PACs are making it tough to sleep.

[John3333333]

I am getting thousands of PACs at the moment, including one in every two beats (bigeminy). I know they are PACs because I have captured loads of events on my Kardia device. I have arranged an appointment with my cardiologist in 3 weeks to talk about medication changes. I cannot pinpoint a trigger, but lack of sleep due to the irregular beats is undoubtedly making them worse.My question to the AF community is what tips do you have for getting to sleep during waves of PACs/PVCs? I am really struggling to sleep for more than a couple of hours per night. Also, has anyone ever used Nytol (or something similar) whilst on beta blockers ( I take 2.5mg bisoprolol daily)?

[SamAdmin Administrator Arrhythmia Alliance AF Association]

Good afternoon

Thank you for your post on the Atrial Fibrillation support forum.

Hopefully another member of the support group will be able to help with the sleep problems you are having, with regards to taking Nytol this would be best to speak to a Medical Professional who will able to advise if you can take this with the medication you are already taking.

I have downloaded a booklet for you ' Mindfulness and Healthy Living with AF'

api.heartrhythmalliance.org...

If you would like further information please download our website;

heartrhythmalliance.org/afa

Kind regards

SamAdmin

Booklet

[BobD Volunteer]

Have you tried the slow deep breathing? Use diaphragm and slow to less than 6 beats per minute for at least five minutes. I went through a period of constant ectopic activity some years ago and this exercise eventually stopped them completely

[John3333333 in reply to BobD]

The slow deep breathing does seem to break the bigeminy.

[Singwell in reply to John3333333]

Try this breathing sequence for ectopics or stress. 1. Sit or lie comfortably so that your stomach can move easily when you breathe in. If you're lying down, this is easier on your left side.

2. Take a breath in.slowly through your nose. I usually count a slow 2. Let your stomach relax when you do this so it moves out gently.

3. There is a natural pause for most people after the inbreath

Try to tune into it but don't force it.

4. Let the breath out again all in one go - don't worry that you'll be out of breath - there's always air in the lungs right up until our last moments

5. Don't be surprised if you feel like another pause after the outbreath but again - don't force it. Keep tuning in either to the feel of the air moving through your nostrils or the sound.

6. If you need to breathe out through your mouth purse your lips slightly as it helps to feel the breath and know we're in charge of it.

7. Repeat.

Typically your breathing rate will calm and slow down. You may even feel like you're about to drop off to sleep.

This technique is one of many used by breath practitioners to help calm our systems and regulate breathing. I have often got my HR down by 15-20 BPM using this technique and sometimes seen my AF off. Also helps me if I cannot go to sleep

[mike1961 in reply to Singwell]

You get your HR down to FIFTEEN TO TWENTY BPM ? ? !!😲😲

[Singwell in reply to mike1961]

Yes I do! I've got the ECG from my Kardiamobile to prove it 😀 The breathing technique hacks into the vagus nerve apparently.

[Luna1824 in reply to mike1961]

He gets it down BY 15-20 bpm😄

[kitenski in reply to mike1961]

down BY not down TO is how I read it

[mike1961 in reply to kitenski]

Of course - stupid me - apologies to all 😖😖🥴😵‍💫🙄🤐

[kitenski]

Are you just taking bisoprolol?

[John3333333 in reply to kitenski]

I take flecainide too. The cardiologist told me to take 100mg every 12 hours if the ectopics becomes hard to deal with. It has not been much use.

[kitenski in reply to John3333333]

I *really* don't want you to just do what I did, but I found after taking flecainide for a few years it actually made things worse for me inc a load of PACS/PVCs etc. I took myself off it and it helped hugely. I'd chat to your cardiologist about it if you can and see if he thinks it could be caused by flec? I think it actually caused my ectopics and PACS/PVCs etc.

PLEASE NOTE I am not medically trained and this is not medical advice, just information for you to be armed with and discuss with your medical team.

