i have occasional bouts of Afib, i guess a couple a year which is not too bad comparing my problem to others. What's worst is my sleeping patterns, very erratic and disrupted. I asked my doctor for somthing to relax me and help me cope at night. Now here's the thing, i am on 80mg of Sotolol twice a day. I was happy when he prescribed Mirtazapine 15 mg as i thought anything that helps would be a godsend. I did a cursory check about drug interaction on web md and to my supprise it came up with serious side affects avoid. One side affect obviously being long QT. I mentioned this to my doctor and he didn't seem concerned. He said on his system it only showed moderate interaction. Should i be concerned
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Avatel
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Been tested for sleep apnia and i don't have it. It seems my brain is overactive while sleeping. I've had some success with valium but obviously can't take that for the rest of my life. Sertraline has been mentioned. Any suggestions?
I’m a great believer in daily Mindfulness Practice to teach ‘Monkey Brain’ as it is known to quieten down. There are many different types of practice and all focus on breathing techniques. I always know when I need to go back to focus on breath as I have a sense of everything speeding up. It’s not instant relief but no contraindications and lasts a lot longer.
I stay away from any type of anxiety suppressants, it’s a band aid only.
”monkey brain” - love it ! I’ve got one of those at night and I know that sleep deprivation as subsequent exhaustion leaves me open to a PAF attack.
Very occasionally when desperate I tell my other half I sleep with Pam … aka Lorazepam but that’s the exception as it’s not obtained easily (quite rightly) - I’m going through a routine of breathing exercises, mindfulness , sleep hygiene , yoga and exercise to calm my mind. Takes time but might succeed where Mirtazipine didn’t … wholeheartedly agree with what you write. I’m not there yet but I am optimistic.
Monkey brain certainly isn’t funny. SCBT - Sleep Cognitive Behavioural Therapy - completely different to CBT for anxiety - seems to be the gold standard so that would be my first port of call. SleepyHead Program - Stephanie was my NHS sleep advisor and she’s now got an online program. Montifiore clinic looks good, but quite expensive, depends on your resources. If you are considering Hypnotherapy or Acupunture, Sleep Clinics may cost a little more. Other suggestions at lower cost is Tapping or EFT (Emotional Freedom Techniques).
All of these suggestions require your input and are not like taking a pill so are not instant fixes, all I can say is helped me.
Either Hypnotherapy or Acupunture may help - personally I’d try Hypnosis and ask to be taught self hypnosis first. Acupuncture I found best for pain and conquering bad habits (smoking) etc and phobias. Anything that helps you relax and switch off your thoughts - usually means learning to focus on something else so I’ve found Yoga Nidra excellent about 30 mins before sleep - it takes you away from your brain and into your body.
Have you seen or asked your GP to refer you to a NHS sleep specialist? You may be lucky, in my area I’ve already been on the waiting list for the sleep clinic for 6 months but that is more for ongoing monitoring of SA. These programs now do not rely on medications as there is a lot of evidence to show that whatever the drug, the side effects of even the best drugs can damage your health, I guess it depends upon how desperate you are.
I have one of the best sleep clinics in the country just down the road in Exeter but my doctor won't refer me because of the cost. I also got no reply when i wrote to the clinic regarding private treatment.
There other clinics out there but to be honest the cost would probably to much for my budget, that is why I'm looking at cheaper options. Can you explain how 30 minutes of youga can set you up for 7 or 8 hours sleep. Does it just help you get to sleep or does it relax the mind through out the sleep?
May be a silly question, but I'm interested to know more.
Yoga nidra or yogic sleep in modern usage is a state of consciousness between waking and sleeping, typically induced by a guided meditation. It’s a practice and like any practice the more you do, the more competent and effective it becomes. It totally relaxes the body and because your mind focus is entirely on the body and the breath, Monkey Brain vanishes. The breath, as stated elsewhere is incredibly important feed back loop for relaxing the whole body, including the mind. CBT works on the retraining the brain to perceive thoughts differently and worry less.
The Exeter clinic used to be excellent and I certainly had no problem getting a referral there but that was 10 years ago. The support I had from the physiologists there was second to none. We just moved to East Sussex and had no problem getting the referral from the GP but long waiting list, even though I’m already registered.
RD&E also had an excellent Psychology Department which ran MCBT - mainly for chronic pain but if it’s still going, worth a stab as the techniques are very similar.
Has your GP given you sleep assessment? I am horrified but sadly not that surprised that it comes down to cost rather than clinical judgement.
I would persist with your GP - as a previous poster outlined if your doctor doesn’t consider Lifestyle and Self Help before drugs, they are nothing more than drug pushers.
Well this blog is certainly better than a doctor's appointment, great advice but lots to take in
Thank you and everyone else who has chipped in with advice and suggestions
Hiya Avatel,
Well, I can easily identify with your comments on sleep, the difference is I can say quite definately that mine is due to the way I sleep and the impact on shoulder pain arising from osteoarthritis in both shoulders. However, thats not the issue .............. I would like to refer you to comments I made to "Gillybean" in the last hour about medication.
To answer your question .... my view is yes. I had recently a very constructive telephone conversation with my Surgery Pharmacist on my use and planned reduction in my dose of Bisoprolol this included an explanation of how Bisoprolol works, in the context of all the other drugs I am currently prescribed.
So, my suggestion to you is to arrange an Consultation/Appointment with a Pharmacist, either one employed by your Surgery or any Senior Pharmacist employed by a Pharmacy in your area. I would want a review from a Pharmacist on the impact of Sotolol twice a day and 15mg of Mirtazapine on your QT interval ..... I certainly wouldn't want to rely on the dismissive views of a doctor.
