Tachycardia during sleep

[Anne77]

Hello. I am a 42 year old women and I’ve had POTS for almost 3 years now. In the past year I have began having tachycardia during sleep and my body never goes into deep sleep. This leaves me useless and tired during the day. My neurologist said this is not related to POTS because I am laying down when it happens. At times my heart rate has been as high as 134 and will stay in the 115-130 range for about an hour and my heart rate never goes below 85 during sleep. Does anyone else have this problem or an idea of why this is happening? I need some good rest!

[jklass44]

@Anne77 Have you or your neurologist looked into IST? A symptom can be a high heart rate while sleeping. Many of the symptoms overlap with POTS minus the postural changes. 

Best wishes!!

[Magalot]

I have suffered with night time tachycardia, more so around the time of diagnosis earlier this year. I still get it a little bit now but not as much. I used to wake up with a racing heart quite soon after going asleep and then towards the morning I would continually wake up with a kind of  adrenaline 'whoosh' feeling coming up through my body from my stomach to my head. It happens less now, maybe only once or twice a week. I've made tons of lifestyle changes so hard to know what helped but the thing I think gave the most benefit was exercising before bed time which I feel helps use up any extra adrenaline. Also ice-packs on my stomach during the night help too.

If you look up Dr Sanjay Gupta on YouTube he has some good videos on poor sleep in POTS patients.

[KaciCrochets]

Sleep problems are my biggest symptom. I am tired and ready to go to sleep but then I get brain shocks and adrenaline rushes, and I don't fall asleep for hours. Last night I got four hours, after spending twenty minutes crying from adrenaline and anxiety. Doctors refuse to even look into it. I don't have the tachycardia like you do but I have some irregular heartbeats. My symptoms are always worse lying down than being upright.

[MomtoGiuliana]

I get symptoms lying down as well.  I don't think this is unusual in POTS.  I also had tachycardia at night that would wake me up when I was early in my diagnosis.  I still get it at times, and my hr can often remain high even when I am asleep (eg in the 80s bpm).  I did not realize this until I started wearing a fitbit regularly to bed.  My hr during the day when seated is typically in the 60s.  For me lying down or standing seems to trigger symptoms (standing moreso--obviously, I guess).

[Random-Symptom Man]

@Anne77 Welcome, and sorry to hear you are having symptoms. 

Could your nocturnal tachycardia be a side effect of medicine? I struggle with brachy or tachy on different medicines. 

[DizzyPopcorn]

3 hours ago, MomtoGiuliana said:

I get symptoms lying down as well.  I don't think this is unusual in POTS.  I also had tachycardia at night that would wake me up when I was early in my diagnosis.  I still get it at times, and my hr can often remain high even when I am asleep (eg in the 80s bpm).  I did not realize this until I started wearing a fitbit regularly to bed.  My hr during the day when seated is typically in the 60s.  For me lying down or standing seems to trigger symptoms (standing moreso--obviously, I guess).

Did your symptoms come back @MomtoGiuliana? I thought the b12 did the trick for your last flare

[Sushi]

@Anne77 Hi Anne, have you looked into being checked over by an electrophysiologist (a cardiologist who specializes in heart rhythms)? I ask because they would probably give you a monitor to wear for a few weeks to discover exactly the tachycardia is. An EP would probably be most qualified to treat it. It would be important to know whether your tachycardia is in a normal rhythm or something like Afib. I have Afib so it on my mind and important to treat. 

[MomtoGiuliana]

8 hours ago, DizzyPopcorn said:

Did your symptoms come back @MomtoGiuliana? I thought the b12 did the trick for your last flare

I've had two major episodes of POTS in my life that were severe and disabling--first one seemed to be brought on by pregnancy, which lasted about a year, 2nd by low B12, some 15 years later.  However prior to and between these episodes, I experienced symptoms off and on.  I've never been back to 100% after the first episode, although a whole lot better.  I still have issues with tachycardia off and on, as well as other symptoms.

[ElektricAmber]

@Anne77 (re: Original Question Posted about Experiences of Night & Sleep Tachycardia):

• Yess!!  1ce or 2ce/month.

•I've been dx'd with Dysautonomia • POTS & EDS (Ehlers Danlos) *& nearly all possible comorbidities too 😧💔*•

• I've not bothered mentioning night tachycardia to Dr. more than 1ce cos I've so many assorted & "stupid" issues (•Stupid: aka. "random" symptoms & inconveniences but are actually POTS-Stuff. W/out a POTS‐literate Dr.?   FEWER PROBS=FEWER DISMISSALS).

