Sleep Study--nocturnal tachycardia

[India]

I was finally diagnosed with POTS in January of this year after years of suffering the dizziness, syncope, sweating, tremors, fast hearbeat etc etc with which we are all so, unfortunately, familiar. Since the beginning of my symptoms twelve years ago I've had periodic problems sleeping and would wake up in the middle of the night gasping for breath and/or with with my heart pounding. Scores of doctors put this down to anxiety. The episodes got more frequent over the past three years and although I would not always wake up with either SOB or noticeable heart pounding, my sleep has been seriously disturbed: on an average night I will wake up at least five times and often have terrible trouble getting back to sleep. Needlesstosay my lack of sleep was creating my POTSholes and I think I've felt worse over the past twelve months than I have over the past twelve years.

To add to all this, I've been under enormous stress: my husband has been ill for three years and my very young father, with whom I was very close, was diagnosed with a brain tumor last August and passed away two months ago. My beloved cat died and my Uncle nearly died from a burst aortic aneyurysm (which runs in the male side of our family) all within the space of a few weeks of my father's diagnosis. Add to this the stress of having to defend attacks on my job at work and I can say that this has been a tremendously trying year.

Anyway, I am sure this has all contributed to my sleeping problems. But finally, and after my positive tilt table test I persuaded a sympathetic family practitioner to order a sleep study, having read about the incidence of POTS and sleep apnea.

O.K. Here's my question. I had the sleep study last night and although the final results are of course not in, the tech did tell me that she observed no cessations of breathing. But she did observe that I had several tachy incidents at night and these seem to be connected with my nocturnal awakenings. I was only aware of the palpitations once, however. Does any one else have these symptoms and are they a manifestation of POTS or something else? I've had holter studies in the past which showed nothing--but of course we never have symptoms when we are tested, do we? I currently take 25mg of Atenolol because I've got the hyperadrenergic type of POTS. I've tried Midodrine and Paxil but had more tachy episodes on these meds and so stopped. Now the doctor who diagnosed my POTS--and seems to be the only medical professional I can find in Hawaii who has any experience with this problem--has left the islands!

HELP!

A very, very tired, India