A good night’s sleep is critical for keeping the heart’s electricity flowing normally. Those who have difficulty sleeping are at higher risk of developing heart arrhythmias, such as AFib. A recent study concluded that poor sleep is a significant risk factor for AFib. Researchers found that frequent waking through the night and less REM (rapid eye movement) sleep contributed to the development of AFib.
It may not be easy to sleep soundly with AFib, however. According to researchers, nearly 75 percent of people with atrial fibrillation also have breathing disorders, such as obstructive sleep apnea (OSA). This common condition causes a person’s airway to become obstructed, or blocked, when they sleep, resulting in less oxygen circulating through the body.
It’s challenging to understand which comes first when discussing AFib and sleeping disorders, especially since they share many risk factors, such as obesity and high blood pressure. But, either way, we know that sleep is essential for heart health, and any deviations can lead to disease.
What triggers AFib during sleep?
While episodes of AFib may be unpredictable, many patients report increased symptoms at night. Sleep apnea and poor sleep can undoubtedly contribute; however, evening eating and drinking habits could also be a problem. Alcohol triggers AFib, so that evening cocktail may be enough to tip the scales. Also, spicy food or a full stomach can set AFib into motion.
There is also an entirely different explanation for nocturnal atrial fibrillation, which has to do with the underlying trigger of your AFib. While not often recognized, there are typically two distinct types of AFib: vagal and adrenergic.
Vagal AFib, which occurs due to issues with the vagus nerve, typically happens after a meal or during rest or sleep. On the other hand, adrenergic AFib occurs due to adrenaline release. Adrenergic AFib often happens during exercise, because of stress, or with stimulants like caffeine. For those experiencing AFib at night, the vagus nerve may be partially to blame.
What are atrial fibrillation symptoms at night?
Symptoms of AFib are the same regardless of the time of day, although you might be more likely to feel symptoms during the night when your body is quiet. When the upper chambers of the heart are not beating in rhythm with the bottom, you may experience:
- Heart palpitations, skipped beats, thumping, a feeling that the heart is out of sync
- Racing or pounding sensation in the heart
- Extreme fatigue
- Shortness of breath
- Dizziness or feeling light-headed
- Pain or discomfort in the chest
- Disorientation or confusion
- Sweating
- Anxiety or panic
Can I prevent AFib at night?
Medical events tend to feel more acute during the dead of night. Therefore, to avoid an AFib episode, steer clear of caffeine, alcohol, and heavy foods close to bedtime. Instead, establish a relaxing evening routine, such as a bath or meditation, to calm your nerves and set the tone for a restful night.
If AFib does wake you up, try to eliminate the problem. First, work on deep breathing or other relaxation techniques. If unsuccessful, attempt to stimulate the vagus nerve with a cold shower or a few jumping jacks. Of course, if you’ve never had AFib before or if you have any health concerns, seek immediate medical care.
What sleep positions are best for AFib?
In your quest for a solid night of sleep, you might be wondering if there is a sleep position that works best for AFib patients. Would it be best to drift away on your back? Would sleeping on your left or right side be more beneficial?
While the research around sleep positions and AFib is minimal, some evidence shows that sleeping on your right side may benefit your heart. A 2018 study examined the effects that various sleep positions had on EKG readings.
The findings revealed that sleeping in the left-lying position caused gravity changes to the heart that could be seen on an EKG. On the other hand, those who slept on their right side had their heart supported by the mediastinum, and researchers noted no electrical changes.
Researchers looked to current AFib patients more recently to determine if nighttime positional changes impacted arrhythmias. They evaluated 94 symptomatic patients and concluded that AFib was triggered more often when lying on the left side.
Fifty-seven percent of the patients experienced AFib symptoms while lying on the left side, compared to only 10 percent lying on the right side. Interestingly, a third of the patients experienced symptoms while lying on their backs. Challenges sleeping on the left side were exacerbated if the patient was overweight.
Since the heart lies on the left side of the chest cavity, it seems logical that sleeping on the left side would create compression and potentially result in a decrease in oxygen flow to the heart. Those experiencing intermittent AFib may want to consider sleeping on their right side.
Avoid back and stomach sleeping
Individuals with sleep apnea should avoid sleeping on their back, especially if overweight, as gravity can cause the tongue and other soft tissue to block the airway. Stomach-sleeping is also a big no-no, as it does not allow your spine to remain in a neutral position, which can create additional health problems down the road.
Keep in mind, however, that every situation is different, and what works for one might not work so well for another. Sleep position is less important than actually getting a good night’s sleep.
Next steps
Poor sleep may give you more than just bags under your eyes. Research has confirmed that quality sleep is essential for health, and skimping out is a surefire way to buy yourself a ticket to heart disease. So turn off your electronics at sundown, set your room temperature a bit cooler, and make sleep a priority. Remember, sleeping on a toxic mattress or sheets will only make your AFib worse. Consider investing in a sustainable, organic mattress from a reputable company such as Avocado.
Bring yourself to optimal health, and sleep position won’t matter.
Eat Well · Live Well · Think Well
Medical Review 2022: Dr. Lauren Lattanza NMD
