Heart Rate fluctuations and spikes during sleep

[WarpedTrekker]

I had a recent Echo Stress test and 2-week Holter monitor which was both normal. No recurrent AFIB nor other issues. Yet I still see these unusual heart rate spikes during sleep. I have tried a couple different Contec SpO2 monitors and another device and they all show the same spikes during sleep, with no movement. (I have video taped myself). So I'm almost 99% sure these are valid and correct. I had NO apneas during most of these spikes.

Is it normal to have spikes like this during sleep or REM sleep?

[dogsarelife]

Disclaimer/Edited to add - I clicked on your posts and it seems like you're older to cpaptalk than me, so possibly none of what I have to say is helpful. Is your O2 still dropping without any events? Did you ever get that figured out?

Original response -

your sleep charts don't provide flow rate so I can't tell what's going on at the times you posted heart rate increases.
My suggestion:
Have you thought about zooming in on the times you are seeing heart rate spikes and if there is maybe a narrowing/decrease of the flow rate or a micro-arousal at the same time? that's what I did. I have UARS though, not sure if you have that as well. with uars your airway is narrow to begin with and then narrowing while you sleep - which shows up as for me as the flow rate getting smaller and smaller until I jerk awake (but of course in no way remember doing so). UARS airway narrowing is supposedly a mild stressor on your body and brain (it sure as heck stressed me out though!), and the papers I have read say that with UARS your brain will micro-arouse a little to get you to widen the airway again, before it lets you go back to sleep. Thus why a lot of people with UARS don't can still feel absolutely awful, especially if that happens 100s of times over the night, but with no corresponding drop in oxygen so doctors are confused why they feel terrible. Another name for the event is respiratory effort related arousal or RERA.



and I find those little microarousals (which I don't remember) can jack my heart rate up a little bit. Not sure if they do for everyone, but they do for me. as opposed to when I have a full blown cessation of breathing and then my heart rate really jumps up.

Also, believe if you search papers /info on REM sleep - this site is very cool - http://thebrain.mcgill.ca/flash/i/i_11/ ... p_cyc.html

, that they say that some heart rate variability is normal during REM stage, but as to what's normal heart rate variability, I am guessing it varies from person to person. Like if your resting heart rate is 80, maybe it's totally fine and normal to spike to 100; but if your resting heart is lower and you're an athlete, then maybe spikes that big would be a concern. If you do some digging on pubmed you might be able to find your answer for your specific heart /health issues that made you get a holter monitor in the first place. if you respiration issues / drops in oxygen without any events I've read that that can sometimes be a sign of brainstem issues?

Who knows how common or rare it is, but I found it fascinating when I learned about a woman Jen Brea who came down with a severe case of chronic fatigue. She made a netflix documentary about her chronic fatigue and other people who were similarly ill, and in her case, it seems like an improperly supported brain stem due to craniocervical instability (sometimes seen in ehlers-danlos, or other people with weak connective tissue) was the root cause of her issues. It took her 8-9 years to find a doctor who was willing to believe her and diagnose her and operate to fuse parts of her spine so that it would support her brain better and she went from being bed bound to years to now being quite active, able to sleep now, etc..

But I think she and some of the other people who had this craniocervical instability had symptoms of dizziness, POTS, random dropping of O2 to the 80s during sleep, and they were called fakers by doctors :/

ANyway, I don't know if that's what you're dealing with, but I hope you get help for whatever you are dealing with.

[HoseCrusher]

Yes.

Fluctuations in heart rate are expected. There are many causes.

IF...

If there is O2 desaturation prior to heart rate spikes, then further investigation is needed.

As you approach death the heart rate spikes go away.

[WarpedTrekker]

Yes.

Fluctuations in heart rate are expected. There are many causes.

IF...

If there is O2 desaturation prior to heart rate spikes, then further investigation is needed.

As you approach death the heart rate spikes go away.

Okay good to know I'm not dying yet in my 40's.

Ive had some unusual O2 desats though that didn't occur due to apneas. Not sure what caused them but if I see them recur I'll be sure to slap my doctor hard on his head and try to get a damn response out of him.

[WarpedTrekker]

But I think she and some of the other people who had this craniocervical instability had symptoms of dizziness, POTS, random dropping of O2 to the 80s during sleep, and they were called fakers by doctors :/

That has been my experience with local doctors here in Austin,TX area. For years I was getting strange "panic attack" symptoms that lasted only a few seconds. Feelings of doom, like I was going to die. Some doctors said it wasn't panic, since it didnt last long enough. Then I developed issues in my sleep with heart racing. They couldn't figure it. Eventually it led me to a sleep study after years with it, and finally got diagnosed with "mild" sleep apnea. First doctor put me on a CPAP and I told her that wasn't working, but she just wanted me to continue with it. She said AHI7 or below was normal. I had AFIB incident after two weeks on it, so I knew the CPAP wasn't working. Had to go to another doctor, which finally agreed to try BILEVEL, which has been working for me.

I kept having issues with O2 dropping and lower O2 during the day. Local doctor said it was just anxiety and to get better sleep. I woke up the next day, and still felt out of breath with racing heart. Couldn't even mow my grass. Went to ER, and CT scan revealed another DVT/PE with blood clots in my lungs. O2 was in mid 80's and they put me on oxygen. Some doctors are just careless or don't listen to their patients. That was the second time I had blood clots. They knew I had a genetic clotting disorder from the first time around. Took me off of Xarelto and just to take baby aspirin. Then I developed blood clots again. Idiots. I had told them I was having trouble sleeping, and when I went to sleep, I'd have a lot of centrals or O2 dropping, but they wouldn't believe me, even when I gave them the charts. I went a night sometimes without sleep, because it gave me so much anxiety.

