,
There is some anecdotal evidence around to suggest that food eaten the night before might aggravate/ stir up/ inflame the vagal nerve. This nerve is worth your reading up on. Briefly it behaves something like an information superhighway between the brain and a number of organs, most notably the heart and digestive system. If you google Vagal nerve schematic diagram you'll see what a mechanism this is.
The rare events that I experience these days have been triggered when sleeping on my left side or after certain foods - or a combination of both, food and sleeping on my left side. Usually happen for me around 2 am to 3 am. Left side sleeping seems more to trigger AF issues with some people who are so disposed.
John
LaceyLady in reply to
My cardiologist recommended that I didn’t sleep on my left as I’d feel PAF more.
Yes, it might be that food is involved. For me it is possibly fizzy drinks like diet lemonade. I like fizzy drinks a lot, try to avoid them but sometimes return and can’t stop temptation. Plus back sleeping position. Plus stress and anxiety which both come together with PAF
Always start on my right. I end up on my back in the morning. I never got on with starting on my left side. My recollection of posts on this forum is that I am in the majority.
Pete
If I have any jumps and bumps, lying on my left side makes them worse, slightly propped up improves things. When I had AF, I could only lie in foetal position on my right side - but sleeping for me was out of the question!
I think that you have to work out for yourself which sleeping position is best. Many find that lying on left side aggravates AF. Lying on right side can cause refux issues due to positioning of the intestines . Personally I alternate between left side and back unless I am in middle of AF or Tachy episode when it has to be extra pillow and on back !
Lying on my my left will start my heart pounding, so always sleep on my right side now and am fine, also occasionally sleep on my back.
Thank you everybody! Highly appreciated!!!!!!😊I had an idea: let’s create the list of everything which was a trigger for PAF. It might help lots of people to understand themselves better.
Mine:
1. Stress , Anxiety
2. Excessive exercising especially in tight clothes
3. Being in a hurry ( might be due to adrenaline), need to control myself and deal with everything in a slower pace
4. Coffee, green tea
5. Sparkling drinks and My favourite- Champagne!
6. Left side and back sleeping position
7. Thoughts and hard conversations before going to sleep
8. Uncomfortable sitting position
More ideas?😊
Hi,
I find that all the reasons on your list apart can can bring on episodes for me. In addition eating and excessive gas is a trigger.
in reply to Kittyca
Hiya Kittyca,
No 6, definately ! However, eating any range of foods that aggravates, stirs up and/or inflames the vagal nerve. No problems with hot or cold drinks, ice cream products, or alcohol.
John
Kittyca in reply to
Sounds great regarding alcohol! I have completely given up it but sometimes I fell that really need a glass of wine or a bit brandy. Possibly alcohol taking in moderation is a good thing. The only concern is never try it while in a hurry, on empty stomach and before bed
Definitely stress & anxiety/worry
Being overtired.
Over indulging food/alcohol
Indigestion
Loud beat music - as at festivals, concerts & band marching
My aFIB was dx after I was exposed to prolonged beat box music that started up daily next door!
Constipation / bloating
Good list 
I agree, and for me I’d also add:
1. Artificial sweeteners and stimulants like caffeine, and sometimes dark chocolate.
2. Shallow or nervous/stressed breathing.
3. Bending forward (sometimes).
I so agree about the thoughts and hard conversations before going to sleep. However much I try to relax my body and mind, it’s like my body ‘holds’ the tension anyway
J x
in reply to JaneFinn
Hiya JaneFinn,
Your post reminded me a period of time bending forward ( shredding some documents from a low arm chair). that for me was the very, very start of my AF, the day it mugged me, 6 January 2010 .
So, Kittyca ... can you add that to my list too please.
🙂John
Interesting Jane, many things on your list trigger mine but the latest is SLIMFAST! Trying to shift the weight I put on in lockdown but slimfast is a definite no no!