I know there is a new service offered by pharmacys. I will have to look into it, but i often feel i am seen as a problem patient, which is not my intention
I order my meds from an online pharmacy and as soon as I was prescribed a new drug I received an email inviting me for a review with a pharmacist. My local pharmacist also asks if I need advice before I collect any medication new to them or indeed buy OTC . My very good doctor told me to ask a pharmacist ‘they are the experts’ when I had a query.
Hiya Buff ......... well that seems to be the way my surgery is now heading too and I am very impressed with the phone consultation I had with my Pharmacist. Good for you.
As a fellow suffer with poor sleep, I've tried most things over the years. Mirtazapine is, I gather, pharmacologically, a potent antihistamine that has found use as an antidepressant, but its main effect is to cause drowsiness. The dose you've been given is a very small one so I'd say trust your doctor. That said, I found it stayed in my system far too long and caused a daytime zombie-like headache. It wasn't for me, but many write well of it.
Zolpidem or zopiclone are the usual drugs given for insomnia. They have few side effects although there's a slight possibility of dependence forming. Sadly doctors prefer antidepressants which, to me, are a poor choice to help sleep.
Thanks Steve, will look into all possible drug options, but getting the GP to prescibe the is another problem. Its difficult. If i read up on a drug and suggest it, he will give me something else.
Doctors worry about hypnotics and the guidelines are very cautious about their prescribing them. I think short acting drugs like zolpidem are safe for most people and reasonably effective.
This recent study might be worth mentioning to you doctor:
What does jump out at me from your post is an urgent need for lifestyle changes - I consider these include diet, meal times, supplements, exercise, jobs, stress, breathing and a lot more as frequently posted here.
Maybe try light early evening meal without red meat. Also check out James Nestor book 'Breathe' or just go on YouTube for his advice. I use nasal strips & (I know it sounds weird) a small strip across my lips forcing nose breathing at night nb don't try if you have any chronic breathing issues. Although my sleep pattern is by no means perfect, I found even with a broken night (waking early, bathroom visits), I am much fresher in the morning, previously I would have been wiped out.
Also if you are looking to relax try breathing through your nose whilst blocking the right nostril. There is some science behind this if I remember correctly, the left nostril emphasises the parasympathetic nervous system, the right one the sympathetic system. I find this helps if I wake up in the night to help send me off again before I start the washing machine of concerns!!
Some interesting comments and i will take the onboard. If i get a bad sleep or a nightmare, it can acually start an Afib attack in the middle of the night. Which is obviously not what. Does meditation really work and how long before you see a difference. I will try the nasel trick because it sounds interesting. Regards diet I'm not a red meat eater, I've cut down on sweet rubbish, and eat fairly healthy. I suppose i could eat more fruit. That is lacking as i prefer vegatables to fruit. Thanks for your comments and all comments
I would strongly second secondtry’s comments (pun intended).
Nestor’s book on breath is fascinating and combine with Patrick McKewon Breath (based on the Buyteko method) techniques and Meditation (based on breath techniques) just works!
Meditation/Mindfullness.....I have adopted a system for a number of years now whereby I have 30 mins at least quiet time before bed involving conscious relaxing, thinking of the 4 positives of the day & prayer. No late night crime dramas on TV! As to whether it works I use 'gut feeling' to decide, if I don't feel I want to give it up I assume it is doing some good.
do you have sleep apnea? I am waiting for my test kit now although I know I have it. I did not realize that it can cause a fib. When you mentioned the sleeping disruption I thought of that for you. Best of luck going forward on this
have you thought of trying CBD oil? As a general calming relaxant, it’s the non psychoactive part of cannabis, so you don’t get ‘stoned’ at all, it’s very popular and legal, have a look into it, but if you do decide to I’d advise buying the stronger versions by the more expensive brands. I’m not aware of any negative side effects. It comes as edible oils, vapes, chocolate and even gummy bears!
its not, had it checked. Its neurological. Thats why valium works. That said valium is not having much affect because I've been on it too long. Looking for safe alternatives
Hello Avatel, when anxiety or depression start creeping in or the onset of AFIB I immediately turn my attention away from the problem and call upon Jesus Christ and begin reading the Bible. I find it calms me down and gets everything back on the right track so I can cope with it. I have had AFIB for 33 years now and HE has never failed me yet. Staying focused on the problem exacerbates things tremendously and I know it's easier said then done but in time it will become as easy and effortless as breathing and the results will be truly worth it. Hope this helps.
Hi kocoach, thanks for your kind words, its really hard to explain. Imagine you are running a marathon in your sleep, well your heart would beat faster right. Well that what happens. Dreams turn into reality. You can't switch off a dream. Have I prayed, believe me I've prayed for a good nights sleep many times
I was offered the same medication and it has the lowest QT possibility. I didn’t want to risk it. I take 1/2 tab about once every two weeks to have a good sleep. It also has a weight gain component to it!
There are so many things that have changed for us with AFib. No anti inflammatory’s, no alcohol, no surgery as we need to come off blood thinners for a few days.
I am doing well on Flecinade x2 daily with Zaralto. No breakthrough AFib for a year. 😊🌻
Hi, I take 1/2 of a 15 mg tablet. I was originally told to take one tablet a day ,it knocked me for a loop. Then the worry about the QT so decided to half the tablet once every couple of weeks to get a good sleep. 😊
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