Low Heart Rate During Sleep: When to Consult Your Doctor?

Low heart rate during sleep?

Hello, I was hospitalized for myocarditis last year, and after being discharged, I have been consistently taking Kankun 1.25.
My resting heart rate is usually around 55.
I previously asked my attending physician, and they mentioned that a heart rate in the 50s is acceptable after taking the medication.
Recently, I started wearing a smart wristband and noticed that my lowest heart rate during sleep has dropped to the 40s, and it has been decreasing over several days (today's lowest heart rate was 42).
Should I schedule an earlier follow-up appointment, or can I temporarily stop the medication?

YI, 30~39 year old female. Ask Date: 2020/12/10

Dr. He Dongjin reply Cardiology

Hello, when you sleep, your whole body is resting, and your heart is also resting, maintaining a low level of operation.
As long as your body is functioning adequately, there is no need to worry.
Changhua Hospital cares about you.

Reply Date: 2020/12/10

More Info

When it comes to low heart rates during sleep, particularly in individuals with a history of heart conditions such as myocarditis, it is essential to approach the situation with caution. A heart rate that dips into the 40s during sleep can be concerning, especially if it is accompanied by symptoms such as fatigue, dizziness, or any other unusual feelings.
In your case, you mentioned that your resting heart rate is typically around 55 beats per minute, which is considered on the lower end of the normal range (60-100 bpm). However, the recent readings from your smartwatch indicating a heart rate as low as 42 bpm during sleep warrant further investigation. While it is true that heart rates can naturally decrease during sleep due to the body's reduced metabolic demands, a significant drop, especially if it is a new occurrence or if it is progressively getting lower, should not be ignored.

Given your medical history of myocarditis and the fact that you are on medication (likely for heart rhythm management), it is advisable to consult your healthcare provider sooner rather than later. Your doctor may want to perform an electrocardiogram (ECG) or a Holter monitor test to assess your heart's rhythm over a 24-hour period. This will help determine if there are any underlying arrhythmias or other cardiac issues that need to be addressed.

Regarding your question about temporarily stopping your medication, it is crucial not to make any changes to your prescribed treatment without consulting your physician. Stopping medication abruptly can lead to adverse effects or exacerbate your condition. Your doctor will be able to evaluate your current heart rate readings in the context of your overall health and medication regimen and make appropriate recommendations.

Additionally, it's important to consider other factors that could contribute to a low heart rate, such as sleep apnea, which is common in individuals with obesity. If you have a history of sleep apnea or if you experience symptoms such as loud snoring or gasping for air during sleep, this could also be a contributing factor to your low heart rate. In such cases, a sleep study may be warranted to evaluate your sleep patterns and any potential breathing issues during sleep.

In summary, while a low heart rate during sleep can be normal for some individuals, your specific situation—given your history of myocarditis and the recent significant drop in heart rate—suggests that it is prudent to consult your healthcare provider. They will be able to provide personalized advice based on a thorough evaluation of your health status and any necessary diagnostic tests. Always prioritize your health and safety by seeking professional medical advice when you notice changes in your heart rate or overall well-being.

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