Nighttime Palpitations: Struggling to Sleep and Waking Up Anxious

Palpitations before sleep, difficulty falling asleep, and experiencing palpitations upon waking?

Premise: Recently, I sought traditional Chinese medicine for arthritis.
After taking the medication prescribed by the doctor, I felt significantly uncomfortable, which led me to switch medications from arthritis treatment to palpitations treatment (Gui Zhi, Sheng Jiang, and Zhi Gan Cao Decoction).
I have had frequent colds since childhood, with various minor symptoms affecting my entire body, but doctors have always said there was nothing serious.
However, I still feel unwell, particularly with chest or airway issues.
I rarely take traditional Chinese medicine and usually rely on Western medicine.
Over the past two days, regardless of the type of medication I take, I experience rapid heartbeats and a feeling of tightness in my chest when trying to fall asleep.
I also feel shaky all over, and even with an extra blanket, the sensation persists.
Just as I'm about to fall asleep, I get startled awake, making it difficult to sleep peacefully (I used to fall asleep quickly).
When I wake up, the feeling remains.
I measured my blood pressure, which was 108/77 with a pulse of 82; the device indicated normal readings, but I still feel a slight fluttering sensation, as if someone is taking small steps on my chest.
Recently, I have often woken up suddenly at night, with my heart pounding loudly and my whole body shaking, or I get startled awake by someone calling me, though this doesn't happen every time.
Earlier this year, I had a check-up with a cardiologist, and there were no significant issues, only benign mitral valve prolapse.
Will this symptom resolve itself in a few days?

Xi Tongxue, 20~29 year old female. Ask Date: 2020/05/23

Dr. He Dongjin reply Cardiology

Hello, it seems that you are experiencing autonomic nervous system dysfunction.
It is advisable to monitor your condition for now, but if you continue to feel unwell, I recommend visiting an outpatient clinic for some medication.
Changhua Hospital cares about your well-being.

Reply Date: 2020/05/23

More Info

Nighttime palpitations and anxiety during sleep can be distressing experiences that significantly impact your quality of life. Based on your description, it seems that you are dealing with a combination of physical and psychological factors that may be contributing to your current symptoms.

Firstly, it's important to understand that palpitations, or the sensation of a racing or pounding heart, can be triggered by various factors, including anxiety, stress, medications, and underlying health conditions. In your case, you mentioned switching medications for your arthritis and experiencing discomfort after taking the new medication. Some medications, particularly those that affect the cardiovascular system, can lead to side effects such as palpitations or increased heart rate. It's essential to discuss these symptoms with your healthcare provider, as they may need to adjust your medication or explore alternative treatments.

Additionally, the anxiety you are experiencing, especially when trying to fall asleep, can create a vicious cycle. Anxiety can lead to physical symptoms like palpitations, which in turn can increase your anxiety, making it even harder to relax and fall asleep. This cycle can be exacerbated by your history of health issues and the feeling of discomfort that you have described.
Your experience of waking up suddenly with a racing heart and feeling shaky is not uncommon in individuals who are dealing with anxiety or panic attacks. These episodes can occur during the night, often triggered by stress or anxiety about falling asleep or concerns about health. The sensation of your heart racing can be alarming, leading to further anxiety about your health and sleep quality.

Given that you have previously undergone a cardiac evaluation with no significant findings other than benign mitral valve prolapse, it is reassuring that there are no major cardiac concerns. However, the psychological aspect of your symptoms should not be overlooked. Anxiety and stress can manifest physically, and addressing these underlying issues is crucial for improving your overall well-being.

To help manage your nighttime palpitations and anxiety, consider the following strategies:
1. Relaxation Techniques: Incorporate relaxation techniques into your bedtime routine. Practices such as deep breathing exercises, progressive muscle relaxation, or mindfulness meditation can help calm your mind and body before sleep.

2. Sleep Hygiene: Establish a consistent sleep schedule by going to bed and waking up at the same time each day. Create a comfortable sleep environment that is dark, quiet, and cool. Avoid screens and stimulating activities before bedtime.

3. Limit Stimulants: Be mindful of your caffeine and sugar intake, especially in the hours leading up to bedtime. These substances can contribute to increased heart rate and anxiety.

4. Physical Activity: Regular physical activity can help reduce anxiety and improve sleep quality. Aim for at least 30 minutes of moderate exercise most days of the week, but try to avoid vigorous exercise close to bedtime.

5. Talk Therapy: Consider seeking support from a mental health professional. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety and can help you develop coping strategies for managing your symptoms.

6. Medication Review: Since you are experiencing these symptoms after a change in medication, it is vital to have an open discussion with your healthcare provider about your experiences. They may suggest alternative medications or adjustments to your current regimen.

7. Monitor Symptoms: Keep a journal of your symptoms, including when they occur, their intensity, and any potential triggers. This information can be valuable for your healthcare provider in determining the best course of action.

In conclusion, while your symptoms may improve over time, it is essential to address both the physical and psychological aspects of your experience. By implementing these strategies and working closely with your healthcare provider, you can take steps toward achieving better sleep and reducing anxiety. Remember, you are not alone in this, and seeking help is a positive step toward recovery.

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