Does lying down make AFib better or worse at 49?

Question

Hello doctor,

I am 49 years old and have had episodes of atrial fibrillation that are rather unpredictable. What I have found, though, is that sometimes the sensations alter with the position of my body, especially when I am lying down at night.

On some evenings, the palpitations feel more noticeable after getting into bed, while at other times resting seems to help settle them. This has made me quite aware of body position whenever symptoms begin.

I was wondering if the underlying reason determines whether lying down improves or worsens atrial fibrillation symptoms in general, or if the effect is conditional.

Is the problem sleep apnea, reflux, or vagal reactions to sleep?
Should I tell my cardiologist position-triggered atrial fibrillation in a different or more specific way?

Please help.

Thank you for your guidance.

Answer 1

Hi,

Welcome to icliniq.com

I read your query and understand your concern.

Symptoms of atrial fibrillation are very variable between people, but can be worse or occur when lying down, especially at night. Episodes of atrial fibrillation may occur in certain people because of elevated vagal stimulation while they are at rest or just after eating. Nighttime palpitations can have multiple causes, including acid reflux, gas, stress, alcohol, and untreated sleep apnea.

Additionally, lying on the left side may make heartbeats feel stronger or more noticeable for some people because of the heart’s position within the chest.

It would be helpful to talk over these patterns with your cardiologist, who may be able to provide you with helpful clues to possible triggers and further investigation. Additional workup may include sleep apnea testing, rhythm monitoring, and assessment and management of reflux symptoms.

Seek emergency medical treatment if you have chest pain, pass out, or if you have any episodes of severe shortness of breath or a long-lasting rapid heartbeat.

A Holter monitor may also be useful as it can detect changes in the heart rhythm over a longer period of time (including sleep time) and may be able to detect any abnormalities that are related to the night.

I hope these suggestions are helpful.

Thank you.