Nighttime Neck Heat and Pulsing Vessels: Which Specialist to Consult?

Q: Nighttime Neck Heat and Pulsing Vessels: Which Specialist to Consult?

Dear Mr. <br>Anonymous： <br>In your letter, you mentioned that there is a blood vessel in the back of your neck that is pulsating and causing heat, making it difficult for you to sleep. <br>This may be related to a disorder of the nervous or endocrine system. <br>It is recommende

If you are experiencing increased heat and pulsation in the back of your neck and head, making it difficult to lie down comfortably, you should consider seeing a neurologist or a primary care physician. They can evaluate your symptoms and determine if further investigation or treatment is necessary?

I have been experiencing increasing heat at the back of my neck, with my blood vessels pulsating strongly.
In the morning, I can wear a jacket, but by night when it’s 23 degrees Celsius, I feel too hot to wear anything but a short-sleeve shirt.
When I try to sleep, I want to use an ice pillow to cool down, but it’s really uncomfortable, and I can’t lie flat (it’s worse at night than during the day).
I’m wondering if using an ice pillow will worsen my condition? This started after I stayed awake for over 36 hours without sleep, and I had four cups of tea to stay alert that day.
I’ve had similar episodes before, but they usually resolved after sitting up for two hours.
Now, even when I try to relax, the discomfort doesn’t go away.

I have seen a psychiatrist who prescribed me medication (MGC0503) for my condition, but it hasn’t helped.
The medication only allows me to sleep without interruption, but I still can’t lie flat and my blood vessels continue to throb.
Before this episode, I was smoking too much and working long hours (my job is related to online competitive gaming).
I can’t lie on my side because my ear hurts, and there are constant dog barks outside 24/7.
I need to lie flat to use earplugs to sleep.

Niming, 20~29 year old female. Ask Date: 2023/03/29

Dr. Chen Bozhang reply Family Medicine

Dear Mr.
Anonymous:
In your letter, you mentioned that there is a blood vessel in the back of your neck that is pulsating and causing heat, making it difficult for you to sleep.
This may be related to a disorder of the nervous or endocrine system.
It is recommended that you first consult a neurologist for a physical examination and any other necessary tests to thoroughly assess the underlying cause.

Sincerely,
Dr.
Chen Po-Chang, Department of Family Medicine, Keelung Hospital, Ministry of Health and Welfare

Reply Date: 2023/03/29

More Info

It sounds like you're experiencing a complex set of symptoms that are affecting your sleep and overall comfort. The issues you're describing—heat in the neck, pulsing vessels, and difficulty sleeping—can be quite distressing. Given your situation, it’s important to approach this from a medical perspective to identify potential causes and appropriate specialists to consult.

Understanding Your Symptoms
1. Heat in the Neck and Pulsing Vessels: The sensation of heat in the neck and the feeling of pulsing vessels could be related to several factors. One possibility is increased blood flow or vascular activity in response to stress or anxiety, especially after a prolonged period of wakefulness. The body can react to stress by increasing heart rate and blood flow, which might explain the pulsing sensation you feel.

2. Sleep Disruption: Your difficulty in finding a comfortable sleeping position and the need to use an ice pack to cool down suggest that your body is in a heightened state of arousal. This could be due to anxiety, stress, or even a physiological response to sleep deprivation. The fact that you mentioned having stayed awake for over 36 hours could have significant effects on your nervous system, leading to heightened sensitivity to temperature and discomfort.

3. Impact of Caffeine and Smoking: Consuming four cups of tea in a single day, especially if they contain caffeine, can exacerbate anxiety and disrupt sleep patterns. Caffeine is a stimulant that can interfere with your ability to relax and fall asleep. Additionally, smoking can affect circulation and overall cardiovascular health, which might contribute to the sensations you're experiencing.

Recommended Specialists
Given the complexity of your symptoms, it would be advisable to consult with the following specialists:
1. Neurologist: Since you're experiencing unusual sensations in your neck and pulsing vessels, a neurologist can help assess for any neurological issues that might be contributing to your symptoms.

2. Sleep Specialist: A sleep specialist can conduct a sleep study to evaluate your sleep patterns and identify any underlying sleep disorders, such as sleep apnea or insomnia, which could be exacerbating your symptoms.

3. Psychiatrist or Psychologist: Since you've already consulted a psychiatrist, it may be beneficial to explore cognitive-behavioral therapy (CBT) for insomnia or anxiety management techniques. This can help address any underlying anxiety that might be contributing to your sleep issues.

4. Ear, Nose, and Throat (ENT) Specialist: If you have persistent discomfort in your ears or if external noises are affecting your sleep, an ENT specialist can evaluate for any underlying conditions that might be contributing to your discomfort.

Addressing Your Concerns About Ice Packs
Using an ice pack to cool down can provide temporary relief from heat, but it’s essential to monitor how your body responds. If you find that it helps you feel more comfortable and does not exacerbate your symptoms, it may be a useful strategy. However, if you notice increased discomfort or if the heat sensation worsens, it would be wise to discontinue use and consult a healthcare professional.

Lifestyle Adjustments
In addition to seeking medical advice, consider making some lifestyle adjustments:
- Limit Caffeine and Nicotine: Reducing or eliminating these substances, especially in the hours leading up to bedtime, can help improve your sleep quality.

- Establish a Sleep Routine: Try to create a calming pre-sleep routine that helps signal to your body that it’s time to wind down. This could include activities like reading, meditating, or gentle stretching.

- Create a Comfortable Sleep Environment: Ensure your sleeping environment is conducive to rest. This includes managing noise levels, adjusting room temperature, and using comfortable bedding.

Conclusion
Your symptoms are multifaceted and warrant a comprehensive approach to diagnosis and treatment. Consulting with the appropriate specialists can help you gain a better understanding of your condition and develop a tailored treatment plan. In the meantime, implementing lifestyle changes and monitoring your symptoms can also contribute to improved well-being. Remember, it’s essential to prioritize your health and seek professional guidance to address these concerns effectively.

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