[HoseCrusher]

When I hear heart fluctuations, I wonder about mineral balances.

When I hear blood clots, I wonder about dehydration.

[WarpedTrekker]

When I hear heart fluctuations, I wonder about mineral balances.

When I hear blood clots, I wonder about dehydration.

Mineral balance issue is possible. But for the blood clots I have Factor Five Leiden which causes me to clot more. So after this last DVT and PE I'm on blood thinner for life. My job requires me to pretty much sit for 8hrs each day too. So that doesn't help. I have a sit stand desk but that didn't help. Still got blood clots. Now I wear compression stockings too.

Other people sit all day and don't drink as much water as I do and they are perfectly fine.

[dogsarelife]

That has been my experience with local doctors here in Austin,TX area. For years I was getting strange "panic attack" symptoms that lasted only a few seconds. Feelings of doom, like I was going to die. Some doctors said it wasn't panic, since it didnt last long enough. Then I developed issues in my sleep with heart racing. They couldn't figure it. Eventually it led me to a sleep study after years with it, and finally got diagnosed with "mild" sleep apnea. First doctor put me on a CPAP and I told her that wasn't working, but she just wanted me to continue with it. She said AHI7 or below was normal. I had AFIB incident after two weeks on it, so I knew the CPAP wasn't working. Had to go to another doctor, which finally agreed to try BILEVEL, which has been working for me.

I kept having issues with O2 dropping and lower O2 during the day. Local doctor said it was just anxiety and to get better sleep. I woke up the next day, and still felt out of breath with racing heart. Couldn't even mow my grass. Went to ER, and CT scan revealed another DVT/PE with blood clots in my lungs. O2 was in mid 80's and they put me on oxygen. Some doctors are just careless or don't listen to their patients. That was the second time I had blood clots. They knew I had a genetic clotting disorder from the first time around. Took me off of Xarelto and just to take baby aspirin. Then I developed blood clots again. Idiots. I had told them I was having trouble sleeping, and when I went to sleep, I'd have a lot of centrals or O2 dropping, but they wouldn't believe me, even when I gave them the charts. I went a night sometimes without sleep, because it gave me so much anxiety.

Wow, I hear this so much, and I'm sure everyone here does too. I sometimes think if only therapists, psychiatrists, doctors, nurses, dentists, orthodontists, dental hygienists, ENTs etc. could just read on cpaptalk.com all the things that many people had to go through before they got told they had sleep issues, that it would be such an education for them on how poorly they are treating patients/why the american health care system is such a disaster. (though, I hear other health care system in other countries can be a disaster too, it doesn't seem like anyone's happy with their doctors these days sadly).

I also read that an ER nurse started an organization called the foundation for airway health to educate professionals on airway centered disorders (including sleep apnea) after realizing she had been blaming patients for not taking better care of themselves, telling them that they were just anxious, when really it was sleep apnea/low oxygen saturation levels.

It took a young, lean guy in his 20s dying for her to wake up and ask what she had done wrong, and go back and review her history, as well as getting her migranes and TMJ treated by focusing on her airway and sleep I think.

[ChicagoGranny]

I also read that an ER nurse started an organization called the foundation for airway health to educate professionals on airway centered disorders

Wow! Good for her! I was skeptical at first, thinking she was promoting some scammy, pseudo treatments. But, I looked at her treatment page ( https://www.airwayhealth.org/p/Getting-Help-p35751.asp ), and it is excellent.

I hope she gets her message in front of a lot of professionals. She has a great screening tool for professionals - https://www.airwayhealth.org/tpn/c/C135 ... eening.pdf

Thanks for mentioning her.

[dogsarelife]

Wow! Good for her!

Yes, I'm so heartened by her efforts and the other medical professionals who feel remorse and guilt at telling patients their sleep issues were down to anxiety. Side note: I can think of about 13 doctors who owe me an apology for missing my sleep apnea.

I hope this foundation spearheads a revolution. In my opinion, her presentation needs to be in schools too. I can remember getting tested for eye issues and hearing issues and scoliosis in elementary school, and I think it's high time for a public health campaign where kids with any of the issues on that list get tested for sleep issues, since it's the basis for learning and growing appropriately.

I know I'm preaching to the choir but this is pretty much the only place where I find people who get it!

I've forwarded that site to my siblings, and friends, and some think it can't be possibly be true, while one or two took me seriously.

Has anyone else here had that experience - that it's hard to get people to understand just how dramatically sleep influences their entire life?

I feel lucky because a sibling is now especially aware after they saw firsthand a dramatic change in a neighbor's child's behavior post adenoid and tonsil removal. The child was in the process of receiving a diagnosis for some serious psychiatric /mental health issues and about to be drugged up on some dangerous psych meds for their behavior, before the pediatrician asked offhand, "does the child by any chance snore a lot?" and the parent replied, "I could tell you some stories! it's so loud I can't believe it!"

It was like it finally clicked into place for my sibling how much I had been suffering.

I hope that, now that Dr. Guilleminault has passed, that whichever organization he raised money for, (Honestly I get them all confused - the Amer. academy for sleep medicine? the American SLeep Association? the Amer. sleep apnea association?) focuses on hiring a publicist from the people who raised awareness about breast cancer or heart attack symptoms, and all these sleep organizations can work together with this foundation for airway health to spread their knowledge.