•Sad•  you'd think "Night Tachy.'s a huge deal (cos it IS). However I learned to reign‐in Problems & Questions (Re: quanity, severity, & frequency of symptoms) to avoid dismissals.

• I'd been dismissed since my 1st faint•11yo.—'til requiring to be "defibrillated" (by proxy) via heart-reset drug Adenosine at 40yo. (*Sidenote: It gave me LONG QT Synd.) • & am still dismissed.  My 2nd time in ER - post adenosine, post dx, & despite telling staff of dx & condition's symptoms?Despite asserting I wasn't a speed addict?  They sent in an addiction counselor to bug me •to just admit I had a coke prob. so he could help me• for 45min.!! My own doctor (sadly I had to move, but he WAS POTS literate) showed up, insisted all toxicology was always clean with me & to please believe patients.

•So yeah. Yes to Night Tachycardia. I believe it's caused by POTS when one has POTS. Stimulation to the vasovagal nerve during sleep can & does occur  (GERDS, a sniffle, a snore, a cough, a hiccup, a sharp intake of breath; (& even a slight shift in head position can trigger tachycardia too). The hypersensitive response issues present in those with POTS can often result  in tachycardia. 

•I feel fairly confident asserting this is POTS-related • Why?

     ▪︎my own sleep study done showed I went into an 8sec. tachycardia • prior to th he POTS dxs • & they were concerned & concluded it was caused by a vasovagal stimulation caused by my sniffles;

     ▪︎my own 15yrs. of pretty extensive research *ONLINE (see below):

          °c/o gift subscriptions (from my old med-school friends who 'get' my *need to know*) to accessing published medical science studies & journals online;

          °taking credit-free-but-tuition-free courses from the universities who offer such things (MIT offers physics courses - which is Soooo cool!!!) & watching recorded medical lectures posted online (Berkeley is great about this!);

          °reading stacks of heavily discounted but current med school texts from students. I'd wanted to be a DR. (Psychiatric & Behavioural Neurobiology with emphasis on an anthro ‐ socio and an 'epidemiological ‐ viral ‐ bacterial' lens) before POTS left me mostly bedridden. My need to learn about everything - especially Medicine. Astronomy,  Physics, & all Social Studies - has yet to be satiated.

    ▪︎my former POTS-literate doctor upon my discussing vasovagal stimulation & its relation to tachycardia, indicated that if vasovagal stimulation brings on Tachycardia, to avoid anything which causes said stimulation - albeit difficult as vasovagal stimulation in those sensitive to it will find it doesn't take much to experience tachycardia.

•I hope this helps you to feel more validated with regard to POTS & Night Tachy. concerns. Be well & everyone try your best to live the best you can despite any & all limitations. 

●PLEASE pardon any/all errors in spelling, grammar. & syntax  • I'm going through a spate of the same ol' vision issues.

*ONLINE: not to be mistaken with sometimes less savvy & generally socially frowned upon - for reasons both good & also less good - reasons which often feel & are dismissive & terrible - googling oneself into believing one has incurable plagues of their Everything & can only cure it with pricey crystals & 'essential' oil pyramid schemes.

Edited October 2, 2019 by ElektricAmber
Autocorrect had changed the word med to new & I just noticed it.

[Anne77]

Thanks for all the reply’s/advice. I see both an EP and a neurologist. I put in a call to the EP and he seems to think it may be a rebounding effect from the beta-blockers I take during the day. I also mentioned it to my pain management doctor (I also have fibromyalgia) and he seems to think it could be a response to pain during the night. I had multiple tests done upon diagnosis including a holter, stress test (I couldn’t even stand on the treadmill let alone walk before my heat rate was in the 190’s and I almost passed out), a nuclear stress test, echocardiogram, 24 hr urine test, and tilt table test. The EP is confident my heart is healthy.  I had an 9cm pheochromocytoma removed about a year before the POTS diagnosis.  I was dismissed and told it was just anxiety for a few years before a doctor finally took me seriously and tested for the pheo. My neurologist suspects that because I had the pheo for so long, it caused my autonomic nervous system to go haywire. 

My POTS symptoms are pretty well controlled with medicine during the day. I just wish I could get it under control at night so I can get a good nights rest!