Fatigue

[Florence-Nightingale]

Does anyone else suffer with extreme tiredness even after sleeping well all night? I have felt tired all the time recently . I am 71 years old and have been in permanent AF for some years and chose not to go down the ablation route. I have been putting it down to the heat but not sure it is. I take Apixaban Bisoprolol Amlodipine and Losartan. Some days I could literally stay in bed all day. Just wondered if anyone else has this problem or is this just the nature of the beast. I have to admit to not being very active in general.

[jwsonoma]

I wake up tired. I put it down to side effects from Flecainide and Bisoprolo . Plus getting older. I seem to get energy from exercising. So if I get my but out of bed and get going it helps me a lot.

[Rubymurray25]

I felt the same on my meds always tired but then started to get high blood pressure during the night so eventually was tested for Sleep Apnea and it was discovered I had severe Apnea so now on a CPAP sleep machine and feel 100% better. I wasn't overweight so it was missed for years. Well worth checking if you haven't done.

[Hidden in reply to Rubymurray25]

Hi,

Did you get your sleep apnea tested via your doctor or did you go a different route.

I have felt I have had sleep apnea for some time but am at a loss as to how to proceed.

Any advice would be appreciated.

[Rubymurray25 in reply to Hidden]

As I am not overweight my Apnea was over looked for what I believe was years and my consultant believes it was the cause of my AF but I think the AF caused a further smokescreen to the issue. Basically I knew something wasn't right as I was waking up 5 time a night thinking I needed a wee but in the main didn't then I thought I would check my blood pressure each time I got up and it was always high 160/85 my normal is 120/70. I told my doctor and it was suggested I took blood pressure tablets, not convinced I posted my issue on this Forum and someone suggested getting tested. I had changed Doctors so went to the new surgery and asked if I could be tested for Sleep Apnea, it was like I was asking for the Crown Jewels and told I would have to bring my wife in to confirm that I do actually suddenly gasping for air during the night, I was then slightly reluctantly given a NHS verbal test which I think for 8 questions each carrying 3 points ( I think if you goggle the test you will find the question, if not I will give you a rough idea, just ask ) , I scored 21 points and instantly put down for an overnight sleep test ( normally sleeping at the hospital but as I am my wife's carer they rigged me up and I could be at home ) . I results came back and I was having 68 episodes an hour , the safe accepted rate is 5 and I think anything over 15 is severe. ( I did a video about my experience for the sister site " SleepMatters" as it is such an overlooked condition ) . Good luck, Max

[Florence-Nightingale in reply to Rubymurray25]

Thank you for your reply. Will ask my go about it next week.

[Hidden in reply to Rubymurray25]

Hi Max,

Thank you for taking the time to explain your journey,

I can relate to waking up many times some nights, whilst other nights I may only wake up 1 or 2 times. Generally waking up many times in the night with a very dry mouth is the norm.

I shall start with taking my blood pressure when I wake up and see where we go from there, that at least gives me something tangible to measure against.

I shall also goggle the verbal test as that sounds useful for when I go and see my doctor.

All the best for the future.

Den

[Rubymurray25 in reply to Hidden]

Hi Den,

I have just had a quick look and I can't instantly see the Doctors test sheet. When asked the questions I would suggest to go for the worse case in each questions otherwise you might not get the all important clinic or home test. The only question I remember being very worried about was " Could you fall asleep at the steering wheel whilst waiting at traffic lights " , the others were " Could you fall asleep after having lunch if you sat in a chair " " Could you fall asleep whilst a friend was talking " " Are you always feeling tired " " Do you wake up feeling tired " etc . Good luck. Max

[Hidden in reply to Rubymurray25]

Hi Max,

I bought an 02 ring after reading how someone on this forum had used it to see if they had sleep apnea.

It continually monitors your 02 level and pulse and records when your 02 level drops by over 4% which I assume is some critical figure.

I wore it last night and in the morning it said my 02 level had dropped over 4% 200 times in the night (30.7 times per hour) and gave me an overall score of zero with the advice to see my doctor.

I shall trial it a couple of more nights and then armed with this information which I can print out as a pdf it’s off to see the doctor.

[Rubymurray25 in reply to Hidden]

Hi DenBoy,

I have never heard of the 02 ring, sounds a very good piece of equipment and a great idea to print it out, certainly should speed things up with your doctor. Wish you well and if you ever need for advice if you do go on Cpap please just ask in case I'm able to help.