Some detail here on my journey healthunlocked.com/afassoci...

and here healthunlocked.com/afassoci...

[John3333333 in reply to kitenski]

I plan to discuss this, thanks. I have been on and off flecainide for a few years too. I mentioned to my wife last night about the possibility that flecainide might be having a negative effect on my ectopics. It has certainly helped in the past with both AF and ectopics but I am not sure now.

[secondtry in reply to John3333333]

Do please report back on your discussion. I had the same chat with my cardiologist last week as after 11 yrs on 200mgs Flec I have started with missed beats and irregular fast ones. He glossed over my suggestion that Flec may be the culprit.

Its very early days but over the weekend I increased my daily magnesium compound supplement (Nutri Megamag Muscleze) and that seems to have improved the situation; I think it may be the taurine in the compound which is popular with Mg with AFers. I take this with CoQ10 as well as a Naturopath suggested this partnership.

On sleeping with arrhythmia issues, over the last 6 months I have found Ancient Minerals Mg lotion with melatonin has helped a lot.

[Pommerania78 in reply to secondtry]

Why do you think that Flecainide might have changed its ways after so many years? Thanks.

[secondtry in reply to Pommerania78]

Others reporting here.

[Pommerania78 in reply to secondtry]

What is YOUR opinion? Thanks.

[Karendeena in reply to John3333333]

I had to come off flecainide as it was causing proarrythmia, I now take Sotalol

[Pommerania78 in reply to Karendeena]

How long had you taken Flecainide? Thanks.

[Karendeena in reply to Pommerania78]

Only a few months

[fann57 in reply to kitenski]

Flecainide gave me constant PVCs, only lasted a week on this medication!

[Cookie24 in reply to kitenski]

Flecainide made me worse. I take Propafenone

[Cavalierrubie]

That’s horrible John not being able to sleep and with everything else going on, you must be shattered. Do you take an anticoagulant? I would ask the Pharmacist if it’s ok to take Nytol as sometimes these sleeping aids interact with the drugs we take. He may be able to help. The breathing does help, so perhaps start practicing. Other than that you need to speak to either your Cardiologist in a few weeks time, or your GP.

[John3333333 in reply to Cavalierrubie]

No anticoagulant. My CHADS score is 0. Although with this high ectopic burden, you can't help but think of a stroke risk. Hopefully I will not progress to AF.

[Cavalierrubie in reply to John3333333]

This is always a worrying condition and ectopics can be scary. The stress of it all doesn’t help. Not long before you see your Cardiologist and then you can talk it all through and get some professional help. You sound as if you need some answers. You will be ok if your Chad score is low, so don’t get stressed with that.

[Ppiman]

I believe that Nytol is based on a first generation antihistamine. These have sedative side effects, hence its use as a sleeping aid. People's experience varies but in my view it is not very effective for this use tends to leave a dull-headed feeling the following day. I have read that they have the potential to be pro-arrhythmic, also, so you would need to ask your doctor.

I also suffer with spells of heavy runs of ectopic beats so I know how you must feel. In many ways they are worse than AF. Luckily, they don't affect my sleep, however, I suffer with persistent insomnia and have done for years.

I think the way forward for you will be an ablation. This will depend on where in the atrium your ectopics are arising but that is what I am going to have doe. It's a long waiting list of about a year, I gather.

In the interim, have you tried flecainide to reduce the ectopic burden? I have only just been prescribed it, myself but after a single dose a few weeks ago, which did give an ectopic free day, I haven't taken more as I was worried by its side effects. Also, both my ectopics and AF have been relatively calm since.

In terms of helping sleep, British doctors are very reluctant to prescribe drugs. That said, the "Z" drugs are far safer than the older forms of hypnotic, and I have taken a small dose (2.5mg) of zolpidem, as an when needed, for many years without apparent harm. I can recommend this if relaxation and "CBT" methods fail.

