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Q. Why do I get violent diaphragm convulsion during sleep?

Answered by
Dr. Sadaf Mustafa
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 10, 2016 and last reviewed on: Feb 27, 2020

Hi doctor,

Last night during sleep, I was awoken by a violent diaphragm convulsion. I felt a sensation of being drawn down into a cold dark blackness. It was very much disturbing and I felt like I was going to die. I had benign arrhythmias with follow up Holter monitor and stress test revealed no signs of heart disease. It occurred thrice in the last 18 months. Please help.



Welcome to

  • I understand that you have been investigated for arrhythmia - paroxysmal (attachment removed to protect patient identity), but my main concern here would be obstructive sleep apnea (OSA).
  • There is a scoring system that we use to stratify your risk for OSA. Please provide me with the following information so that I can plug in your numbers.
  • Please answer either yes or no. Do you snore loudly? Do you often feel tired, fatigue or sleepy during the daytime?
  • Has anyone observed that you stop breathing during your sleep? Do you have or being treated for high blood pressure?
  • Is your neck circumference more than 16 inches?
  • If it is not OSA, my other consideration would be nocturnal hypoglycemia.
  • Also it would be helpful to know if you have any past medical history of ENT related issues, seizures or respiratory problems. Also let me know if you are a smoker.
  • All the information above will be obtained in an attempt to generate better plan of care and to rule out certain conditions including but not limited to OSA, nocturnal hypoxia during sleep due to chronic respiratory failure, hypoglycemia during sleep and also arrhythmia.
  • Yes, in arrhythmia you have to remember that the Holter monitor only checks you for 48 hours or so. You may need a loop recorder that stay with you longer and catch events that are more spaced out.

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