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What Causes Rapid Heartbeat And Difficulty In Falling Asleep After A Strenuous Day?

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Posted on Mon, 21 Mar 2016
Question: After a physically strenuous day, when I try & fall asleep my heart starts pumping very fast for a while & it's hard for me to fall asleep. Then after a while I fall asleep. Then upon awaking the next morning- I experience the same phenomena- my hart beats extremely fast for several minutes then calms down.
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Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:

Hello,

Welcome on HCM!

- Regarding your concern, I would like to explain that having difficulty when trying to fall asleep after a physically strenuous day is quite a normal reaction, because physical exertions stimulate further Reticular Activating System (RAS) or what is otherwise called Extrathalamic Control Modulatory System, which is responsible for regulating wakefulness and sleep-wake transitions.

This is why you are experiencing a strong beating heart for a while before falling asleep.

This entire phenomenon is further exacerbated by increased anxiety and several psychological stressful situations.


Coming to this point, I recommend trying to modulate your daily physical activity, harmonize your daily commitment with recreational activities especially outdoor walking and socializing with your close friendships.

This will have a positive impact in relieving your current unpleasant feelings.

- Regarding the same phenomena when awaking (experiencing extremely fast heart beats), it is important to investigate for a possible Postural Orthostatic Tachycardia Syndrome (POTS), especially if other orthostatic related symptoms occur (light-headedness, chest discomfort, shortness of breath, weakness, blurred vision, and even fainting), when assuming from a supine to an upright position.

(1) If an increase in heart rate by at least 30 beats per minute within 10 minutes of assuming an upright position, is present without a decline in blood pressure, then POTS is quite likely to be the responsible cause of your complains.

(2) Otherwise, if heart rate increase (more than 30 bpm) is also associated with a decrease in blood pressure (at least 20 mmHg in systolic, or 10 mmHg in diastolic BP) then orthostatic hypotension should be suspected.

In both cases [(1) and (2)], a Head Up Tilt test would be necessary to diagnose exactly these issues.

But, if nothing of the above is present, then everything is a consequence of your exhaustive daily engagements and also your increased anxiety.

Coming to this point, I strongly recommend you to relax yourself, and follow the above mentioned advises about more recreational activities.

Hope to have been helpful to you!

In case of any further uncertainties, feel free to ask me again.

Kind regards,

Dr. Iliri

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9545 Questions

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What Causes Rapid Heartbeat And Difficulty In Falling Asleep After A Strenuous Day?

Brief Answer: I would explain as follows: Detailed Answer: Hello, Welcome on HCM! - Regarding your concern, I would like to explain that having difficulty when trying to fall asleep after a physically strenuous day is quite a normal reaction, because physical exertions stimulate further Reticular Activating System (RAS) or what is otherwise called Extrathalamic Control Modulatory System, which is responsible for regulating wakefulness and sleep-wake transitions. This is why you are experiencing a strong beating heart for a while before falling asleep. This entire phenomenon is further exacerbated by increased anxiety and several psychological stressful situations. Coming to this point, I recommend trying to modulate your daily physical activity, harmonize your daily commitment with recreational activities especially outdoor walking and socializing with your close friendships. This will have a positive impact in relieving your current unpleasant feelings. - Regarding the same phenomena when awaking (experiencing extremely fast heart beats), it is important to investigate for a possible Postural Orthostatic Tachycardia Syndrome (POTS), especially if other orthostatic related symptoms occur (light-headedness, chest discomfort, shortness of breath, weakness, blurred vision, and even fainting), when assuming from a supine to an upright position. (1) If an increase in heart rate by at least 30 beats per minute within 10 minutes of assuming an upright position, is present without a decline in blood pressure, then POTS is quite likely to be the responsible cause of your complains. (2) Otherwise, if heart rate increase (more than 30 bpm) is also associated with a decrease in blood pressure (at least 20 mmHg in systolic, or 10 mmHg in diastolic BP) then orthostatic hypotension should be suspected. In both cases [(1) and (2)], a Head Up Tilt test would be necessary to diagnose exactly these issues. But, if nothing of the above is present, then everything is a consequence of your exhaustive daily engagements and also your increased anxiety. Coming to this point, I strongly recommend you to relax yourself, and follow the above mentioned advises about more recreational activities. Hope to have been helpful to you! In case of any further uncertainties, feel free to ask me again. Kind regards, Dr. Iliri