Autonomic Nervous System Disorders and Heart Palpitations

I would like to follow up on #148090 (autonomic nervous system). Thank you, doctor?

I would like to follow up on the issue of autonomic nervous system dysfunction.
Thank you, Doctor.
I'm not sure if this falls within your area of expertise, as my symptoms primarily manifest in my heart (heart examinations have generally shown no significant issues).
My main concerns are palpitations and sudden increases in heart rate.
In addition to these cardiac symptoms, I also experience tinnitus and nightmares.
Although my condition has been improving slowly over time, I still feel a lack of confidence and am very conscious of my heartbeat.

I've noticed that over the past month or two, I often have anxious dreams, such as earthquakes, tsunamis, gunfights, and running.
On several occasions, after running anxiously in my dreams, I become aware of my heartbeat, which then feels like it starts to race again, even while dreaming.
I'm unsure if this is a reflection of my excessive concern about my heartbeat in real life manifesting in my dreams, or if it indicates some sort of episode occurring in my sleep.

Is it possible for autonomic nervous system dysfunction to cause such phenomena? I recall reading an article stating that the autonomic nervous system is always active, even during sleep, and that a sudden imbalance in the sympathetic nervous system can lead to an increased heart rate while sleeping.
Although I occasionally had anxious dreams before my condition worsened, and would feel a slight increase in heart rate upon waking, I never considered it a problem back then.
This issue seems somewhat outside the realm of cardiology, but I wonder if you have encountered similar cases in your clinical practice.
Thank you very much.

Niming, 30~39 year old female. Ask Date: 2019/07/22

Dr. He Dongjin reply Cardiology

Hello, that's right.
The body is always functioning, including controlling heart rate and breathing.
It's normal for the heart to race when feeling anxious; this is the body’s way of signaling that something is about to happen, prompting the brain and heart to prepare for action.
It seems that you have been under a lot of stress lately, which may be causing some disruption.
Faith, prayer, exercise, or medication might help you get through this.
Autonomic nervous system responses are not a big deal; everyone experiences heightened awareness of their heartbeat at times.
Try to relax and take it easy.
Peace from Changhua Hospital is with you.

Reply Date: 2019/07/22

More Info

Understanding autonomic nervous system (ANS) disorders and their relationship with heart palpitations is crucial for managing symptoms and improving quality of life. The autonomic nervous system plays a vital role in regulating involuntary bodily functions, including heart rate, blood pressure, and respiratory rate. When the ANS is dysregulated, it can lead to a variety of symptoms, including palpitations, anxiety, and sleep disturbances.

From your description, it seems that you are experiencing heart palpitations and other symptoms such as tinnitus and vivid dreams, which may be linked to autonomic dysfunction. Heart palpitations, characterized by the sensation of a racing or fluttering heart, can be distressing and often lead to increased anxiety, creating a cycle that exacerbates the symptoms. The fact that your heart examinations have returned normal results is reassuring, but it does not eliminate the discomfort caused by these palpitations.

The connection between anxiety, stress, and the autonomic nervous system is well-documented. Stressful situations can trigger the sympathetic nervous system, leading to an increase in heart rate and blood pressure. This response is often referred to as the "fight or flight" response. In your case, the anxiety surrounding your heart palpitations may be causing you to become hyper-aware of your heart rate, leading to increased feelings of panic when you perceive changes in your heartbeat.

Regarding your dreams, it is not uncommon for individuals experiencing anxiety or stress to have vivid or distressing dreams. These dreams can reflect your subconscious worries and fears, including those related to your health. The autonomic nervous system remains active during sleep, and disturbances in its regulation can lead to increased heart rate and other physiological responses, even while you are dreaming. This could explain why you wake up feeling your heart racing after a stressful dream.

To address your concerns, it is essential to focus on strategies that can help regulate your autonomic nervous system and reduce anxiety. Here are some recommendations:
1. Mindfulness and Relaxation Techniques: Practices such as deep breathing, meditation, and progressive muscle relaxation can help calm the nervous system and reduce anxiety. These techniques can also help you become more aware of your body’s responses without becoming overwhelmed by them.

2. Regular Physical Activity: Engaging in regular exercise can help improve your overall cardiovascular health and reduce anxiety. Exercise releases endorphins, which can enhance your mood and promote relaxation.

3. Sleep Hygiene: Establishing a consistent sleep routine and creating a calming bedtime environment can improve the quality of your sleep. Avoiding screens before bed and engaging in relaxing activities can help reduce nighttime awakenings and improve sleep quality.

4. Cognitive Behavioral Therapy (CBT): If anxiety and panic symptoms persist, consider seeking therapy. CBT can help you identify and change negative thought patterns related to your health and anxiety, leading to improved coping strategies.

5. Medication: If your symptoms are significantly impacting your daily life, discussing medication options with your healthcare provider may be beneficial. Medications such as beta-blockers or anti-anxiety medications can help manage palpitations and anxiety.

6. Monitoring and Education: Understanding your condition and recognizing that palpitations can be a benign symptom of anxiety can help reduce fear. Keeping a symptom diary to track your palpitations and associated triggers may provide insights into patterns and help you manage your anxiety more effectively.

In conclusion, while your heart examinations are normal, the symptoms you are experiencing may be related to autonomic nervous system dysregulation and anxiety. By implementing strategies to manage stress and anxiety, you can work towards reducing the frequency and intensity of your symptoms. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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