Question
I have been waking up frequently every night - up to 7 or 8 times - for the past 12 months although I have no problem falling asleep. I always wake with a start, my pulse is fast and somethimes my breathing is laboured. My hands are usually hot, puffy and sweaty - and they continue to be so during the day. I did a self-administered sleep study through the British Sleep Apnea Association which showed I did not have apnea, but their report said I had an "unusually high pulse rise index" (with the pulse rising sharply to a max. of 114 on wakening) which it suggested was the cause of my fragmented and poor quality sleep.
I've seen a cardioligist and an endocrinologist who checked me out and couldn't find anything abnormal. My exercise ECG, 24-hour ECG and blood tests are normal. My heart rate during the day is normal, as is my blood pressure. However, on the few occasions I measured my BP immediately on waking, it was very high and for this reason I hve been taking the beta-blocker Labetalol for some weeks. Although I feel exhausted, ill and distressed every morning and can only work in the afternoon or evening, I try to go for a brisk walk most days (with a few spurts of jogging even!). Because the symptoms started when my mother died, my doctor feels anxiety is the culprit. I'm sure the shock of my mother's death played a part initially, and could have been the trigger, but I think the stress and anxiety I experience now is the result of the symptoms that have persisted for so long. I've had CBT but this has not changed my symptoms. Any ideas as to how to proceed from here would be greatly appreciated.
Answer
First of all it sounds like anxiety, however I would see a pulmonary doctor just to outrule any copd, emphysema, or asthma since the shortness of breath is when you are lying down. If this checks out you might want to ask your md for some xanax to relax although all of these are habit forming. Next try to reset your sleep cycle by following the tips below.
Try these tips religiously for about 6-8 weeks but many have seen results
in as little as 2 weeks.lYou must go to bed and awaken the same time each day regardless
of how little or how much sleep you got the night before.
This starts to reset your sleep clock.
3 hours before bedtime stay away from
tea, coffee, caffeine, caramel colored soda like, coke,pepsi, ginger ale,
or root beer, chocolate and exercise .All these make for restless sleep.Do the following religiously for 4-6 weeks although some have seen changes in as little as 2 weeks.
Make sure room is quiet and dark. When you go to bed if you start to
twist and turn or if you wake up in the middle of the night and cant
go back to sleep, twist and turn for only 20 minutes, then get up, go
into a different room and read a book or magazine only! No computer!
When you start to doze immediately go back into the bedroom.This retrains
the brain into thinking that the bedroom is for restful sleep only. Do
this as many times as you awaken thru the night, it will lesson.
30 minutes before bedtime take a hot bath and immerse hands under the
water.Latest research states that the palms of the hand when immersed
in hot water send signals to the brain to relax. 15 minutes before bedtime\
drink a glass of warm milk. Milk when heated contains tryptophan, a natural
amino acid sleep inducer should do the trick. If this fails you should consider seeing a sleep center.
Your local hospital can refer you. Also go to sleepnet.com click on disorders insomnia
for more tips. Feel free to email again karel
