How do I sleep safely during an AFib episode at 64?

Question

Hi doctor,

I am 64 years old and suffer from atrial fibrillation. The problem is most obvious at night when everything is calm. Sometimes I wake up with my heart racing, which makes me apprehensive about going back to sleep right away. How do I sleep safely during an AFib episode? I ask myself so often.

For an hour at a time, sometimes I lie watching my pulse, fearful that something terrible may happen when I am asleep. I take my medicines as prescribed and have regular follow-up sessions with my cardiologist, but these nighttime episodes still make me concerned.

My wife thinks I worry more than I need to, but it is hard to relax when I’m so aware of every abnormal heartbeat. I am also not sure when an episode may be safely monitored at home, and when it may require immediate medical intervention.

Any advice you can provide on how to handle these issues and when more evaluation is indicated would be appreciated.

Thank you for your time and advice.

Would really appreciate any recommendations you have.

Answer 1

Hi,

Welcome to icliniq.com

I read your query and understand your concern.

I am sorry to hear that these episodes have been causing you concern.

For most individuals with known atrial fibrillation who are under regular cardiology care and taking their medications as prescribed, it is generally safe to sleep during an episode if symptoms remain mild and stable. It is common to become more aware of an irregular or rapid heartbeat at night when the environment is quiet, and anxiety can further heighten that awareness.

In many cases, an episode can be monitored at home if it settles on its own, you are breathing comfortably, and you do not experience concerning symptoms such as chest pain, fainting, near-fainting, or a persistently very rapid heart rate that remains elevated for an extended period.

However, if you experience chest discomfort or pressure, severe shortness of breath, fainting, new confusion, or a high heart rate that does not go away and your symptoms get worse, call emergency medical services.

Also, remember that if you check your pulse constantly or stand for long periods of time, this might cause anxiety and make the

atrial fibrillation

feel worse. If your symptoms are steady and you have no warning signs, it is frequently better to return to bed and focus on relaxation techniques such as deep, controlled breathing rather than monitoring continuously.

Without red-flag symptoms, these tend to be able to be dealt with by medication review or adjustment rather than emergency intervention, as you already work closely with your cardiologist. If you are getting episodes more frequently and/or they are longer or more concerning, it would be reasonable to discuss this with your cardiologist at your next consultation.

I hope this addresses your concerns.

Please feel free to follow up if you need any additional clarification.

Thank you.