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Palpitation when waking up at midnight
#1
Hi I am writing on behalf of my father. He is 61 years old. He has untreated snoring problem for over 30 years. He usually snores very loud.

Recently, he wakes up around midnight (after sleeping 3-4 hours) with a feeling of heart palpitation which goes away in about 10 minutes time. This does not usually happens when he takes a 1-2 hours nap in the afternoon or any time in the day.

The doctors first checked his ECG, Echocardiogram, Stress Test. Everything came out normal and they came up with the idea that it is anxiety.

Recently, a respiratory doctor said that he is probably having sleep apnea as he usually wakes up frequently for urination and often gets dry mouth and soar throat after loud snoring. He will take a polysomnography test soon.

As this is new to me I have some questions and I will be thankful if I get answers from the nice people here.

1. Can palpitation/feeling of heart pounding is one of the symptoms of apnea?

2. Will BiPAP be better than CPAP for over 60 people?

3. Can you give some advice what to do regarding the problem?
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#2
(12-30-2016, 05:45 PM)sjishan Wrote: 1. Can palpitation/feeling of heart pounding is one of the symptoms of apnea?
The heart doesn't like it when it doesn't get oxygen.

(12-30-2016, 05:45 PM)sjishan Wrote: 2. Will BiPAP be better than CPAP for over 60 people?
This will depend on what the polysomnogram shows.

(12-30-2016, 05:45 PM)sjishan Wrote: 3. Can you give some advice what to do regarding the problem?
If he can position himself to sleep on his side and not his back, that will help slightly.
If he drinks any alcohol, stop for now, until the doc says it is OK to resume.
Check any and all of his medications; some of them could be contributing.
Avoid big meals within 3 hours of bedtime. Reflux could be waking him.
Keep consistent bed time and waking times.
If overweight, aim to eat healthy - a dietitian consult can be helpful.
- Losing weight can, for some, take a near fanatical obsession with eating - what, when, where, how much, how often. His mileage may vary; if he can, great.

If it is determined that he has sleep apnea, he will be prescribed a CPAP. He should get one which is "data capable", ie, capable of recording details about what is happening in terms of different apnea types, snores, mask leaks, pressure used, etc.
This link identifies some of the better candidates:
http://www.apneaboard.com/forums/Thread-...ew-machine

                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#3
Good questions. The symptoms you list are tied pretty closely to obstructive sleep apnea:
snoring,
awakening
nocturia (night time urination)
tachycardia
fatigue, sleepyness etc.

A sleep test is the next step. A CPAP is a prescription device and he needs to be diagnosed with sleep apnea using a clinical or home test. Once confirmed auto CPAP can be prescribed with instructions on self-titration, or a CPAP with clinical titration study. BiPAP is not indicated unless pressure are very high or he doesn't tolerate CPAP. Modern auto CPAP like the Resmed Airsense 10 Autoset offers exhale pressure relief similar to a bilevel, so that is a great choice. since he is 60, he is probably insured through employer or self-insured. Your course of action kind of depends on how good insurance is and deductibles. It is possible to save a lot of money if necessary, or using good insurance it should be no problem.
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#4
The heart palpitations were the primary reason for my sleep study and apnea. EKG, ECG, and stress test came back normal too. No sleepy problems however I am feeling much better since therapy.
Dont-know  I am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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#5
Thank you everyone.


(12-30-2016, 07:14 PM)Rcgop Wrote: The heart palpitations were the primary reason for my sleep study and apnea. EKG, ECG, and stress test came back normal too. No sleepy problems however I am feeling much better since therapy.


Glad to know that you are doing better now. May I know what was your AHI and Oxygen Saturation Level when you were diagnosed?
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#6
sjishan:

Your father should be put on a 24 hour cardiac monitor (called a Holter Monitor) to catch possible arrhythmia. A condition called a-fib is sometimes found in people who have sleep apnea. If a-fib is found, a cardiologist may try to treat it with medication (such as a beta blocker). When a-fib is frequent, then blood thinners may be prescribed to prevent blood clots.

Arrhythmia may be induced by apnea as the adrenal glands on the superior poles of the kidneys will push epinephrine and norepinephrine to kick start the body. Treating the apnea may treat the arrhythmia.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
(12-30-2016, 07:41 PM)justMongo Wrote: sjishan:

Your father should be put on a 24 hour cardiac monitor (called a Holter Monitor) to catch possible arrhythmia. A condition called a-fib is sometimes found in people who have sleep apnea. If a-fib is found, a cardiologist may try to treat it with medication (such as a beta blocker). When a-fib is frequent, then blood thinners may be prescribed to prevent blood clots.

Arrhythmia may be induced by apnea as the adrenal glands on the superior poles of the kidneys will push epinephrine and norepinephrine to kick start the body. Treating the apnea may treat the arrhythmia.

No AFib was found in the Holter Monitor Test.
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#8
Yes, sleep apnea can cause palpitations. I have had sleep apnea for about 10 years and my only symptom was tiredness. I didn't use cpap because the apnea was mild . The last couple of years I started with the palpitations. I was sent to cardiologist and had all kinds of test and all were clear. My sleep doctor gave me a sleep study and my apnea had gotten a lot worse so I tried Bipap and it worked on my palpitations. I don't have them anymore.
Good luck and I hope your dad has a sleep study.

Sleepyv
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#9
Hi sjishan,
WELCOME! to the forum.!
I wish your father good luck as he works through finding out about his health problems.
trish6hundred
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#10
Quote:Glad to know that you are doing better now. May I know what was your AHI and Oxygen Saturation Level when you were diagnosed?

7 on both. Mild apnea but very scary on the palpitations. Both have improved but still not where I think I might get to. May have had SA for many years prior to palpitations but not aware.

OBTW 24 hr Holter monitor did nit show any problems either.
Dont-know  I am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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