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Difficulty in sleeping post CABG - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Good Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
User :   Re: Fighting lung congestion after a CABG (coronary artery bypass grafting)?I have a similar problem though I am home.I am taking spirometry exercises but my main concern is that I am having difficulty sleeping due to shortness of breath. I have had fluid removed and tho there is some residual fluid, the Drs say I'm progressing. But I can't sleep. Ambiend causes depression. How can I get some sleep?2 D Echo and heart funnctions are good. Any time table on this.? I am a strong 81.

Doctor :   Hi
Doctor :  
Let me read it
Doctor :  
Your age is 81 if I am not wrong
User :   Yes, I forgot to mention that I had Mitral valve repair and a artery bypass.
Doctor :   Great, and you are strong that is still greater

Doctor :  
Since how long have you had the problem with your sleep?
User :   But I can't sleep because ps shortness of breath
Doctor :   Ok

Doctor :  
Now shortness of breath, is it mainly during night or present during day as well
User :   oFF AND N ALL DAY what can i DO OR TAKE AND HOW LONG WILL THIS GO ON NORMALLY
Doctor :   Ok

Doctor :  
Now shortness of breath is mainly when your heart is not capable of bearing the stress
Doctor :  
Does this occur at rest or on exertion or lying down?
User :   Mostly on lying down. I am ambulatory at home.
Doctor :  
Ok
Doctor :  
and it also happens on working or exerting yourself, right?
User :   Not really. the Main problem is unable to sleep because of breath.
Doctor :   Ok

Doctor :  
This is called as Paroxysomal Nocturnal Dyspnoea if you are aware
Doctor :   The cause of these symptoms is a sudden build-up of fluid in the lungs.

User :   I know. But what can I take or do?
Doctor :   This is a result of a cardiac strain
Doctor :  
and this itself is not a disease
Doctor :  
the treatment options available are diuretic therapy
Doctor :  
along with anti hypertensive medications
User :   What is your advice? I am taking diuretics. Anything else? How long> What is the prognosis?
Doctor :   The dosage should be increased or else another diuretic needs to be added

Doctor :  
but should be done only on Prescription by your cardiologist
Doctor :  
along with that there is other medications like Digoxin and ACE inhibhitors
Doctor :  
which you can discuss with your treating doctor
User :   I have a good Dr. In general, how long will this take and how can I sleep?
Doctor :   One tip which you need to follow is avoid a heavy meal at night
Doctor :  
this will happen as the body responds to medications
User :   Anything else?
Doctor :  
Take your food 2 hours before going to bed
Doctor :  
Do minor exercises which your doctor has permitted
Doctor :  
Do not take caffein, chocolates, during evening
Doctor :   hours

User :   What do I do about being unable to sleep?
Doctor :   the main reason is dyspnea

Doctor :  
which has to come down
Doctor :  
with the heart medications
Doctor :  
Sleep upright in chair(special chairs)
User :   What medications?
Doctor :  
where your legs rest and the upper body is not down
Doctor :  
Medications the normal heart ones which I mentioned you before
Doctor :  
those are the key
Doctor :  
Are you getting it?
User :   I treied that but no sleep
Doctor :   Ok

Doctor :  
You should ask your cardiologist/surgeon to alter the medications in terms of dosage
Doctor :  
or add another one
User :   How about massage?
Doctor :  
because it is quite important to stop that nocturnal dyspnoea
Doctor :  
Massage is for psychological relaxation
Doctor :  
and you should not opt for that without consent from your treating doctor
User :   Ok I'm offf
Doctor :  
because massage can increase the strain on heart
Doctor :  
Are you there?
User :   Yes, I have mild back and feet massage [and head]
Doctor :   Ok

Doctor :  
because that triggers the circulationa
Doctor :  
and comparatively more cardiac activity
Doctor :  
just like an exercise you can compare to
Doctor :  
Feet massage is fine
Doctor :   as it has a very relaxing effect
User :   How about a light back rub?
Doctor :  
You wont get much help from these supportive treatments
Doctor :  
The most important thing you need to do is to approach the doctor once again
User :   Sometimes it puts me to sleep for a while
Doctor :   Yes, but again you would be wakened by breath issue

User :   So there is nothing I can do about the breath issue except don't recline.
Doctor :   once the shortness of breath is resolved, you can get more relaxation from these treatments and better sleep

Doctor :   From your side, yes that is the thing

Doctor :  
Do you smoke?
User :   Off hand how long will this last under normal conditions?
Doctor :   3-4 weeks

User :   OK Thanks. Signing off
Doctor :   Please fill the feedback form say done when done.

User :   done
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please refer your friends to our service.
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