Oh yes! Funnily enough, long before I had AF I tried slim fast and it gave me an itchy skin and fast heartbeat. I blamed the artificial sweeteners or one of the other additives. (Very disappointing though as it seemed like a helpful way to lose weight!) (Which I still need to do 😖) xx
Aged cheese, dark chocolate 70%++, anything overly sweet, alcohol of course
Thanks Jane, same with me. Last time before having PAF at 04.10am for 34 hours, I tried meditating, tried relaxing my mind but tension was inside and as a result: PAF welcomed! I also would like to add:Post event syndrome. It means all problems and worries have been sorted out and everybody around feels relieved but not me! For me it is the beginning of panic attacks etc
I have also identified 'post event syndrome' as a potential AF trigger.
My solution is after any difficult event, I make a conscious effort not to 'drop on the sofa with my favourite drink' but to continue to do something less demanding thus winding down slowly.
After considering my own experience in conjunction with years reading cases on this Forum, I put the PES trigger down to the Vagus Nerve which through years of bad/stressed lifestyle gets stuck in the parasympathetic mode; this deals with your 'problems & worries' well but when they are over it does not adjust back to normal promptly and continues to reduce stress when you are already relaxed. This in turn reduces heart rate down to a level that gives the 'little drummers' i.e. AF the chance to start up.
This idea is exactly what happens with me. Sadly I live some considerable distance from my family and has meant that when we have big family get togethers and it is so lovely and exciting to see everyone it now invariably sets off an episode of PAF the following day.😱
Set something up before they visit for the following day that is challenging; I know it will detract a bit from the family reunion thinking about it but that's exactly what's needed. Trial and error will soon show how challenging it needs to be !! I firmly believe there are ways around these things but they are very individual.
If I know there’s an event on next door that’s going to be loud it worsens my internal shakes. Even a loud muffler car will do it! A plane flying low overhead or loud engine boat on the lake! I don’t want my aFIB to be labelled as stress triggered but it looks like cardio physiologist could call it this as he can’t distinguish between ectopic bests and true aFIB. Whaaaah. I just want the shakes to go!
My reasoning on my first reply applies the same to you getting AF at night between 4-6am, when you are probably most relaxed in REM sleep. I don't think it is sleeping position unless you have rolled onto your left side which I avoid.
Sleeping slightly on my left side propped well up with pillows is best for me. I have no idea whether it's best for the heart or not but I do know that it seems to be less violent thus more comfortable.
I had a sleep test at a center where they do these things and they found mild apnea. My doctor prescribed a CPAP machine which I obtained and tried but I couldn't stay with it. Since then, however, I dropped 55 pounds which, as you might imagine, made a big difference. I also don't eat anything after dinner which does help. I sleep on my back for part of the night and then on my right side for a smaller portion. I would say that most of my arrythmias occurred while sleeping on my back. Sleeping on the side has been shown to mitigate apnea and sleeping on the left side in particular, is more associated with triggering Afib, etc. than the right side.
I found that lying on my left was the trigger for me. so I try to sleep on my right as much as possible. Good luck
It's well known that sleeping on Left Side can trigger AFIB in some people. Just be careful . . . .
I would add getting up too fast in the night to go to the bathroom. This has triggered it for me.
My trigger was sleeping on my stomach and then getting up in the middle of the night to use the bathroom. The second I went to lay back on my stomach I would get a boom boom in my chest and get an irregular heartbeat. Now I sleep on my back propped up.
Quite a lot of the things discussed resonate with my own experience.
When I began getting PAF I noticed that I was getting a lot of atrial ectopic beats when relaxing in the evening after work, and that sitting in a reclined position made them worse - so I would watch TV in an upright chair rather than using the sofa or an armchair.
Lying in my left side in bed seems to make ectopic beats and AF more likely, so I now try to go to sleep on my right side.
I hadn’t heard of ‘post-event syndrome’ before, but that fits too. If I’ve had a busy or stressful day, when I relax afterwards I seem to be more likely to get the ectopic beats that can trigger my AF.
Alcohol (even a very small amount) and dark chocolate have also been triggers for me, but I can have coffee without any problems.
My cardiologist thinks there is a vagal component to my AF as I have a fairly low resting heart rate and the episodes seem to mainly happen when I’m relaxing or asleep.
