Can rapid awakening pulse be caused by vivid dreams or gerd?

[old dude]

I had an incident a couple of nights ago when I awakened abruptly around 5:00 am with my heart pounding and I was breathing fairly heavily. I couldn't check it at the time, but from experience I'd guess around 140 bpm or more. It calmed down pretty much in a few minutes but I was too wired to go back to sleep. Interestingly, my AHI for the night more than tripled from an average around 0.5 to 1.8. The entire 1.8 was hypopneas, not OAs. I'm of course not complaining about a 1.8 but mention it only as a possible clue as to what was up. My RERA number for the night was very high at almost 8.

Two things come to mind. One, I was in the middle of a very vivid dream. Not a nightmare per se, but I was having a somewhat contentious discussion with some government bureaucrat. Could a very vivid dream possibly be causative of this episode?

Secondly, what about gerd/reflux? I foolishly had a small-ish helping of chili a couple hours before bed, and I remember feeling a small amount in my throat upon awakening. It wasn't getting into my lungs or anything, I thought I just sensed something there. I'm not quite sure how gerd/reflux might cause awakening with a rapid pulse, but I'm trying to think of all variables.

Thanks for your thoughts.

[BlackSpinner]

For many people REM sleep causes many more apneas then regular sleep, probably due to the sleep paralysis that keeps you from acting out your action/adventure dream and killing your spouse.

Gerd is also related to having events. So maybe the chilli combined to give you more vivid dreams which trigger more apneas and gerd?

[chunkyfrog]

For me, cpap stopped these awakenings.
There could be other causes. (including heart disease)
See a doctor.

[Julie]

Even some noise outside of your house could have awoken you if it was sharp, though I'd be more inclined to go with the chili... but the anxiety of your dream (however long it seemed) might have been a response to a long apnea in REM, though tracing the cause of any at this point is... pointless. I wouldn't necessarily call your MD yet, but wait and see if you have any repeats, or daytime problems. Bedding could have temp. blocked the CO2 vent, anything could be responsible and these things happen to people who aren't on Cpap and don't have any 'conditions' otherwise.

[hegel]

140 bpm is very high. When this has happened to me, I'm in full fledged atrial fibrillation.

From what I've read, gerd can result in afib (or possibly in your case higher bpm)--can't remember the causality right now (I'm at work) but I think it has to do with affecting the vagal nerve. I'm not sure if 'one off' cases of indigestion can cause these problems. I seem to remember that a hernia is usually involved.

The video that Respironics has on their web site explaining how apnea can cause your heart to wildly lower and then increase its activity is telling. Also, apparently sometimes a sleeper gets a shot of adrenaline when becoming aroused from sleep and gasping for air--more heart pounding. Maybe your body responded to an apnea event with a shot of "danger!" adrenaline? (I understand that your ahi numbers are so low that this may seem unlikely.) I'm just guessing.

But again, 140 is a really high number. How long did it take for your heart to calm down? That would have been one heck of a dream!

[jamiswolf]

Old Dude,
A long, deep central apnea can do that to you also. Used to happen to me regularly. An oximeter reading can reveal whether that may be the case.
J

[old dude]

Old Dude,
A long, deep central apnea can do that to you also. Used to happen to me regularly. An oximeter reading can reveal whether that may be the case.
J

Good thought, but on this particular night no CA events were score. Just a few hypopneas.

[old dude]

140 bpm is very high. When this has happened to me, I'm in full fledged atrial fibrillation.

From what I've read, gerd can result in afib (or possibly in your case higher bpm)--can't remember the causality right now (I'm at work) but I think it has to do with affecting the vagal nerve. I'm not sure if 'one off' cases of indigestion can cause these problems. I seem to remember that a hernia is usually involved.

The video that Respironics has on their web site explaining how apnea can cause your heart to wildly lower and then increase its activity is telling. Also, apparently sometimes a sleeper gets a shot of adrenaline when becoming aroused from sleep and gasping for air--more heart pounding. Maybe your body responded to an apnea event with a shot of "danger!" adrenaline? (I understand that your ahi numbers are so low that this may seem unlikely.) I'm just guessing.

But again, 140 is a really high number. How long did it take for your heart to calm down? That would have been one heck of a dream!

I didn't mention it in my OP, not wanting to confuse the issue but I am indeed an atrial flutter patient. It took a cardioversion to reverse mine, but when it was present 140 bpm was nothing. 185-190 was not unusual. Given that my A-flutter wasn't paroxysmal I don't think that was the problem on this night. It likely wouldn't have normalized in a few minutes, if at all.

I appreciate your mention of the gerd-vagal nerve thing; I intend to investigate that. I'll also look into the Respironics video you mention, as that too seems plausible.

[jamiswolf]

Old Dude wrote: Good thought, but on this particular night no CA events were score. Just a few hypopneas.

Dude,
You have more faith in machine data then I do. I prefer to trust my body.

If you have an oximeter, just keep it by your bedside, and if this sort of thing occurs again...just do a one time O2 reading. It'll still be low if it's related to an apnea.
J

[archangle]

Don't get CPAP blindness. Not all medical problems are caused by CPAP/apnea. We PAPers are subject to all the same medical problems that non apneacs are.

Don't neglect the possibility it's totally unrelated to apnea.

[old dude]

Don't get CPAP blindness. Not all medical problems are caused by CPAP/apnea. We PAPers are subject to all the same medical problems that non apneacs are.

Don't neglect the possibility it's totally unrelated to apnea.

Actually, that's kinda what I was thinking. Neither of the two possibilities I mentioned, i.e., vivid dreaming and gerd are directly related to PAP therapy in this instance.

[Janknitz]

How's your fasting blood sugar? People who experience the "dawn phenomenon" which is a rapid rise in blood sugar just before waking also get a surge of adrenalin. If your fasting blood sugar runs high, that may be another cause.

[CarpeNoctum]

Old Dude,
And while I'm sure you're aware of this, but just to provide the info for readers. Atrial flutter, PAT and other atrial arrythmias are irregular while a rapid pulse from an adrenal surge or central apnea would be rapid but regular.
CN

[jnk]

. . . I was in the middle of a very vivid dream. Not a nightmare per se, but I was having a somewhat contentious discussion with some government bureaucrat. . . .

That meets my definition of "nightmare."

Just sayin'.

Anything can happen once or twice for any number of reasons. Such an event without the context of medical history, family history, and direct observation may or may not have significance.

Your body may have noticed something about your state at that moment that made the body think there was a reason to pump some panic-juice into you at that instant. Your body may have been right. Your body may have been wrong. If the body THOUGHT you were having an obstructive event, for example, even if you weren't, the body/brain is fully capable of hitting the panic button to get you from sleep to fight-or-flight. If the dream changed your breathing, your body may have overreacted. May.

But it happens for reasons completely unrelated to sleep-breathing, so any deeper meaning might only be found in an interaction with your doc if the "problem" happens often and disturbs you significantly.

In my opinion as nobody medical.

[old dude]

How's your fasting blood sugar? People who experience the "dawn phenomenon" which is a rapid rise in blood sugar just before waking also get a surge of adrenalin. If your fasting blood sugar runs high, that may be another cause.

That's also a very good thought, especially given that I am a Type II diabetic and do indeed suffer from the dawn phenomenon (as well as gluconeogensis). And as such, my fasting BS is always the highest of the day. But that's true every day, and this was only one instance so I'm assuming it had to be some other variable.

Whatever it was, I'd just like to try to avoid it again if possible.