hi everyone
I hope it’s ok to post this here! I recently had a sleep study to rule out sleep apnea . There was no snoring but it was noted that there was over 170 episodes of pulse rate rises (dr noted this would be consistent with periodic limb movement disorder ) .
I should say reason for sleep study was for 5 years of waking headaches .
I am really interested to know if anyone here has knowledge of what the pulse rate rises may mean ?
Thanks so much for reading x
Have you been diagnosed with a limb movement disorder? Basically, your pulse or heart rate can do at night the same thing as it does in the daytime while you are being active or resting.
The pulse rises will occur if you are having a restless sleep, or moving about, because you body and mind are active and require more oxygen to work triggering your autonomic nervous system to speed up the flow of blood to your moving body. Some people will also get a rise in blood pressure too.
If someone has a pulmonary health condition, sleep apnea or hypotension you may get many short pulse rises because you get little dips in your oxygen levels , so heart rate rises to help dilate the capillaries in your body to get more oxygen to your extremities and organs. This is why a person with these conditions can sometimes wake up feeling like their limbs are throbbing and hot, or feel chilly and clammy because they wake up as they cool off after this has happened.
Any sleep activity, even excessive movements happening when you are not conscious, or lower oxygen levels, means that your rest is disturbed and you may become more tense in your sleep to try to stay asleep ( even if you don't know you are doing it).
That tension can involve grinding your teeth, stiffening your jaw, head , neck and upper body, clutching your hands , or even tapping feet and hands if you do that to relax when you go to bed.
All of these activities cause muscle and joint pain or can trigger intense morning head pain and stiffness.
Over time disturbed or overactive or low oxygenation sleep patterns cause similar sleep deprivation daytime symptoms to those suffered by people whom have insomnia like headaches and migraines, extreme tiredness, mood swings, sadness, slow thinking skills , poor coordination, changes in digestion and bowel activity, and more sensitive reactions to normal daily stressors or cardiac response sensitivity to normal stress (your heart rate or blood pressure may go up or down quickly and further than it should for a few moments when you change what you do giving feelings of palpitations or anxiety when you are not anxious until it corrects to normal which can be tiring to experience). It creates a vicious circle , because then you become so tired that you can't get to sleep and because you can't sleep the symptoms become more severe or happen regularly which makes you more tired!!!!
It's why it's important to get whatever help you can to control a sleep disorder condition because good sleep is so important for managing your general health and health conditions each day.
oh my goodness me blearyeyed! you've got me absolutely spot on! It's like you've been spending 24 hours with me!
Thank you so much for your reply and interesting as I wear a garmin watch and it shows I am stressed a lot of the time in the day because it uses HRV to calculate stress.
With regards to your question no I haven't been diagnosed with PLMD but the letter that came with the sleep report said that the headaches could be caused by PLMD.
" there were a number of pulse rate changes seen through the night in particular between hours 3 and 5 which we sometimes see with PMLD and this can also trigger headache".
They've suggested trying 210mg ferrous a day for a month or rotigotine patches. I am very reluctant to try that especially as I don't even know if I have pmld.
thanks again for your brilliant response. They have mentioned video sleep study but sounds like they want me to try the drug first .
I'll keep you posted xxx
ps forgot to say I monitored bp for couple weeks when I woke up and generally 90/55 sometimes bit lower
When they suggested ferrous , do they just mean an iron supplement, is your iron low? May I suggest that if this is just an iron supplement that you may prefer to take the equivalent ferrous dose of Iron Bisglycinate. Solgar make a version which I need from time to time , it's sold on Amazon.
It's called Gentle Iron. It doesn't cause the digestives issues of ferrous products and is the active form of iron so absorbs more easily and stores longer reducing recurrence of Anaemia.
They use it instead of ferrous iron after significant results for pregnant and elderly patients in the Netherlands, but for some reason ( probably cost) you can't get it on prescription on the NHS unless it's given to severe patients in hospital ( my GP tried).
I know some people whom have used the patches , as ever some swear by them others didn't like them or found no difference. With sleep disturbance caused nerve issues it is very much trial and error. You could double check what your BP results were through the night first before making a final decision.
Have you been tested for other vitamin deficiencies or insufficiency ( borderline or low normal results). Low B 12 or Folate is actually often the cause for low iron and Vitamin D levels because low B vitamin levels reduce absorption and metabolism of other nutrients , especially iron and Vitamin D. They also contribute to many nerve based problems , migraines , pain and fatigue.