Kittyca in reply to
It seems that my case is similar to yours. My PAF started in 2003, lots of ectopics before it happened first. I tried to speak to different cardiologists regarding ectopics but they all said that it was not a problem and I shouldn’t worry. Eventually it finished with PAF which started at 6 am. The episodes were infrequent first but by now the situation has changed. Has had a numerous cardioversions. What advice regarding a vagal component has your cardiologist given you? My rest heart rate is also fairly low. Are there any special techniques to stop PAF or medication if vagal component is the reason? I have an appointment with a cardiologist very soon and would like to ask the right answers. Would very appreciate your answer and recommendations,!😊
in reply to Kittyca
I’m still in the process of being sorted out, as my PAF was very occasional for many years and I successfully managed it with pill-in-pocket doses of flecainide when required.
Recently I began to get AF episodes a lot more frequently so I’ve just been started on a trial of regular medication. If that doesn’t keep the episodes away then I’ll likely need to go for an ablation.
The only things I can suggest are optimising any lifestyle factors (sleep, exercise, nutrition, cutting out known triggers etc.) and to try to minimise any life stresses that seem to lead to ectopics or AF afterwards.
The only specific thing the cardiologist did in view of a likely vagal component was to take care with the dosing of medications that might further reduce my resting heart rate.
Kittyca in reply to
Thank you so much! Did your cardiologist refer for any additional tests before prescribing’pill in the pocket’? Do you take bisoprolol when an episode of AF occurs?
in reply to Kittyca
Before I started pill-in-pocket flecainide I had an echocardiogram and a blood test for thyroid hormone levels. I had to go to the hospital the first time I took the pill-in-pocket flecainide so they could check for any adverse effects on my ECG.
Recently I was told that it was recommended to be on either a beta-blocker or diltiazem if taking flecainide. As I have asthma I was prescribed diltiazem.
secondtry in reply to
My London Naturopath said he treats all his AF patients with a Magnesium compound and CoQ10. I have done this for 6+ years (as well as taking 200mgs Flecainide) and have recently started reducing the amount of both supplements. I agree 'Lifestyle Factors are Life Savers'. My results: just 2 AF episodes under one hour since diagnosis in 2014.
Dr Stephen Sinatra, a US cardiologist with a strong interest in nutrition , (and I think many others now follow this protocol) has advocated magnesium and CoQ10 for many years. He has a website, and also has written several books about general heart issues.
in reply to secondtry
I'd like to give supplements a try if they might help. Would you be able to share the type of supplements and the doses that you take?
secondtry in reply to
Sure, the Mg compound is nutriadvanced.co.uk/megamag... and lambertshealthcare.co.uk/co... with the dose as per the instructions. I did start out on these by getting my levels checked with 6 monthly blood tests sent by post to BioLab London to gauge how much I need and of course checked with my medics in case they had an opinion, they didn't! Hope it goes well.
Hi, my partner had persistent AF now in remission following Cardioversion and daily Amiodarone tablet. She used to sleep on her back and would prefer to do so but she found using an oximeter worn overnight that her oxygen levels dropped quite a bit at times.At one point it went down to 80% briefly. Now sleeping on her side and oxygen levels stay much higher, although dipping into low 90's occasionally. Her breathing is also more regular through the night.She has been told she does not have sleep apnea but apart from age(73} does not have any other usual AF triggers. Hope this helps.
Andy
Yes you're right,sleeping on your back may give you sleep apnoea- (you involuntarily hold your breath in your sleep). I would recommend on your side- pref your right side-your heart is on the left.I personally use a CPAP breathing machine which helps with my snoring . If you're on any heart arrhythmia meds take them an hour or two before you go to bed.Good luck.
I recently read that the best sleeping position for the heart was to lay on your right side because sleeping on the left puts pressure on the heart. But then there is also info that if you have GERD it is best to sleep on your left side. It relieves regurgitation of stomach acid.
I have also read sleep on your right side for AF left side for GERDS , don’t sleep on your back if you snore, I have all three so it is a bit of a conundrum.
Me too, I have all three. I have found that if I prop up pillows behind my back while I lay on my right side, and make sure my upper body is elevated by several pillows, I tend to do pretty well. For me, the key is to make sure that stack of pillows behind my back stay there so I don't roll onto my back. Best of luck to you!