Best wishes Max

[Hidden in reply to Rubymurray25]

Thanks Max,

only one question if I may, when you scored 21 at your doctors did he not tell you not to drive as new legislation has come in recently tightening up on this.

Also the chart you were looking for is called the Epworth Sleepiness Scale.

[Rubymurray25 in reply to Hidden]

I recognise the name of the test now you have said it! The doctor didn't say anything but when you get the equipment from the sleep department at the hospital you are given a leaflet and are meant to inform the DVLA , bit of a grey area and because I didn't do much driving and didn't " Fall asleep at the traffic lights, I didn't make contact!!! ".The following is from Google:- " Do I have to stop driving if I have sleep apnea?"Mild Obstructive Sleep Apnoea Syndrome (OSAS), i.e. Obstructive Sleep Apnoea with the symptom of excessive sleepiness: You must not drive until your excessive sleepiness symptom has been satisfactorily controlled.

So I worked on the basis mine is totally controlled by CPAP so haven't informed the DVLA but I am guessing when my licence expires in 14 months it will come up!

[Hidden]

Hi,

Over the last three weeks or so I have written posts on here about Bisoprolol and its side effects that I've experienced. If you click on my user name and then look for posts in the last 3, maybe 4 weeks it may be of interest to you. I think I entitled the posts .......... Bisoprolol gets me in the end or something.

If not let me know. Sorry in a hurry have to get to hospital for some check ups (not heart).

John

[CDreamer]

Apart from all the affects of the drugs, especially Bisoprolol, which can make you feel like that, have you been tested for:- Thyroid Function and Sleep Apnea? If not, ask your GP because it’s not normal to feel that tired and both are antagonists for AF.

Go back to your GP because if you feel like that you cannot function. I take no heart meds now and feel 200% better for not taking them. Lack of exercise will also make the problem worse so even a short walk each day in nature will help.

[Florence-Nightingale in reply to CDreamer]

Thank you for your reply I have yearly blood test and to date all tests normal next due next month. Would I know if I had sleep apnea or not ?

[CDreamer in reply to Florence-Nightingale]

Not from blood tests. You would need to see your GP who will ask you to complete a questionnaire. Dependant on your answers you would get a referral to a sleep clinic who would give you a monitor to wear overnight and from those results you would be diagnosed and then treated.

[Florence-Nightingale in reply to CDreamer]

Thank you for your reply

[Ppiman]

Unlike you, I never sleep well, so feel tired, terribly so, at times. You have my sympathies. Have you asked your GP to test you for sleep apnoea? This can cause severe daytime tiredness.

Out of interest, I read that the next version of the excellent Apple Watch will contain an app to detect sleep apnoea. I think that will be very useful.

Steve

[Florence-Nightingale in reply to Ppiman]

Thank you will see if I can invest in new watch.

[Ppiman in reply to Florence-Nightingale]

It’s not out yet. I think the announcement is early September. There’s talk it will measure blood pressure, too. We’ll see.

Steve

[BobD Volunteer]

Interesting mix of drugs. Why two for blood pressure? Are you on max for losartan?

[Florence-Nightingale in reply to BobD]

Hi Bob I am supposed to take 75mg of Cozaar (Losartan) daily but only take 50mgs and a small dose of Amlodipine 2.5mgs per day as well as 7.5mgs a day of Bisoprolol plus Apixaban 10mgs daily. The reason for Losartan and Amlodipine is I react so badly to antihypertensives we had to find something to help my very high BP. I cut down the Losartan as I now have the opposite problem of low BP. I would add trying to see a GP here is somewhat of a nightmare.

[Buffafly]

Definitely tell GP. And insist if he doesn’t suggest it that he do a blood test plus ferritin test.

[TracyAdmin Partner]

It is not unknown that fatigue is a common side effect to many anti-arrhythmic medications such as beta blockers. Perhaps visit the Patient Resources tab on the AF Association webpage heartrhythmalliance.org/afa/uk to view\download some of the resources? I would particularly recommend the booklet 'Atrial Fibrillation (AF) drug information.

If you require any advice, our Patient Services Team are here to help, [e-mail] or 01789 867 502

booklet

[Florence-Nightingale in reply to TracyAdmin]

Thank you will have a look. I think it’s Bisoprolol that’s the culprit. Have a telephone consult next week with GP to discuss tiredness.