Looks like you do have periods of hypotension during the night which could be another cause for the movement and increased pulse as well , I hope things improve soon, take care , Bee
Thank you so much great advice about the iron as I’ve had bowel resections in past so have to avoid constipation at all costs . Ferritin was 31 cut off for low 30 (UK) .
Great tip about B12 etc .. can recommend any good home testing finger prick please ? Think I’ve used medi check before .
Take care x
Ps GP didn’t check haemaglobin just ferritin and I asked him as he wasn’t going to
If you haven't had the tests done by your GP in the last 3-6 months and had normal results you can request to have those nutrients tests done by your GP on the NHS.NICE actually recommends that people with diagnosed chronic health issues , especially those whom take medications should have the tests done every 12 months because certain medications can reduce how well we absorb nutrients, so if your GP questions the need you can point that out and just say you are trying to be proactive in your preventative self care and need the set of baseline figures to amend your diet to help improve your symptoms.
It is better to get the tests done before you start taking supplements. If you already take a multivitamin or supplements, you should stop using them for 4-7 days before the blood test so that you get accurate results.
You can request for your GP to do the following standard tests : full blood count , ferritin/ iron, (although you have already had those you should ask for them to be repeated after three months of your iron treatment to see if it has improved) Vitamin B12, Folate, Kidney function ( Electrolytes), Vitamin D , Total Cholesterol. If you haven't had one getting a Diabetes HbA1C , just as a baseline.
Get copies of the results of all the blood tests you have. If you have access online still create a hard copy and create a file on your computer to keep them for your own reference.
Many GPs will just tell you tests are normal , when they are very low normal or high normal. Borderline results don't mean it's fine it means you have an Insufficiency, the beginning of signs that a deficiency, or excess, and issues can occur if you don't take some very simple preventative measures at that point and they still cause mild to moderate symptoms and make your diagnosed health issues harder to manage.
So I always suggest that you get the results and if they are too low or too high you can make the right diet choices or then take supplements that will help resolve the issue and help you feel better.
B 12 and other B vitamins are generally better taken separately, as Folate and most B's are better absorbed taken with Vitamin C of some sort , usually after food at the same time as your Iron supplements if you need them ( as iron is also better absorbed alongside Vitamin C).
Vitamin B12 is better absorbed either as an oral spray , or liposomal or sublingual oral, after food that does not have a log of vitamin C and with water.
Active forms of supplements , as a spray or oral supplement, are always easier to absorb so better for people whom have digestives issues or take things like antacids , statins , PPIs (like omeprazole) or whom are on medications that can alter stomach acid like pain killers , some heart medications and nerve relaxants and antidepressants.
I have to have injections for B12 , Folate and Iron but I also require them in supplement form between injections because I have functional B12 and Folate conditions.
I use an active Methyfolate Folate version because I have the MTHFR mutation.
I use a sublingual B12 oral tablet that you chew from Lindens, also on Amazon , or the BetterYou B12 spray both are recommended.
I use a liposomal non acidic Vitamin C liquid from Natroliq , it's on Amazon, but not the dose on the pack you can only absorb 5ml a day the rest just goes to making expensive wee!
And I use the BetterYou Vitamin D3 with K2 spray every day in Winter every 2-3 days in Summer , as I suffered with severe Vitamin D deficiency for some years ( because of B12 / Folate deficiency which had not been spotted).
If you have deficiencies you can request for liquid or sublingual forms of vitamins or iron on your NHS prescription rather than the generic most common supplements prescribed. They are better if you are older or have stomach issues , remind your GP and ask for the liquid forms instead.
Many people may need the additional help of supplements even if they have a good diet to keep nutrients in healthy ranges , especially if they are over 65 or take medications that alter their stomach acid.
Really GPs should test before prescribing things and every 12 months to prevent people getting the side effects of joint pain and fatigue that can happen over time on essential medications that understandably put people off using them.
They don't, not just because of cost, but because most doctors do not get a lot of training about the relevance of nutrient insufficiencies in Preventative Care when they qualify.
Goodness you understand movement in sleep so well. Do you have any idea what causes someone to sleep with NO movement at all. I don't move even an inch in my sleep . I wake in exactly the same position I fell asleep in and obviously incredibly stiff. It takes ages for me to get moving or just to turn over. The only blessing is that I never need to make my bed as my bedding hasn't moved at all. Google only comes up with sleep paralysis which is totally different..
