Morning Chest Pain: Causes and Solutions for Better Sleep

Waking up in pain frequently in the morning?

For the past two months, I have been waking up in pain almost every day after about 5 to 6 hours of sleep.
The pain usually subsides within an hour.
Initially, for over a month, I experienced pain in my entire upper back, specifically on both sides of the spine at the level of the heart.
After waking up in pain, it would take about half an hour to an hour for the pain to go away, and I would remain pain-free throughout the day.
I suspected it might be a spinal issue and consulted two orthopedic specialists who performed X-rays, but they found no relation to my symptoms.

In the last 2 to 3 weeks, the pain has become more localized to the left chest area.
I wake up in pain when I turn over, and deep breathing also causes pain in the left chest.
Similar to before, the pain resolves within half an hour to an hour.
A week ago, I visited a cardiologist who performed an electrocardiogram and reported no issues.
Now, I am unsure what the problem could be, and I am distressed by my daily lack of sleep.

I would appreciate any assistance.
Thank you.

Notes:
1.
I recently started brisk walking for the past two months at a speed of about 6 km/h, doing it more than three times a week.
I have considered whether my walking posture might be poor, but I have been particularly mindful of maintaining the correct posture.

2.
I have changed my pillow, but the situation remains the same.

3.
I have a herniated disc in my lower back, but orthopedic doctors believe it is unrelated.

4.
I have scoliosis that curves towards the heart, and the cardiologist thinks it may have an impact.

5.
In early July, I underwent a health check-up, and my CPK (creatine phosphokinase) level was 302, which the doctor attributed to my exercise.

6.
I have been experiencing long-term dizziness (but various tests have shown no abnormalities).
Doctors believe it is psychogenic; my brain waves are normal but less active, and some neurologists think it may be due to poor cerebral circulation.

A-Wen, 30~39 year old female. Ask Date: 2019/08/08

Dr. He Dongjin reply Cardiology

Hello, it seems that the issue is related to muscle and nerve problems or possibly internal organ issues, which are generally unrelated to posture.
If you experience pain when turning over, try eating some bananas, take B vitamins, and use muscle relaxants or pain relievers.
Let's observe the situation further.
Take care from Changhua Hospital.

Reply Date: 2019/08/08

More Info

Experiencing morning chest pain can be concerning, especially when it disrupts your sleep and affects your overall well-being. Based on the symptoms you've described, it seems that there are several potential factors contributing to your discomfort. Let's explore these factors and possible solutions to improve your sleep quality and address the chest pain.

Possible Causes of Morning Chest Pain
1. Musculoskeletal Issues: Given your history of back pain and scoliosis, it's possible that your chest pain is musculoskeletal in nature. Poor sleeping posture, especially if you are not using the right pillow or mattress, can lead to strain on the muscles and ligaments around the chest and back. Even if you've recently changed your pillow, the alignment of your spine during sleep is crucial. A pillow that is too high or too low can exacerbate these issues.

2. Referred Pain: Sometimes, pain in the chest can be referred from other areas, such as the back or neck. Your history of a herniated disc could be contributing to nerve irritation, which may manifest as chest pain.
3. Anxiety and Stress: Psychological factors can also play a significant role in physical symptoms. Anxiety can lead to muscle tension, which may cause pain in the chest area. If you are experiencing stress or anxiety, it might be worthwhile to explore relaxation techniques or consult with a mental health professional.

4. Sleep Apnea: Although you have not mentioned any specific symptoms of sleep apnea, such as loud snoring or gasping for air during sleep, it is worth considering. Sleep apnea can lead to fragmented sleep and may cause discomfort upon waking.

5. Cardiac Concerns: While you have seen a cardiologist and had tests that came back normal, it’s important to continue monitoring your symptoms. If the pain persists or worsens, further evaluation may be necessary.

Solutions for Better Sleep and Pain Management
1. Sleep Hygiene: Establishing a consistent sleep routine can significantly improve your sleep quality. Aim for 7-9 hours of sleep each night, and try to go to bed and wake up at the same time every day. Limit exposure to screens before bedtime, and create a relaxing pre-sleep routine.

2. Optimize Sleep Environment: Ensure your mattress and pillows provide adequate support. A medium-firm mattress is often recommended for spinal alignment. You might also consider a body pillow to help maintain a comfortable position while sleeping.

3. Physical Activity: While walking is a great form of exercise, ensure that your walking posture is correct. Consider consulting a physical therapist who can provide guidance on proper body mechanics during exercise and daily activities.

4. Stress Management: Incorporate relaxation techniques such as deep breathing, meditation, or yoga into your daily routine. These practices can help reduce muscle tension and improve your overall sense of well-being.

5. Consultation with Specialists: Since your symptoms are complex, it may be beneficial to consult with a multidisciplinary team, including a sleep specialist, a physical therapist, and possibly a psychologist. They can work together to address the various aspects of your health that may be contributing to your symptoms.

6. Monitor Symptoms: Keep a journal of your symptoms, noting when the pain occurs, its intensity, and any associated factors (like stress levels or physical activity). This information can be invaluable for healthcare providers in diagnosing and treating your condition.

Conclusion
Morning chest pain can stem from a variety of causes, including musculoskeletal issues, anxiety, and potentially sleep disorders. By improving your sleep hygiene, optimizing your sleep environment, managing stress, and consulting with appropriate specialists, you can work towards alleviating your symptoms and enhancing your overall quality of life. If your symptoms persist or worsen, do not hesitate to seek further medical evaluation to rule out any serious underlying conditions.

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