Recently diagnosed with micro vascular angina. Taking Tildiem 200, Isosorbide 25, Asprin GT spray. Struggling with sleep. Is this normal?

[Worvera]

Tildiem Isosorbide

[Milkfairy Heart Star]

Hello,

Coming to terms with any heart condition can take awhile. Lots of what ifs can rattle around in your brain.

Are you being kept awake by your thoughts or being in pain?

I sleep really poorly as I experience most of my coronary vasospasms at night. I was awake again at 5am this morning.

I use a hot water bottles at night to help relieve my chest pain.

I also listen to music, pod casts or the Insight Timer an app with lots of meditations.

insighttimer.com/en-gb

If I can't sleep a yoga nidra meditation helps me relax.

If I haven't slept well, I will if necessary rest in the afternoon the following day and have a nap if I need to.

It could be worth discussing with your GP the timing of your tablets.

I take my isosorbide at 6pm and 11pm.

My Diltiaziem at 8am and 8pm.

I hope you feel more rested soon.

[Worvera in reply to Milkfairy]

Thank you for responding again 😊 My meds are taken early morning (7AM in bold on the box). I have no trouble going to sleep but probably about 5 nights out of 7 I wake up with chest pain before that. I have to take my spray to relieve it. Do you just lie a hot water bottle on your chest?? Thanks for the link. I’m a psychotherapist so do know a lot about health anxiety and the benefits of mindfulness. Time to start practicing what I preach perhaps 😊

[Milkfairy Heart Star in reply to Worvera]

Haha nothing like practicing what you preach.

The standard advice is to take anti angina medications in the morning. That's for obstructive coronary artery disease.

However if you live with non obstructive coronary artery disease such as microvascular or vasospastic angina taking your nitrate later in the day, early evening can be more effective. This may help better if you are being woken at night.

I am also on extended release tablets of isosorbide mononitrate and diltiazem .

My Cardiologist suggested to me to work out for myself when to take my medication.

Perhaps discuss this with your GP or Cardiologist?

I have one hot bottle on my chest the other on my upper back.

I hope you sleep better. 😴

[Worvera in reply to Milkfairy]

Oh I’ll definitely invest in a couple of hot water bottles. Thanks for that. I’m on the same meds as you for Microvascular angina. I’ll talk to my GP about changing timing. Thanks again Milkfairy

[Gcart]

I am an amateur with this disease compared with Milkfairy ,however, whilst being told to take Tiltiazem together in the morning I find one in the evening and one in the morning much better .

Hope you get some improvement as you get to know your own body .

[Worvera in reply to Gcart]

Good morning! My tablets are Tildiem 200mg and Isosorbide 25. They are in capsule form so can’t cut in half. To try to help the GP gave me Isosorbide in tablet form of 2 x 10 mg to try to space it out but after a week I experienced cluster angina of 6 episodes and ended up in coronary care for 5 days until it settled and was represcribed as above. As you can imagine, I’m a little anxious about changing again as the prescription indicates 7AM in bold letters. I’m glad this approach has helped you and others suggested it too in a previous thread. I truly appreciate your input. This site is so helpful for us newbies 👏🏻