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What Causes Insomnia, Heart Palpitations, Anxiety, Panicking Dreams While Treating BP?
Question:
Severe difficulty sleeping. Situation began around mid december where by I would awake in the night after about 4-5 hours sleep with my heart racing and really pounding very hard; often I would have been experiencing a panicky/high stress dream as well that seemed very real. I would also have to urinate a large amount and could not get back to sleep afterward.
Since December the condition has gotten progressively worse. Now and the last few weeks I can't sleep very much at all. I lay in bed for 3-4 hours to get only 45 minutes to 2 hours sleep maximum before I wake again; always with my heart beating either somewhat or very fast. Almost always there is a high stress/anxiety/panicking dream just before I'm forced awake. Something like someone chasing me, or a fight, or an argument or something intense like those examples.
I would say the dreams occur about 80% of the time, but I always awake with my heart racing away and every night or day I only get a few hours sleep. I'm now spending all day laying in bed trying to get some sleep. At best i'll get 3 hours if im lucky and can relax, I've been taking Kalms pills in addition in Bisoprolol 7.5 mg and blood pressure medication as have hypertension stage 1. BP is usually in the high 130s over 80s sometimes 90-95. Recent BP average over last few weeks - 124/77.
To give some history and medical background, I have been overweight since 2006 with problems of heart palpitations and have been noted for hearing fluid in chest by doctors since 2006. my BMI is now 36 and have been obese for about 10 years with a weigh problem since 2002. I regularly get sharp stabbing chest pains in the middle of my chest, and at the base of my left side of chest. Sometimes middle of left side of chest as well, these occur anytime sitting or laying down mostly.
Also since september I have developed two small balls of soft swelling just under and infront of my ankle bones one on each foot, that are there permanently, concurrent with aching pain like muscle strain along the back of my ankles, feels like alot of ankle spraining but have not done any intense or over exertive exercise. Once or twice in September/ November it was so bad I couldn't walk, like severe sprained ankle. I wonder if this is related. The swelling stays about the same and is always there, never goes away doesn't get bigger or smaller.
I have suspected heart failure due to fluid heard in chest my obesity and getting out of breath just walking a few stairs, this has been so since 2006-7. I havent been diagnosed yet though and am due for chest x-ray and liver ultrasound but one doctor was telling me about muscle tonicity being reduced or lax during sleep and now have been wondering if my heart maybe so weak, or bi-ventricular heart failure may be so advanced that my heart can't pump much during sleep; like muscle is too weak, and so stress hormone is released to make the heart pump faster and so i wake up; thus going through this vicious cycle. Could that be the case? If so what is the remedy?
Very much welcome your insight, thoughts and advice. Many thanks.
Severe difficulty sleeping. Situation began around mid december where by I would awake in the night after about 4-5 hours sleep with my heart racing and really pounding very hard; often I would have been experiencing a panicky/high stress dream as well that seemed very real. I would also have to urinate a large amount and could not get back to sleep afterward.
Since December the condition has gotten progressively worse. Now and the last few weeks I can't sleep very much at all. I lay in bed for 3-4 hours to get only 45 minutes to 2 hours sleep maximum before I wake again; always with my heart beating either somewhat or very fast. Almost always there is a high stress/anxiety/panicking dream just before I'm forced awake. Something like someone chasing me, or a fight, or an argument or something intense like those examples.
I would say the dreams occur about 80% of the time, but I always awake with my heart racing away and every night or day I only get a few hours sleep. I'm now spending all day laying in bed trying to get some sleep. At best i'll get 3 hours if im lucky and can relax, I've been taking Kalms pills in addition in Bisoprolol 7.5 mg and blood pressure medication as have hypertension stage 1. BP is usually in the high 130s over 80s sometimes 90-95. Recent BP average over last few weeks - 124/77.
To give some history and medical background, I have been overweight since 2006 with problems of heart palpitations and have been noted for hearing fluid in chest by doctors since 2006. my BMI is now 36 and have been obese for about 10 years with a weigh problem since 2002. I regularly get sharp stabbing chest pains in the middle of my chest, and at the base of my left side of chest. Sometimes middle of left side of chest as well, these occur anytime sitting or laying down mostly.
Also since september I have developed two small balls of soft swelling just under and infront of my ankle bones one on each foot, that are there permanently, concurrent with aching pain like muscle strain along the back of my ankles, feels like alot of ankle spraining but have not done any intense or over exertive exercise. Once or twice in September/ November it was so bad I couldn't walk, like severe sprained ankle. I wonder if this is related. The swelling stays about the same and is always there, never goes away doesn't get bigger or smaller.
I have suspected heart failure due to fluid heard in chest my obesity and getting out of breath just walking a few stairs, this has been so since 2006-7. I havent been diagnosed yet though and am due for chest x-ray and liver ultrasound but one doctor was telling me about muscle tonicity being reduced or lax during sleep and now have been wondering if my heart maybe so weak, or bi-ventricular heart failure may be so advanced that my heart can't pump much during sleep; like muscle is too weak, and so stress hormone is released to make the heart pump faster and so i wake up; thus going through this vicious cycle. Could that be the case? If so what is the remedy?
Very much welcome your insight, thoughts and advice. Many thanks.
Brief Answer:
Consultation
Detailed Answer:
Hello, and thanks for your question.
I'm sorry you're going through this, it must be very difficult. Let me give you my thoughts.
There are a few possible solutions here. First, your anxiety and panic at night seems to be the root cause of the problem. A low-dose short-term course of a benzodiazepine such as clonazepam or lorazepam taken at night would calm you through the evening enough to allow for a peaceful sleep. A long-term solution would be to take an antidepressant such as mirtazepine that would act in the long run in a non-addictive way to help you. I would start both of these together, and taper off the benzodiazepine within a few weeks as the antidepressant begins to kick in. Finally, prazosin is a medication used to combat nightmares, and may be helpful for you. Altogether, this can fix your problem.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Consultation
Detailed Answer:
Hello, and thanks for your question.
I'm sorry you're going through this, it must be very difficult. Let me give you my thoughts.
There are a few possible solutions here. First, your anxiety and panic at night seems to be the root cause of the problem. A low-dose short-term course of a benzodiazepine such as clonazepam or lorazepam taken at night would calm you through the evening enough to allow for a peaceful sleep. A long-term solution would be to take an antidepressant such as mirtazepine that would act in the long run in a non-addictive way to help you. I would start both of these together, and taper off the benzodiazepine within a few weeks as the antidepressant begins to kick in. Finally, prazosin is a medication used to combat nightmares, and may be helpful for you. Altogether, this can fix your problem.
Please remember to rate and close this answer thread when you are finished and satisfied.
In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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