Hi Dr. I Have Had Every Test You Can Name

Posted on Fri, 31 May 2019

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 31 May 2019 Answered on

Last reviewed on

Question : Hi Dr. I have had every test you can name for palpitations when I'm sleeping up right or my head is elevated on a pillow. I have had 3 holter monitors 15 ECG,s stress test with eco cardio attached and plenty of blood work and all is normal. I have read on the vagus nerve and it reads out can cause the issue of waking up during relm sleep with palpitations. my heartrate goes from in the 60's to the 70's beats per min. Do they have any cream or herbal medicine that would help relax the vagus nerve? Thanks XXXXXXX

Answered by Dr. Dr. Antoneta Zotaj (2 hours later)

Brief Answer:
Treatments recommend and further advices given

Detailed Answer:
Hello and welcome to "Ask a Doctor" service,

Vagus nerve supplies all the internal organs, the heart included.Most of the time it may cause palpitations after heave meals or if we are anxious.
There are herbal drugs that play the role as tranquilizers, which means they are thought to help patients relax and could help with palpitations due to anxiety but not that they work directly on vagus nerve.
On the other hand, many of these herbal drugs are not well studied and contain the risk for serious unknown side effects, thus I would recommend you to take drugs that are studied for a long time and orooven effective and safe.

To help with your symptoms I would advise you to:
- eat small meal at the evening and do not eat 3-4 hours before bed time. This way the stomach will not be so full and will reduce the chance for vagal related palpitations.
- try to avoid caffeine products at the second part of the day (including cola or other energy drinks). This is because these stimulants may cause stimulation of the heart and palpitations.
- if you have not had a TSH to rule out thyroid problems, it might be recommended to have it done and just make sure thyroid is OK. Thyroid problems are common in women and may cause palpitations.
- propranolol 40 mg before bed time may help have the heart rate under control and avoid palpitations.
- drinking a warm camomile tea before sleep may help relax and may avoid palpitations
- anxiety may be considered as a possible cause of palpitations at night. In this case, SSRI drugs (sertraline or citalopram) are recommended and some counseling.

I hope this answers your query and is helpful to you. I remain at your disposal if any further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj, General and Family Physician

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Antoneta Zotaj (49 minutes later)

Thanks Dr. Very helpful. Have you ever heard of someone having this issue during relm sleep? once I wake up and walk around things goes back to normal in 5 min or less! Thanks

Answered by Dr. Dr. Antoneta Zotaj (3 hours later)

Brief Answer:
Yes, it is common for people to have such episodes while asleep

Detailed Answer:
Hello and welcome back,

REM sleep is a period of sleep where the brain is very active and patients may dream a lot. It is not uncommon that this phase of sleep may spark anxiety and the patient to wake up with palpitations. I have had patients that wake up from their sleep with anxiety which could be with shortness of breath, palpitations, or shakiness, etc. Each of these can be due to anxiety, especially if they happen when the patient is relaxed and during sleep.

Heart and lung problems would be expected to cause palpitations during exercise and not during rest, and the normal examinations in your case fully explain that your palpitations are very likely due to anxiety.

I hope this answers your query and is helpful to you. I remain at your disposal if any further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj, General and Family Physician

Above answer was peer-reviewed by : Dr. Vaishalee Punj