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What Causes Sudden Increase In Anxiety And Blood Pressure While Sleeping?

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Posted on Tue, 29 Mar 2016
Question: I'm been treated for anxiety disorder after my first serious panic attack (heart attack was suspected) with b/p 210. First 2 weeks had 140-205, then, after cardiology showed that the heart is fine, I was referred to psychotherapy. 5 weeks getting sertraline, 50mg + CBT. My family doctor (and walk-in clinic doctors) think that the cause (of everything including b/p) is anxiety. However I strongly believe that it's my endocrine system which plays games with me: I'm been awaken around 3- 5 times each night (for the last 5 days, even after I'm getting sertraline for 1 month, which made me pretty calm), with huge amount of adrenaline from nowhere: wet hands, wet feet, chaotic/shortness of breath, uncomfortable around heart (muscles or arteries), feeling every muscle in legs, they want to run, and I feel like I never slept. Although just a few seconds ago I had been in a completely relaxed state, seeing nice relaxing dreams. Starts 5:30, once started 2:30AM. Then (since I'm on sertraline and CBT), after the first flash I'm able to deal with it mentally, doing deep breathing, forcing legs to relax, not even to move. I fall asleep sometimes. In one hour the same repeats. After 6:30 I'm not able to fell asleep again. Then b/p gradually goes up (I feel it) but I do not take measurement, like was advised (they think it causes more worries). My mind was for sure not busy with thoughts before the adrenaline flash, I was completely relaxed.
My physician checked blood, and said that thyroid, electrolyte and [something else, I didn't understand in my blood ] are checked and OK, and my liver is OK, and he thinks it is pure panic attacks. He said nobody knows where they come from. Another doctor (specialist, psychiatry) is treating me for social anxiety and anxiety.
But nobody checked or explained to me: why it comes so sudden, during nights, and when I'm for sure not anxious and even unconscious. And after few weeks of relaxed state on sertraline.
I think it might be a tumor, like pheochromocytoma or else. And it seems they miss it. This may add to my anxiety.
Is it possible that my unconscious in the very calm state (during deep relaxing dreams) is able to flash so much adrenaline during the nights from some hidden worries/anxiety? (what doctors think) Or it is impossible, they miss the real cause, and it is purely endocrinal system and some gland, flashing chemistry into my blood during the nights? And the anxiety comes later as a consequence. (this is what I believe).
My doctor does not send me to a endocrinologist or neurophysiologyst for some reason. Am I wrong with my thoughts? Any advice will be appreciated.
doctor
Answered by Dr. Dr. Rakhi Tayal (29 minutes later)
Brief Answer:
Do take a second opinion from an endocrinologist.

Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
A sudden increase in anxiety and blood pressure while sleeping is worrisome. You are already taking sertraline to calm your mind. The panic attacks can be sudden and can be triggered during sleep. But an organic cause like pheochromocytoma needs to be ruled out after detailed investigations. It is best to take a second opinion from and endocrinologist before assuming the cause to be purely psychological.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Rakhi Tayal (7 minutes later)
If tests should I request from my family doctor before my visit to endocrinologist (it's a policy in XXXXXXX that all tests should be done before a specialist visit)? If it's a blood test - which parameters should be checked?
doctor
Answered by Dr. Dr. Rakhi Tayal (3 hours later)
Brief Answer:
Blood test mentioned below.

Detailed Answer:
Hello.
Thanks for writing again.
You can request for plasma metanephrine levels and 24- hour urinary catecholamines and metanephrines.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. Rakhi Tayal

OBGYN

Practicing since :2001

Answered : 14041 Questions

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What Causes Sudden Increase In Anxiety And Blood Pressure While Sleeping?

Brief Answer: Do take a second opinion from an endocrinologist. Detailed Answer: Hello, Thanks for trusting us with your health concern. A sudden increase in anxiety and blood pressure while sleeping is worrisome. You are already taking sertraline to calm your mind. The panic attacks can be sudden and can be triggered during sleep. But an organic cause like pheochromocytoma needs to be ruled out after detailed investigations. It is best to take a second opinion from and endocrinologist before assuming the cause to be purely psychological. Please feel free to discuss further. I will be glad to answer the follow up queries that you have. Wishing you good health. Regards. Dr. Rakhi Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal