Mitral Valve Prolapse and Its Impact on Anxiety and Sleep

Q: Mitral Valve Prolapse and Its Impact on Anxiety and Sleep

Hello： Based on your description, your symptoms of chest tightness, insomnia, and palpitations may be related to panic disorder. <br>In addition to medication treatment, relaxation training, distraction techniques, and cognitive-behavioral therapy can also be helpful. <br>If your

Mitral valve prolapse

Hello, two weeks ago after exercising, I suddenly experienced palpitations, shortness of breath, and chest tightness.
These symptoms had not occurred before during rest.
I visited a cardiology clinic and underwent a 24-hour Holter monitor and echocardiogram, which confirmed mild mitral valve prolapse and autonomic nervous system dysfunction.
However, since the condition is not severe, the doctor did not prescribe any medication but advised me to maintain a regular routine.

After that, it seemed like my body had switched on some sensitivity; I became very reactive to many things.
For instance, I used to drink tea without any issues, but now I experience palpitations whenever I drink tea.
I also have difficulty with cold drinks, and even being startled can trigger palpitations.
Sometimes at night, I wake up feeling inexplicably cold, and in August, I found myself needing to cover with a thick comforter and drink hot water to feel better.

After researching similar experiences online, I realized this might be due to autonomic nervous system dysfunction.
Since then, I have tried to maintain a regular lifestyle, avoid caffeinated beverages, limit cold drinks, and engage in regular, moderate exercise.
This has significantly improved my condition.

However, the only issue troubling me is insomnia at night.
It’s not that I can’t fall asleep, but I wake up in the middle of the night with chest tightness.
Previously, I would also experience palpitations, but that has improved.
It feels like something is pressing on my chest, making it hard to breathe, and then I wake up startled.
Once I wake up, I feel fine, but this happens whenever I am close to falling into deep sleep, leading to a cycle of poor sleep throughout the night.
This situation has persisted for several days, but I only experience these symptoms at night; during the day, I can sleep without any issues.

Samuel Hsu, 20~29 year old female. Ask Date: 2015/10/15

Dr. Liang Sunyuan reply Psychiatry

Hello: Based on your description, your symptoms of chest tightness, insomnia, and palpitations may be related to panic disorder.
In addition to medication treatment, relaxation training, distraction techniques, and cognitive-behavioral therapy can also be helpful.
If your condition continues to show no improvement, it is recommended that you visit a psychosomatic or psychiatric outpatient clinic for an in-person evaluation by a physician, and to discuss effective intervention methods that are suitable for you.
Wishing you all the best.

Reply Date: 2015/10/15

More Info

Mitral Valve Prolapse (MVP) is a condition where the two flaps of the mitral valve in the heart do not close properly, which can lead to various symptoms, including palpitations, anxiety, and sleep disturbances. Your experience of sudden heart palpitations, shortness of breath, and chest tightness after exercise, followed by increased sensitivity to stimuli and sleep issues, can indeed be linked to MVP and autonomic nervous system dysregulation.

The autonomic nervous system (ANS) controls involuntary bodily functions, including heart rate, blood pressure, and respiratory rate. When there is a disruption in the ANS, it can lead to symptoms such as anxiety, palpitations, and changes in sleep patterns. In your case, the heightened sensitivity to caffeine and cold drinks, as well as the increased heart rate in response to stressors, suggest that your body is reacting more intensely due to the dysregulation of the ANS.

Your description of sleep disturbances, particularly the sensation of chest tightness and the feeling of not being able to breathe, is concerning. This phenomenon, often referred to as "sleep-related breathing disorder," can occur in individuals with MVP and anxiety. It may be exacerbated by anxiety itself, which can lead to hyperventilation or panic attacks during sleep. The fact that you wake up feeling better after these episodes indicates that your body is responding to a perceived threat, which is a common response in anxiety disorders.

To manage these symptoms, it is essential to adopt a holistic approach that includes lifestyle modifications and possibly therapeutic interventions. Here are some strategies that may help:
1. Regular Sleep Schedule: Maintaining a consistent sleep routine can help regulate your body's internal clock, making it easier to fall asleep and stay asleep.

2. Relaxation Techniques: Practices such as deep breathing exercises, meditation, or yoga can help calm the mind and reduce anxiety, which may improve sleep quality.

3. Avoid Stimulants: As you've already noted, avoiding caffeine and other stimulants is crucial. This includes not only coffee and tea but also chocolate and certain medications that may contain stimulants.

4. Create a Comfortable Sleep Environment: Ensure your sleeping area is conducive to rest. This includes a comfortable mattress, a cool room temperature, and minimizing noise and light.

5. Physical Activity: Engaging in regular, moderate exercise can help reduce anxiety and improve sleep quality. However, avoid vigorous exercise close to bedtime.

6. Consult a Healthcare Provider: Since your symptoms are persistent and affecting your quality of life, it may be beneficial to discuss them with a healthcare provider. They can evaluate whether further treatment, such as therapy or medication, is appropriate for your situation.

7. Cognitive Behavioral Therapy (CBT): If anxiety is a significant factor in your sleep disturbances, CBT can be an effective treatment for anxiety and insomnia. It focuses on changing negative thought patterns and behaviors that contribute to anxiety and sleep issues.

In summary, while MVP can contribute to anxiety and sleep disturbances, managing these symptoms through lifestyle changes and professional support can lead to significant improvements. It’s important to listen to your body and seek help when needed, especially if your symptoms persist or worsen.

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