Psychogenic Sudden Death: Anxiety, Sleep, and Heart Health

Psychogenic Sudden Death

Hello, doctor.
First of all, Happy New Year.
I am a senior in high school and currently experiencing significant academic pressure.
Since school started in September, I have been dealing with intermittent neuralgia, occasionally accompanied by symptoms resembling chest tightness and palpitations (I tend to be quite sensitive and worry about even minor symptoms), along with frequent lower back pain and gastrointestinal discomfort.
However, my main concern is my sleep issues.
I've heard that insufficient sleep can lead to sudden death.
I usually go to bed around midnight and sleep about 5 to 6 hours (waking up around 6 AM).
I’m not sure if this is due to stress or something else, but I always feel mentally unrefreshed when I wake up.
Recently, during the winter break, I’ve been going to bed around 1 to 2 AM and sleeping about 8 to 10 hours, which feels more comfortable.
However, yesterday I only slept for a little over 5 hours, and I noticed a significant difference in my energy levels.
I planned to stay up until the New Year celebration was over before going to bed, but I constantly worry that sleeping only 5 to 6 hours regularly might lead to sudden death one day.
I fear that my heart might start beating irregularly at any moment and cause my demise.
I fell asleep around 2 AM, but woke up less than an hour later, just as I was about to drift off.
After waking up, my anxiety didn’t improve; in fact, I felt even less sleepy.
I have a bad habit of scrolling through my phone, which kept me up until after 7 AM.
I was very tired, thinking that even if I could sleep for two or three hours and wake up around 10 AM like I do on weekends, it would still count as sleep.
But when I tried to close my eyes, I found that even though I was exhausted, I couldn’t fall asleep.
Each time I pull an all-nighter, it takes me several days to recover to a better state.
I lay in bed browsing articles and came across various news stories, which made me fear that I might die one day like this.
After a sleepless night, I ended up crying alone in bed.
In September, I had a brief ECG due to chest pain, and the doctor told me there were no issues.
Does this mean I do not have congenital heart disease? Also, am I being overly worried? Do you have any suggestions or recommendations for me? Thank you.

Lan Yu, 10~19 year old female. Ask Date: 2022/01/01

Dr. He Dongjin reply Cardiology

Hello, there is no indication that sleeping 5-6 hours will lead to sudden death, so don't worry.
It likely means you do not have congenital heart disease.
For a senior in high school, getting 5-6 hours of sleep is actually quite good.
In a few months, you'll be through it, so just hang in there.
Don't overthink it, and keep pushing forward.
Sudden death is not related to you, so don't be concerned.
Changhua Hospital cares about you.

Reply Date: 2022/01/01

More Info

Hello! First of all, Happy New Year! It sounds like you are going through a challenging time, especially with the pressures of school and the accompanying physical and emotional symptoms. Your concerns about sleep, anxiety, and heart health are valid, and it's important to address them comprehensively.

From what you've described, it seems that you are experiencing a combination of anxiety and stress, which can manifest in various physical symptoms such as nerve pain, chest discomfort, and gastrointestinal issues. These symptoms can be exacerbated by insufficient sleep, which is a common issue among students, especially during high-pressure periods like exams or major projects.

Understanding Your Symptoms
1. Anxiety and Physical Symptoms: Anxiety can lead to heightened awareness of bodily sensations, which may cause you to perceive normal bodily functions as alarming. For instance, mild chest discomfort or palpitations can feel more intense when you are anxious, leading to a cycle of worry and physical symptoms.

2. Sleep and Health: Sleep is crucial for both physical and mental health. Chronic sleep deprivation can lead to a range of health issues, including increased anxiety, impaired cognitive function, and even cardiovascular problems. However, it’s important to note that occasional poor sleep does not directly lead to sudden death. The body is resilient, and while consistent lack of sleep is harmful, a few nights of poor sleep will not cause immediate catastrophic health issues.

3. Heart Health: You mentioned having an electrocardiogram (ECG) that showed no issues. This is a good sign, as it suggests that there are no immediate concerns regarding your heart's electrical activity. However, if you continue to experience symptoms like chest pain or palpitations, it would be wise to follow up with a healthcare professional for further evaluation.

Recommendations
1. Sleep Hygiene: Establish a regular sleep routine. Aim to go to bed and wake up at the same time every day, even on weekends. Create a calming bedtime routine that helps signal to your body that it's time to wind down. This could include activities like reading, meditating, or gentle stretching.

2. Limit Screen Time: Try to reduce the use of electronic devices at least an hour before bed. The blue light emitted by screens can interfere with your ability to fall asleep. Instead, consider engaging in relaxing activities that do not involve screens.

3. Mindfulness and Relaxation Techniques: Incorporate mindfulness practices such as deep breathing exercises, meditation, or yoga into your daily routine. These techniques can help reduce anxiety and improve your overall sense of well-being.

4. Physical Activity: Regular exercise can significantly reduce anxiety and improve sleep quality. Aim for at least 30 minutes of moderate exercise most days of the week. This could be anything from walking to more vigorous activities, depending on your fitness level.

5. Talk to Someone: If your anxiety and physical symptoms persist, consider speaking with a mental health professional. Therapy can provide you with tools to manage anxiety and help you understand the underlying causes of your fears.

6. Nutrition: Pay attention to your diet. Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can positively impact your mood and energy levels.

7. Stay Informed but Not Overwhelmed: While it's good to be informed about health, excessive research can lead to increased anxiety. Try to limit the time you spend reading about health issues, especially if it tends to heighten your fears.

Conclusion
It's understandable to feel overwhelmed during stressful times, especially with the pressures of school. Remember that your feelings are valid, and seeking help is a sign of strength. By implementing some of these strategies, you can work towards reducing your anxiety and improving your sleep quality. If you continue to struggle, please reach out to a healthcare provider for further support. Take care of yourself, and best of luck with your studies!

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