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What is the causing extremely rapid heart rate and sweating after waking up?

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I am 42 year old female. Every time I wake up from sleeping, I have an extremely rapid heart rate, am sweating and very irritated. What could be causing this?
Mon, 28 Jan 2013 in Sleep Disorders
Answered by Dr. Jonas Sundarakumar 2 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

From the description of your symptoms, the most likely possibility is a form of disordered sleep arousal called "Sleep Inertia". In this condition, persons can become, groggy, irritable, confused or even agitated when they wake up from sleep. This can be accompanied by signs of autonomic nervous arousal such as palpitations (rapid heart beats), increased sweating, increased blood pressure, etc.

Now a slight degree of grogginess or sleep inertia is found in everyone, but it becomes a disorder, when the symptoms become excessive and disturbing. There is no single or specific cause identified for this problem of disordered sleep arousal, but it has often been associated with two factors:
- poor sleep habits
- stress

Treatment is predominantly by following strict sleep hygiene and by minimizing stress levels. In some cases, where symptoms are severe and don't respond to conservative management, medication may be used. There are certain medication like tricyclic antidepressants, melatonin agonists, etc. which can be effective in regulating sleep.

I would suggest the following sleep hygiene techniques:
- Fix a specific bedtime and an awakening time. Do not allow bedtime and awakening time to drift.
- Avoid napping during the day.
- Avoid coffee, tea or any caffeinated drinks or alcohol 4 hours before bedtime.
- Avoid heavy, spicy, or sugary foods for dinner. Have a gap of at least 1 hour between dinner and bedtime.
- Exercise regularly, preferably in the early evening, at least 4 hours before bedtime.
- Set up a comfortable environment which is dark, quiet and disturbance-free. Block out all distracting noise, and eliminate as much light as possible.
- Practice relaxation techniques before bed. Relaxation techniques such as yoga, XXXXXXX breathing and others may help relieve anxiety and reduce muscle tension.
- Don't take your worries to bed. Leave your worries about studies, work, daily life, etc., behind when you go to bed. Some people find it useful to assign a "worry period" during the evening or late afternoon to deal with these issues.

If these simple sleep techniques don't work, then you have to consult a pyschiatrist in person for a detailed evaluation (which may include a sleep study - "polysomnography") and further treatment.

Wish you all the best.

Dr. Jonas Sundarakumar
Consultant Psychiatrist
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