The professionals, as ever , give the cause of this a very scary name , even though it is normal and unharmful and everyone experiences it at some stage in REM sleep.They call it Sleep Paralysis, although in people whom don't move at all the term Static Sleep would probably be better. What you experience is a type of Sleep Paralysis it's just a borderline effect.
Basically , at the point in REM when you are going towards deep sleep or waking , which usually also is the point that you dream the brain actively stops muscle activity in the body to promote sleep.
In some people with disturbed REM activity the brain is active while the body has already been told to relax but the brain can keep sending new messages to stop muscle movement.
Causes for lack of body movement , static sleep or sleep paralysis can be varied :
Anxiety , Over Exertion before bed or too much Stress (that's not just bad things , Stress in contrast to Anxiety is just any physical or mental activity , positive or negative that is too much for the brain or body to cope with at its individual health level) can cause the brain to suffer disturbed REM or to override and send increased messages to the muscles to relax.
Some neurological or pain health disorders can cause it.
Tension in the head and body if you scrunch up because of pain , delayed muscle soreness or insomnia. That I must go to sleep clench, basically.
It can even just be habit.
Many children whom sleep soundly have a very active dream state and their muscles relax well , they get in a comfy spot and just don't move.
I was like that as a child, in fact my parents or relatives would come and look at me nervously convinced I'd fall out of bed because I'd fall to sleep leaning right over the edge , but when I was asleep , I never moved. I wish I could do that now!
As you get older , you're sleep habit is still there ( if you are lucky) , but you may have stiffer joints and muscles, or you might have joint , chronic pain or rheumatoid or osteo conditions , so this static sleep state does cause you more numbness , stiffness and pain in the mornings.
Basically , it can be scary when you wake up and feel numb or unable to move certain bits but if it passes quickly after you are fully awake and you've had a good shake it's normal, although the stiffness and pain as you get older is yet another irritating thing to bear. Just remind yourself maybe your brain isn't a morning person and is a bit slow to wake your muscles up because it would prefer to hit the snooze button😆😆😆
If you haven't always had it , or you are having added pain or numb muscles during the day as well it's worth speaking to a GP in case something else is also causing the morning symptoms.
One way to reduce the two extremes of sleep disturbance, sleep paralysis and restless legs or repetitive muscle movement, is to make sure you create a good bedtime regime and don't do any very active exercise for at least three hours before bed , and no exercises at all in the 90 minutes before ( non moving, non pressure gentle yoga positions that help release muscles can still be done an hour before bed to reduce pain).
Exercise stimulates brain activity and keep you awake or can cause the brain to override in it's messaging to the body to relax.
I learnt this while participating in an 18 month sleep study for people with Sleep Disturbance and Migraine.
FAscinating, thank you so much. ALl I had read on sleep paralysis was saying you wake suddenly trying to move but can't and go into a panic state. That's not me at all. I also fall asleep within 30 seconds of hitting the pillow. I guess the cause of mine is easy then, neurological and chronic pain for 30 years. I have 5 different conditions wrong with my spine. I have an excellent bedtime routine; half an hour with a crossword or book then into bed and I'm asleep but definitely not a morning person . I just want to roll over but can't. I had asked my GP but he hadn't a clue and wasn't concerned at all. After I've had a meal I can guarantee also i'll be asleep in half an hour until teh dog wakes me wanting her tea......
Yes, if you have bone or joint related pain disorders you are more likely to stay very still too, your brain has learned from your conscious daytime movements that you prefer to stay still to reduce pain. In that incidence, the brain then uses it's training to ensure that you keep as still as possible during sleep as a protection from pain , without understanding that the total lack of movement can also cause pain.
It's amazing how many involuntary actions ( jobs done by the brain without our conscious input) are altered either positively or negatively by what the brain learns from our deliberate activities to cope with long term health conditions, or if it repetitively gets pain or " fight or flight" from our waking reactions to certain stimuli.
Sometimes it feels the need to overprotect and changes messages to the body and this can begin various pain and neurological conditions.
I have Fibromyalgia, as well as all my other conditions ( honestly, I often say to the doctor if I was a horse they'd just shoot me😆😆😆).
Fibro causes lots of different syndromes in the body because of the breakdown of neurological messaging between the brain and body relating to pain and stimuli.
The brain really starts overreacting to everything and creating pain responses when they aren't appropriate and then it and our conscious actions begin to change often negatively to cope with the pain signals that are activated.
It can become a horrible vicious circle and affects all different involuntary jobs in the muscles and organs, including affecting sleep.
