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    Elevated Sleeping Heart Rate and Daytime Sleepiness

    I am a 32-year-old male C4/5 complete quad, 13 years post injury. I recently got a Fitbit Charge HR to monitor my activity (not so much steps) and heart rate. I use an RT 300 twice-weekly, stand twice-weekly, and do wrist weights twice-weekly. I always wanted to know how much my heart rate changes!

    Since getting the activity tracker, I have learned that might heart rate goes up when I go to sleep. It's nothing crazy, but it goes from my resting heart rate of ~65 BPM to ~80/90 BPM. As the night goes on, my heart rate slowly trends down. It's fairly linear. It trends down until about noon, even though I wake up at 5:30 AM during the week and 9 AM on the weekend. When I googled this, but they maainly discuss very rapid heart rates (>110 BPM).

    I sleep on my back and think that it's possible that I have sleep apnea. I always feel like I sleep really well at night. I wake up occasionally, but I fall asleep easily. However, in the last couple of years I started having spurts during the day where I'm uncontrollably tired. It's usually when my brain is very active (manipulating spreadsheets at work on my computer, in a meeting where I'm just listening, etc.) Is this worth trying to get a sleep study done?

    #2
    Do you have elevated blood pressure or tiredness, sleepiness during daytime? A sleep study can be done overnight. Your PCP can order it. CWO
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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      #3
      When you sleep, you are lying down. Often, blood pressure drops when you lie down. Sometimes it drops so low that your body has to increase the heart rate to be sure enough blood is moving around your body to supply your organs. Maybe your blood pressure has dropped a little low, for you, when you are sleeping/lying down.

      You could test this yourself, if you have one of the home blood pressure / heart rate cuffs you can buy at Walgreens. You should probably have one of those anyway. Just check your blood pressure while you are sitting comfortably. Then lie down. Wait a minute or two, and check your blood pressure again. See if it drops significantly and if your heart rate goes up.

      It is true that if you are having sleep apnea at night, your heart rate might increase with that. Sleep apnea is pretty common, and is often undertreated.

      You could chat with your primary care doctor about it.

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        #4
        Originally posted by SCI-Nurse View Post
        Do you have elevated blood pressure or tiredness, sleepiness during daytime? A sleep study can be done overnight. Your PCP can order it. CWO
        Yes, I do have daytime sleepiness, but it's inconsistent. It can be either morning or afternoon, but it's always when I'm doing something with low mental stimulation. Are all sleep studies done in a facility? Can they be done at your home?

        hlh, my heart rate increase seems to coincide with the time that I fall asleep. I'm usually laying down for 30-45 minutes before that while I get undressed, stretch, etc. I have a portable unit to check blood pressure, and it's generally very normal while I'm laying down. If anything, it's usually higher while laying down and lower when sitting up.

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          #5
          I'd like to briefly follow up on this old post of mine. I did a home sleep study in January 2016, and confirmed that I have sleep apnea. I did an on-site sleep study in February 2016 to determine my optimal CPAP settings. I've been using a CPAP sense late February, and I could never go back! One night without it isn't totally horrible, but after a couple of days of no CPAP, my extreme fatigue starts to set in.


          For what it's worth, AGI (apnea-hypopnea index) was 90. Which means I was stopping breathing 90 times every hour… Or more than once per minute!

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            #6
            I hope you have the ability to vary your CPAP settings yourself. It's easy to find out how on YouTube. My docs and sleep therapists were clueless. Their direction was always to increase the pressure, but when I got a Philips Respironics BIPAP machine, I found on my own that I had central apnea, not obstructive apnea. It turned out that lower IPAP pressures gave me dramatically better AHI numbers. I also found that a smaller differential between IPAP and EPAP reduced the AHI. With experimenting, I've reduced my AHI from 30+ with their settings to less than 4 with my own choices. I'm not through experimenting and believe that further improvement is likely.

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              #7
              Originally posted by EyesOfTexas View Post
              For what it's worth, AHI (apnea-hypopnea index) was 90. Which means I was stopping breathing 90 times every hour. Or more than once per minute!
              Wow! That's a lot! Do you know what CPAP pressure you are using? And what your AHI is now? My results go to a website every night, so it's easy to check.

              I used CPAP for 6 years with a pressure of 12 cmH2O. It gave me lots more energy, but I was still falling asleep driving. I didn't know about AHI, but my doc finally noticed that it was 15/hour (with CPAP at pressure 12), so he ordered an overnight sleep study. It has really cool results, which I could post for the other geeks here. Anyway, my AHI was 42/hr without CPAP, and they found optimal results at pressure 16, giving AHI =4. So now I use CPAP at pressure 16, and I am unbelievably happy to report that I no longer fall asleep driving! I wouldn't have gone to pressure 16 on my own (if I knew how to reprogram it) because it leaks so easily at higher pressure, and causes red marks on the bridge of my nose. With different mask styles, I think I will solve that eventually. I actually didn't expect that CPAP at pressure 16 would solve the driving problem, when CPAP at 12 didn't, but it really was the answer! The sleep study result shows the effectiveness clear as day.
              "Cherish your tears. If you can cry, you still have some humanity left, and you are reclaiming more of it." -- David Kelly


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                #8
                Everyone will be unique, but here's a summary table of 9 months of my data. My doc and "sleep specialists" consistently recommended higher pressures when my apneas were not under control.

                I hope the table shows that my lowest AHI was with pressures of 011cm and 14cm of H2O. I have two pressures because I use a BIPAP which supplies a lower pressure for exhaling. As dnvrdave mentioned, higher pressures bring the misery of mask leakage, so even if the higher pressures had worked for me, I wouldn't get much sleep because of the leaks. Fortunately, reprogramming how-to videos are easily found on YouTube.



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                  #9
                  If you have an elevated HR at night, I would look at the medications you are taking at bedtime and see if you are experiencing side effects that would cause tachycardia.

                  pbr
                  The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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