My a-fib has always been higher when I lie down and since getting my pacemaker (January 2019) I have developed insomnia.  It has been erratic until the last four months, but now bedtime has become a source of stress.  Once I fall asleep I'm fine, but the problem is at the beginning.  Has anyone else had a similar problem?  Other than taking sleeping aids, could the pacemaker setting be changed?


sleep deprivation

by Gemita - 2020-06-27 15:17:39

Hello Cinefan,

Insomnia is miserable.  Before my pacemaker I experienced it almost every night, so I do know what you are going through.  I couldn’t get to sleep for hours because I experienced arrhythmias on lying down.   In my case it was because my heart rate was falling too low as I tried to drift into sleep (which I know can be normal for many of us) but low heart rates just didn’t suit me and I would always wake up either in Afib or another tachy-arrhythmia after only a few minutes, although often I was never able to even get to sleep.

My dual chamber pacemaker implanted in 2018 is now set at 70 bpm night and day.  My nocturnal palpitations have almost disappeared and most nights I manage to get to sleep quickly and wake up more rested.  My doctor said I had “bradycardia induced arrhythmias”.

I wonder what your heart rate is set at and whether you could ask your doctor if some changes could be made to help you to get to sleep more quickly?  By now your body should be used to pacing, but clearly something has changed or worsened.  Have you recently had a monitor to check whether your Afib has progressed?  I would speak to your doctors first before you reach for the sleeping pills.  You might also benefit from consulting a sleep consultant who could do a sleep study to see what might be happening to you as you try to go to sleep.  A sleep study, if your insurance covers it, can be very revealing.

What meds are you on?  I do know that betablockers can interfere with sleep because they can lower melatonin levels.  My sleep consultant gave me a course of melatonin which helped.  I have switched to taking my betablocker (Bisoprolol) in the morning now which helps  

I hope things improve for you soon


by AgentX86 - 2020-06-27 22:59:43

I had severely symptomatic Aflutter.  When it wasn't being actively treated (after ablations) I was complete miserable.  I couldn't sleep for weeks which pretty much wrecked my life.  After the third ablation failed (my EP pretty much said it wasn't going to work) I was ready for anything.  At the same time, the drugs I had been on damaged my SI node, so needed a pacemaker.  A pacemaker will do little to nothing for Afib or Aflutter so opted for an AV ablation to go with the pacemaker.

Can settings be changed to fix Afib?  It's not at all likely.  Some, with paroxysmal Afib, can be paced out of AF with special programming of the PM (not all PMs can run the software) but it's not at all guaranteed.  My EP told me not to bother trying so the AV ablation was the fix, as drastic as it is.

I know all about arrhythmias keeping one from sleeping.  It's horrible just staring a the ceiling all night, every night.  It makes working impossible, as well.  Anything to fix that.


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You have a 25 year mortgage on your device.

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Hi, I am 47 and have had a pacemaker for 7 months and I’m doing great with it.