Waking up with palpitations - laying on back

[MyronH]

Hello folks. I thought I almost had my sleep problems fixed. Been sleeping better for the last couple of weeks. I started allergy drops over a month ago, and that has seemed to help clear up my sinuses and help breathing. I also started laying on my side for part of the night, usually at the beginning of the night. Then I move to my back later in the night. This had been no problem, except for tonight....I had major palpitations that woke me up. I was laying on my back at the time. Also a little night sweats. I want to get this resolved this year, since when I have palpitations, it feel like my heart was being overworked sometimes, and felt like I ran a marathon.

I'm still taking Multaq for AFIB, and bystolic, but my doctor wants me to try and stop the Multaq at some point. But I want to get this sleep issue controlled first. These charts are during the time I was laying on my back 

Does anyone know why laying on the back could cause palpitations? 

Do these charts show anything that could indicate why palpitations are occurring?

[Sprig]

Heart palpitations at night can be caused by the way in which you sleep. People who sleep on their left side or back may inadvertently put pressure on their vagus nerve. The vagus nerve is a component of the parasympathetic nervous system and is partially responsible for controlling your heart rate. When external pressure is applied to the vagus nerve, it is possible to trigger an abnormal electrical impulse which travels the length of the nerve. This harmless impulse can cause a temporary awareness of your heartbeat.
This could also be runs of afib that you are more aware of while supine. They could be be benign pac’s or pvc’s. Talk to your physician about this. Arrhythmia and osa is always worrisome and can be serious. A holter or event monitor may be called for.

[MyronH]

Ahh I see where you quoted that from. Found the website. But the question remains, what to do about it?
I sleep basically in same position every night that I can tell. I had a CT scan done that did show a slightly compressed disc in my back.  But the spine doctor wasn't worried about it. I wonder if I should go see a different spine doctor?

What type of doctor would I go see for Vagus nerve issues?

[Sprig]

I quoted it for expediency, my background is medicine. The palps  may or may not be due to sleep position but it is a possible cause. OSA itself can cause various arrhythmia including afib and the more serious ventricular tachycardia.  Your O2 looks good (O2 desat can cause arrhythmia) and your heart rate is not in the tachy range. You should discuss this with your cardiologist. Your physician may order a holter or event monitor to see what your heart is actually doing during these events. Then cause and appropriate treatment can be determined.

[Sprig]

Almost forgot, you state that you take allergy meds.  I do not know what you are taking but some of those meds can cause heart palpitations. If it’s an otc with a decongestant, that can cause palps. Others can also. Something else to ask your doc about.

[mesenteria]

It is also possible that your heart is responding to a sudden production of epinephrine (adrenalin).  If you are startled awake, your natural instinct is to sense anxiety or fear, and that in turn will result in the adrenal cortex responding to the fear and producing a dollop of epinephrine.  That, also, may trigger paroxysmal AFib.

AFib is considered to be a progressive disorder.  It is highly unlikely to 'cure' itself over time.  So, my cardiologist told me that I would be on at least a mild dose of metoprolol for the rest of my life.  That and a modern anti-coagulant to minimize the threat of blood clots inside the atrium that is no longer clearing itself properly when I experience AFib.  So, I wonder why your physician means to get you off of the medication you have indicated is meant to keep a handle on your AFib.  Seems odd to me.

[MyronH]

It's custom allergy drops that I take in the morning. Allergy drops from my allergist  Instead of taking shots. Since I take in morning it shouldn't cause this. Plus I had this palpitations issue before I started taking the allergy med's and also Multaq and other medicine. So I'm pretty sure it is not medicine related. It's more of a breathing issue I think that is causing it. Like UARS and labored breathing. But I shouldn't have that being on Bilevel. And especially not if I have no obstructions.

[mesenteria]

Ah, that's much more like it.  Thanks for the clarification.

[ardenum]

I quoted it for expediency, my background is medicine. The palps  may or may not be due to sleep position but it is a possible cause. OSA itself can cause various arrhythmia including afib and the more serious ventricular tachycardia.  Your O2 looks good (O2 desat can cause arrhythmia) and your heart rate is not in the tachy range. You should discuss this with your cardiologist. Your physician may order a holter or event monitor to see what your heart is actually doing during these events. Then cause and appropriate treatment can be determined.

You must mean ventricular fibrilation, because how is ventricular tachycardia any serious? I have a known history of ventricular tachycardia and supraventricular tachycardia and my cardiologist said its nothing serious to worry about.

[MyronH]

I quoted it for expediency, my background is medicine. The palps  may or may not be due to sleep position but it is a possible cause. OSA itself can cause various arrhythmia including afib and the more serious ventricular tachycardia.  Your O2 looks good (O2 desat can cause arrhythmia) and your heart rate is not in the tachy range. You should discuss this with your cardiologist. Your physician may order a holter or event monitor to see what your heart is actually doing during these events. Then cause and appropriate treatment can be determined.

You must mean ventricular fibrilation, because how is ventricular tachycardia any serious? I have a known history of ventricular tachycardia and supraventricular tachycardia and my cardiologist said its nothing serious to worry about.

It's my understanding that "Ventricular Tachycardia (v-tach)" is serious. But not supraventricular tachycardia (SVT). And I'm unfamiliar with ventricular fibrilation.  

My only issues I've had so far with sleep apnea, were AFIB, and one time Bigeminey. I do have issues with SVT and innappropirate sinus tachycardia. I think this is all due to my past sleep apnea before I knew i had it. My cardiologist said not to worry about either of these things either. He said even his coworker doctor had bigeminey and himself too, and also one of his coworkers went into AFIB. He said he just shocked him back into rhythm.