Steve

[Leechg]

Hi, I have used Boots Sominex with no problems to help me sleep. Often half a tablet is enough. Regarding extra beats I found that drinking more water (not tea or coffee) reduced mine substantially. All the best.

[MaryCa]

Are you taking co enzyme Q10? It really helped me with PACs . Obviously check with pharmacist first. I take 600mg. I get it from Amazon. It reduces inflammation. Loads of research on google scholar about afib and inflammation and Q10.

[John3333333 in reply to MaryCa]

I picked up Q10 today. I will take it alongside magnesium glycinate. Thanks for the advice.

[MaryCa in reply to John3333333]

According to prof Sanjay Gupta London cardiologist magnesium taurate is what we should be taking.

[Pab1]

I have taken the occasional nytol. It worked for me without any side effects. I am on 5mg bisoprolol.

[John3333333 in reply to Pab1]

This is good to know. Thanks.

[OzJames]

like some of the others said try magnesium in specific mag taurate, coq10 and for me Vitd3 has helped with my ectopics. I make sure I allow 2 hours either side of Flecainide and metoprolol so they don’t interfere with each other. CoQ10 is fat soluble so I always have a few almonds and spoonful of olive oil with the Supps. I started the 3 after I discovered in my blood test that I was low on all 3… of course get your doctors approval first

[PleasantPink]

Just echoing other comments here. I too have found increasing my magnesium very helpful in quieting the PVC's/PAC's. I use Slow Mag because cardiology said the magnesium chloride in it is more easily absorbed. Another helpful suggestion is making sure your electrolytes are in balance. I've added a drink called Body Armour which seems to have helped as well. Cardio explained how activity causes multiple changes in our electrolytes & this can trigger the ectopics. Good Luck.

[BigDunc]

Hi John

I have suffered with Bigeminy and Trigeminy ectopics over the years horrible experience and was always a precursor to going into AF. I was actually glad to go into AF.

I have tried various breathing exercises square breathing etc the one that helps me is breath in to the count of four and breath out to the count of four.

I’m on a drug called disopyromide that has alleviated my symptoms and AF

Good Luck

[John3333333 in reply to BigDunc]

I will definitely take a note of disopyromide. Thanks.

[JOY2THEWORLD49]

Hi

Oh dear. John.

Not nice.

For the first time I experienced flutters or palpations.

Covid Jab 23 July or untreated UTI because the Dr didn't check what the Nurse had noted down. Her results.

I also had vertigo mild I had to close my eyes to get rid of it. Also the survey asked lightheaded - a bit more than that with the world kinda slightly spinning.

Now we don't know for certain but flutter stopped on Saturday and spinning stopped after commencing my Amoxil-Clav.

These are the problems faced with as another diagnosis is going on at the same time.

I did take 1 amozil-Clav early morning before jab and another in the evening. As I am immuned compromised. I'd just my T3 in normal range.

I would take yourself to A&E or your appointment needs to be today.

I take 2.5 Bisoprolol PM. Better at night to get you through early morning raise in BP.

I take 120mg CCB Diltiazem AM for rapid heart rate.

Take care.

[WildIris]

I take half a doxylamine succinate (another antihistamine) tablet for sleep plus a quarter dose of a CBD preparation that is made locally. Plus meditate w slow breathing while in bed. I hope to reduce the dox dose as it does leave me a bit groggy in the morning. Took years to figure this out. Your sleep routine will be different, I also had hours of bigemeny. An ablation helped. Good luck.

[Pigleywigley]

Hi John, you could have written this post for me! I have PAF. Sleep is one of my biggest triggers (lack of). I’m currently in day of consistent PAF. My cardiologist told me not to take my flecanide. I only take mine as PIP. Really stressful as lack of sleep triggers AF & PAF & here we are not sleeping from PAF! Like someone mentioned in an earlier response, it feels worse than AF and if AF is coming just get on with it. Let us know what your cardiologist says. Rachel