Good night of sleep

Continuing the theme of using this exclusive club as my form of support...

The last month has been pretty tough as far as sleep goes. I didn't have sleep issues pre pacemaker install. However, post procedure...I have been waking up (sometimes several times a night) with "thud thud thud" pounding heart rate. Most of the time its when I lay on my poaemkaer side, probably has nothing to do with anything, but that's when I notice the issue. 

Also, I believe  when I fall asleep and my heart rate goes below my PM setting and my heart rythem goes back to 60bpm, that may be what wakes me up. 

Anyway, for no rhyme or reason last night it was a flawless night of rest. No interuptions at all, slept like a baby. This after being up 24 hours and traveling via plane, I even had a night cap of bourbon (maybe even three!). Normally, I run from the idea of having a drink, not getting 9 hours of sleep, avoiding "triggers" that may blurp may heart rhythm (sinus node pauses).  

My Sinus Node pauses used to happen...I would get super dizzy, take a knee...feel like poo for about 15 mins. Post pacer...I can feel the symptoms of a pause coming on...my pacer kicks in after about 2 seconds of the pause...I feel my heart rhythm flutters from the interaction of pacer and all is good. 

Maybe these new sensatios/experiences are just a part of my new lifestyle, something I need to accept and get used to. I must admit, It's better than passing out, better than getting dizzy...but I don't know if I need to get my pacemaker adjusted, I'm not sure if its normal to still feel a few seconds of my sinus node pauses or not...

All is good for the most part. 

Best, 

-Michael 


6 Comments

Sensitivity

by MinimeJer05 - 2021-11-24 14:10:20

Michael,

First off, I am sorry to hear that you have been having difficulty sleeping this past month. Sleep is such an essential part of the recovery process, yet it almost feels like a foreign "thing" after getting a PM.

When I first had mine installed, I was constantly waking up in the middle of the night, feeling my heart racing and generally just feeling uncomfortable and on high alert. I would even have these moments where I would start passing out and then get "jolted" awake, almost like I was losing my breath. 

I can say that my sensitivity to all of this lessened over time as they say, time heals all wounds. 

I wouldn't begin to worry just yet, but I would alert your cardiologist just to verify things are as they should be. For me, I even went as far as getting a sleep study test done and apparently I went from being a fine sleeper to someone with mild sleep apnea -- I am getting fitted for one of those CPAP machines within the next month and to be honest, I am okay with that, because ever since the PM, I have always felt a little more tired and drained, but I have been reassured that this is all normal and that it can take a while for the body to adjust.

Have you tried taking any sleep aids such as melatonin to see if that helps at all? 

Take care and sleep well

Jer

Sensitivity

by atiras - 2021-11-24 16:09:55

I think that all of us who have become accustomed to our hearts malfunctioning are then super sensitive to the feel of our new normal until the novelty fades. 

In my case, I had long standing persistent AF so my heartbeat was consistently high at all times and irregular and usually weak. After I had an AV node ablation and pacemaker, it took some time to get used to a slower stronger heart beat. I used to wake in the night when I was lying on my left side and hear thud thud thud like you. It was only beating 60bpm but because it was a stronger beat I was hypersensitive to it. Eventually my sleep brain learned not to worry. 

Now, after gaining an ICD, my semiconscious brain is convinced my heart is going too slow and the beat is somehow weaker during the night. The rate IS slower as the new device has a night rate of 50bpm, but thinking rationally the strength of the beat is down to the mechanical status of the heart and not the electrical system. I have heart failure, so it may well be weaker, but my night brain still blames the device! It will pass... 

waking

by AgentX86 - 2021-11-24 17:33:08

First, rest (pun intended) assured that your heart rate is not going below its set rate. Your pacemaker doesn't wait for a pause. It will pace if the SI node doesn't. If your base rate is 60bpm, that's one beat per second. If your pacemaker doesn't see a heartbeat in one second, it starts one. It doesn't wait for one to be missed.

If you're woken at night, it could be that your pacemaker is doing a self-test at this time. If so, it'll be the same time every night. It could be testing your "capture threshold", which might be weird. Ask your EP. They can move this time or even turn it off.

restful sleep

by Julros - 2021-11-24 19:31:43

A restful night's sleep is bliss, isn't it? 

I did not sleep well after implant for several months for a variety of reasons:i had a great deal of pain, and swelling,  that the cardiology office refused to treat. I believe this, plus the pain of an infected corneal ulcer, drove my sympathetic nervous system and blood pressure into overdrive. I felt that thump, thump, thump every night, until my blood pressure came down. Plus, my pectoral muscle was twitching, and once the settings were adjusted that stopped. I became very angry with the office for brushing off my questions and concerns. 

Yes, the pacemaker is not going to allow a pause for more that one second. One thing that may be happening, is you might have a PVC (premature ventricular contraction) that happens before the ventricles are ready to contract. Normally, the muscle contracts, and then there is a pause while the cells repolarize. Also during this time, the ventricle begins to fill. If there is a early electrical signal, the normal conduction pathway is not "ready" to trigger a contraction, nor is the ventricle full enough to push out blood. But the pacemaker senses electrical activity which tells it to wait another second. In this time the ventricle fills more than usual, and you make sense this as a bigger beat. The only way to know for sure is to see the ekg and correlate it with exact time as symptoms.

It may get better

by stillshocked - 2021-11-24 21:51:20

I have been implanted for 20 ish years.   When I first got it I had trouble sleeping, My doctor told me one reason was my body was now relearning how to sleep right.  For many years while sleeping  my heart rate would be about 35-40 bpm.  I was oxygen deprived and in too deep a sleep.   Then I had to get used to "normal" oxygen sleep.   

I will pop up to 125 bpm for no reason at night while sleeping.  I was told the PM is running a report.  Ughhh... It does it at night because I shouldn't feel it but I do.   Also I can feel when I ventricle pace and it still feels like a bit of a kick.   

The odd thing is the PM check shows every minute.  Write a journal of the times and bring that up during your next check.   

If you are like me, your body will get used to its new normal.  Best wishes.

Sleep and your pacemaker

by Gotrhythm - 2021-11-28 12:43:55

Your pacemaker does not cause your heartrate to fall to 60bpm.  It allows the HR to slow once you are lying still. It's natural for the heartrate to fall as we relax and drift off.  So the pacemaker allows your HR to decrease too--but only to 60bpm. The drop in base HR is gradual. It's unlikely you would notice it even if you were awake. It certainly wouldn't wake you if you were asleep. 

I'm sure the short "pauses" you feel are real, not your imagination. It's possible they make sleep difficult. But you are mistaken when you imagine that the pacemaker has anything to do with them.

Glad you had at least one night of good sleep. Many people have trouble with sleep at first. It gets better after a month or so.

You know you're wired when...

Your ICD has a better memory than you.

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