Dr. Muhammad Zubayer Alam
Pulmonology (Asthma Doctors)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I own a Fitbit smartwatch. My resting heart rate, and my lowest heart rate at night, is relatively low. However, I am neither particularly young nor extremely fit although I train a little daily and have done so all my life (cardio and gym). I have enclosed some pictures that first show that my resting heart rate often is 40 BPM, and secondly that my lowest heart rate at night can be as low as 33 BPM (I only use the watch at night and sometimes when I am running). Especially my feet are often quite cold, and I can often feel tired (at the same time, I generally sleep poorly for some reason). During the periods when I eat vegan, the resting heart rate tends to be lower (according to my measurements).
Question: Is this bradycardia? Should I be concerned?
I have had possible heart problems for several years now, especially at night. The heart beats at an increasing rate for no apparent reason. It can last for long periods, sometimes for an hour or more, and often more than once per night (according to Fitbit and Qardiocore). Based on clips or samples of ECG (from my Qardiocore), a cardiologist has judged that I have traces of sinus tachycardia in some of the clips (although most cases regarding palpitations are benign).
When I wake up, I often have vague but precise pain around the heart area (and I can, e.g., 'feel it' in the heart when I bend down towards the sink on the toilet when I get up from bed). Further, I often also have an abnormally high heart rate and long periods of "peak" (according to Fitbit) when I jog directly in the morning - this even though I jog at a leisurely pace. Measurements that I have made with the watch also show that I often have a high variation in blood oxygen variation (although probably considered 'normal').
Furthermore, doctors have determined that I have a visibly pulsating aorta. My sleep is characterized by constantly too little deep sleep and REM sleep (compared to the control group). No other problems, no medication, taking some melatonin for falling asleep. I eat or live quite healthily.
Hello,
Welcome to icliniq.com.
I can understand your concern. According to your symptoms, you have suffered from low heart rate during sleeping time, insomnia, and low body temperature.
Average resting heart rate during sleeping time may vary from person to person. Resting heart rate during sleeping time may vary from 40-100 per min and can be considered normal. It may also vary from day to day, hydration status, physical activity, body temperature elevation, etc.
At the initial sleeping period, your body becomes relaxed, and your heart rate declines or decreases. The lowest resting heart rate is at the midpoint of your sleep as melatonin reaches a peak. Before waking from sleep in the morning, your heart rate begins to increase. Again, your resting heart rate may increase during REM sleep, which is quite normal.
Your body temperature can decline during your sleeping time. Average body temperature is between 97-99° F. When your body temperature declines below 95° F it is known as hypothermia which may result from hypothyroidism, hypoglycemia, poor nutrition, psychological disorders, stroke, spinal cord injury, medications such as sedatives like melatonin, alcohol consumption and many more. A heart rate of less than 60 per min is known as bradycardia, and it may happen during deep sleep.
You can undergo investigations like Holter monitoring, ECHO (echocardiogram), RBS (Random blood sugar), thyroid function tests, CBC (Complete blood count ), etc., to find out the exact underlying causes for low heart rate and body temperature during sleeping and then we may treat them accordingly.
Do not be worried at all. Your low heart rate during sleeping time and low body temperature may be normal, confirmed by the investigations mentioned above.
Patient's Query
Hello doctor,
Thanks for your suggestion.
I understand that the lowest heart rate has a connection to melatonin reaching a peak at night. Additionally, I want to mention that I often seem to have several different 'lowest heart rates' during the same night where the values are the same.
Hello,
Welcome back to icliniq.com.
As I have already mentioned, your body usually becomes relaxed at the initial phase of sleeping, and your heart rate decreases. At the midpoint of the sleeping, the lowest resting heart rate is because melatonin reaches a peak. Variation of melatonin level during sleeping may alter resting heart rate.
As suggested, you should get some investigations done like Holter monitoring, ECHO (Echocardiogram), etc., which may help to exclude the causes. If you have any doubt, you can physically visit your doctor for further evaluation and treatment purposes.
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Pulmonology (Asthma Doctors)
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