Thanks everyone for ideas will try some out.
Reminds me of pregnancy, don't eat too much or certain things or sleep on your back. Lol. I sleep on my right side with pillows under knees, chest and chin or I dribble! I put another pillow behind me so I don't roll completely onto my back. No added salt or caffeine during the day! Salt pushes bp up and caffeine with beta blockers makes small capillaries close hence cold hands and feet. I'm sure that doesn't help your heart either which is full of microvascular structures. I drink ginger powder in hot water with a dash of lemon juice now. Still figuring out how to help myself.
Sleeping on my side can lead to AF if I don't roll onto my back at the first signs of it. I also can't sleep on my side when I have an episode. Having said that, I find sleeping on my back really uncomfortable and hate it when I have 5 hours until the AF subsides.
When I have ectopics during the night, I roll onto my back to reduce the risk of AF taking hold.
A lot of people cannot sleep on their left side, which can be a trigger for afib. I am one of those, BIG trigger for me. My EP at the Cleveland Clinic agrees that quite a few of his patients have the same issue, although he cannot provide clinical confirmation why this would be. It is something physical probably, as the heart is on our left side also and putting pressure on this might agitate the heart. Right side and back are no problem.
To complete the picture: I think that if you have PAF episode for the first time you MUST accept that it has come for ever and never lets you free. You should not cheat yourself pretending it’s gone. Of course, you MUST understand your triggers, try to find as much info as possible, change your lifestyle.....BUt, in my case I was completely free from it for nearly 7 years (during this period took only tiny dosage of tranquillisers ) then after I got rid of panic attacks, ate only healthy food , lost about 25 kg , did swimming and walking regularly IT (PAF) suddenly came out of the blue ...... I think the best thing is to try to accept it and do everything (at least try) SLOWLY 😊
in reply to Kittyca
Your PAF seems to have behaved very similarly to mine. Mine started with a few episodes within a few months about 15 years ago, after which it rarely happened. I even had a period of 7 or 8 years without an episode.
Then this year it started happening once or twice a month, so I got referred to a cardiologist again. Good thing, because it then increased to happening about twice a week!
Because it disappeared for a long period once before, I kept hoping that it would disappear again, but that didn’t happen. I had to haul up the white flag and go onto regular medication as I couldn’t keep going with pill-in-pocket a couple of times a week.
Kittyca in reply to
Yes, it seems so. I guess, it might be connected with adrenaline. Also one very knowledgeable???? neurologist advised me that underlying cause might be pheochromocytoma which is rather rare condition and often goes unrecognised. He suggested 24 urinary collection for catecholamines but I didn’t do it
Since I've had AF, I now always wake up on my back, after starting on my side. Never happened ever before AF... No idea what it means.
Yes, it seems so. I guess, it might be connected with adrenaline. Also one very knowledgeable???? neurologist advised me that underlying cause might be pheochromocytoma which is rather rare condition and often goes unrecognised. He suggested 24 urinary collection for catecholamines but I didn’t do it
I woke up in the middle of the night a few days ago to feel disconcerting twinges in the heart region. I had been sleeping on my left side (the better to hear my audio CD book). I turned over to the right side and the twinges went away; I slept well thereafter. I also find that sitting up, semi-reclined, can give me an extra hour or two of sleep if I've woken up at, say 5 a.m. I grab my laptop and watch/listen to a YouTube video of someone giving a lecture or talk. I recommend Rupert Sheldrake -- he has a very pleasant voice that usually sends me to sleep after 10 minutes. Make sure the laptop is secure and won't fall off the bed, and dim its light to the minimum. We're all different in some ways, so I suggest you try out different sleeping positions, but, for me, I'm one for the right side.
Sleep on your right side. Left side and back worse for the heart. As far a s CPAP..I haven't had an afib episode in 2 years after getting CPAP machine. Huge link between apnea and afib
When first diagnosed my consultant advised me to use at least 3 pillows. I'm unable to sleep flat as this seems to start the Afib off.Hope this is some help for you
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