I've always had insomnia , even as a child I only slept 3-4 hours a day but I've now got severe arthralgia and restless legs syndrome to add to it. I wish I could keep still on a bad night , and sometimes I have to get up to remake the bed.😆😆😆
Oh yes I get that. I was diagnosed with fibromyalgia around 35 years a go. For the first20 to 25 years by far the best treatment for me was to keep active. The more I did, the better the pain was. 11 years ago we moved house and I literally dug every inch of the garden which hadn't been touched for 6 years. Yes it hurt but I was better for it. Last year I could still do the weeding and pruning albeit much slower and for a shorter time but then my spine slipped out of line and now I can't even walk across the lawn. I know the lack of exercise is making me worse but the pain is just unbearable now and the peripheral neuropathy has become far worse. I can't feel my lower legs and feet and now have arthritis in my shoulders too. I often say they wouldn't let a dog suffer so much pain.
I'm so sorry.I also have Ehlers Danlos Syndrome ( EDS) which is the root cause of most of my other health issues, I subluxate and dislocated joints , bones and ribs or get injuries numerous times a week.
The conditions and chronic pain eventually triggered Fibromyalgia, RLS and Peripheral Neuropathy.
I keep asking active as I can but also make sure I pace my activities very carefully, it's a real balancing act between improving the pain or making it worse.
It's been much harder since my Chronic Dysautonomia has become more severe and I now have numerous arrhythmia and tachycardia problems, POTs and Afib so I can't maintain my muscle strength as much as I could.
The reduced mobility has increased the overall pain.
I'm feeling like it's a full time job managing my health issues. I know I will eventually require a wheelchair because of the Dysautonomia ( I have to have sticks to preventing falls from dizziness or near fainting) or joint problems, but I appreciate every day I can still have mobility.
I really empathize with you , I know how bad the pain can be when I am recovering from injuries and cannot move. You should feel proud of your efforts every day no matter how big or small.
Have they offered you any physio or help with your spine? Is there anything that the physical therapists do to help or a surgery that would correct things?
I know it's hard to balance between the risks and benefits of treatments though?
Have you heard of Spinal Cord Stimulation Devices and is that possible with your particular type of cardiac issue?
I have a prescribed Vagus Nerve Simulator for Chronic Pain and Migraines but I know they aren't happy to fit me an SCS because of my EDS.
My word and I thought I had problems. No spinal cord stimulator is the one thing I haven't asked about and even the pain clinic hasn't suggested. I thought they only worked on one or two areas and I have 4 that need treating although lumbar is by far the worst. I can't even have steroid injections because I react terribly badly to them. Cannabis was the final thing suggested but heart problems preclude that' a hear attack and stents plus an arrhythmia that isn't AF and ectopics. Oh well we manage as best we can. They won't consider surgery until the lysthesis causes paralysis. \Won't the vagus nerve stimulator affect your AF?
I can't use the vagus stimulator during tachycardia of 120+ or an AFib event but low therapy sessions , originally prescribed for Migraine , are ok and they are doing studies about the use of vagal stimulation for people whom have heart arrhythmias or AFib caused by autonomic rather than other mechanical or electrical cardiac causes alone and I fit in that category.I wouldn't say a stimulator works alone but in combination with medication , relaxation , physio and pacing it does have some effect on my pain levels in general.
Your local Pain Clinic may not have even considered looking into the option of SCS for you , especially if you have to go out of area to have a trial and then get one fitted, although anyone with pain conditions affecting the back that is eligible and does not get adequate pain relief from medication or cannot use steroids injections can be referred to their nearest SCS clinic to have this free on the NHS. It might be something you want to look into and request your Pain Clinic to organise. They just need to send a letter with a request and your details. I know some people have had very good results from them. Obviously, as with any treatment for Chronic Pain conditions you won't ever be 100% pain free but if it can help you manage pain to increase your mobility it's a success.
That does sound odd about the vagus nerve when so many say that's what triggers AF attacks but worth investigating. I'll have a w ord with my GP about SCS - thanks. My new pain clinic is an hour away and I've only seen him once. I asked for another appointment 8 months ago but heard nothing. My excellent consultant in Manchester retired. Such a shame. He was the one who, within 5 minutes, diagnosed what I knew was my original problem after I'd searched for a diagnosis for 2 0 years.
Is My Resting Heart Rate Too Low?
Max pulse rate
High BP plus bradycardia
Low heart rate 
EP Study - Done