[seniorita]

I sympathise. I have had fatigue since well before I got PAF. There was no problem with my heart as confirmed by a CT angiogram. Sadly my GPs just shrug and leave me to get on with it.

[Florence-Nightingale in reply to seniorita]

I suspect that’s the reaction I will get when I speak to my GP next week.

[jeanjeannie50]

At one time I felt totally drained and needed to sleep afternoons. It was discovered that I had an underactive thyroid. Have you had yours checked?

Jean

[Florence-Nightingale in reply to jeanjeannie50]

Thank you for your reply I have yearly check due in September. My thyroid and iron levels have been normal to date.

[jeanjeannie50 in reply to Florence-Nightingale]

If you let us know what your thyroid test results are (the numbers) we can probably advise more. GP's sometimes aren't that knowledgeable about the rates. Mine left me at too high a rate for ages and I felt dreadful. I'd be out walking and suddenly feel as though I just needed to flop down lifeless wherever I was. Not an ounce of energy left! It wasn't until I saw a specialist and had a blood test re something else that he rang my doctors surgery and said I needed to go on thyroid medication urgently. I'd been thinking that my tiredness was all part of AF.

Jean

[Florence-Nightingale in reply to jeanjeannie50]

Thank you Jean.

[Beverleyb]

Hi tiredness has taken over my life , I don’t have a thyroid and my thyroid levels are ok . The medication I take for afib give me terrible dreams . I feel exhausted when I wake up . I really need to exercise but haven’t the energy. I go out once a week shopping and I fall asleep as soon I come home . I felt on top of the world when I had my cardioversion sadly that didn’t last long 4 months . I really do sympathise with you ..

[Florence-Nightingale in reply to Beverleyb]

Thank you for your reply .Some BBlockers cause nightmares. I take my evening dose at least 2hours before bed otherwise if taken just prior to bed will have nightmares.

[Bagrat]

You have my sympathy. I'm not in AF but still get days when lying on the bed after lunch seems the best option.Incidentally " tired all the time- TATT" is one of the most common reasons for contacting a GP I'm told.

[BernardS]

Just a thought. Have you possibly had Covid? I did several months ago and still feel very tired and lethargic. Could possibly be this 'long covid' the press is full of.

[Florence-Nightingale in reply to BernardS]

Bernard I have been lucky to date and managed to avoid COVID. Am fully vaccinated and awaiting the autumn one.

[foxglove1]

I agree with Buffafly and suggest you ask your GP to check your Ferritin levels. I was found to be very low (but not anaemic) several years ago and GP put me on to Iron supplements. Been on them ever since.

[mary70]

Maybe helpful - recently, the study of sleep problems is the problem for many who have sleepless nights.

"sciencedaily.com › 202...

Weighted blankets can decrease insomnia severity - ScienceDaily"

"Michael Mosley - BBC

Michael Mosley uncovers the latest science and surprising health benefits of better sleep"

[Keano99]

I wake up tired too. Sounds like it’s the Bisoprolol and/or Ramipril. I came off the Bisoprolol after a Cardioversion, for a couple of days, I felt so good, shame it was short lived. But I’ve had a successful ablation, so should come off it shortly. It was 15 weeks ago, my next follow up isn’t four weeks, so I’ve decided to ween myself off the drugs now as I’ve had no issues….

[excel1234 in reply to Keano99]

My Husband is like this all the time, due to what we thought was the affects of Edoxaban and at last the Dr has now exchanged it for Apixaban. I really hope that this will work as he is getting weaker and weaker by not exercising. Can't tell him though!!

[Shemac52]

I am also tired even after a great night sleep. Take Digoxin, Diltiazem and Apixban.

[Ducky2003]

As others have suggested, thyroid and sleep apnea tests would be prudent. Also B12 if you don't have the jab for it already.

[DawnTX]

I absolutely feel that way. I am only on my Multaq and Xarelto now. I was on amlodipine And was miserable the whole time I was on it it made me so ill. I was on it for over four months. Lisa Ryan does not bother me. It’s hard to tell you anything because we are all so different especially with medication. Best of luck

[Florence-Nightingale]

Thank you all for your very informative replies. I suspect my fatigue is drug induced as well as lack of motivation. It’s very reassuring I’m not alone.