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[tired lady]

I haven't been on the forum for a while because I was hoping my terrible sleep problem would go away but sadly it hasn't and I'm in need of some reassurance and advice as to what is happening to me.

My problems started when I turned 39 when I woke up suddenly one night with my heart pounding, had a panic attack because I thought I was having a heart attack and then it started to happen night after night and I also started getting nightmares and waking up sweating.  I went to the doctors over and over again with the frightening symptoms and eventually had some heart tests which showed my heart was normal but was reacting to adrenalin at night which was making it pound.  I also developed severe anxiety and agoraphobia and had panic attacks day and night.  I had some telephone CBT which helped a bit with the panic attacks during the day but at night it is a different story, I don't seem to have any control over what is happening to me.

I am now 43 (44 in June) and I am waking up every single night with either terrible nightmares, my heart pounding/racing or the thing I hate most, I wake up suddenly in a complete fright with a feeling of utter dread and my heart pounds really hard.  I also get a completely dry mouth and occasionally feel very hot.  The nightmares are dreadful and sometimes have about 3 a night and some of them a recurring dreams.  They always start off benign and then end very badly and then I wake up and my heart is going bonkers.  I have learnt to relax when I wake up rather than ending up with a full blown panic attack but it is really difficult and I'm always scared of getting a heart attack because my heart has been going bonkers every night for 5 years!

Last summer I went back to my GP and mentioned whether I could be in perimenopause and I had another hormone test which came back normal but she said that it didn't mean I wasn't in perimenopause because it is difficult to catch it at first.  She perscribed me some beta blockers which I tried only once because they made me feel absolutely dreadful the next day and I didn't have the energy to do everything I needed to do (I'm a carer for my son who has M.E.)  However, they did stop my heart pounding at night although I still had the anxiety and if anything my heart not pounding along with it intensified the anxiety!  I haven't been back to the doctors again yet, I'm just trying to get through it at the moment.

I would be most grateful for any help and advice on what on earth is happening to me, I feel absolutely dreadful due to the broken nights.  I have been feeling a bit depressed too because I dread going to bed and the sleep deprivation is really getting to me.  The nightmares are sometimes so bad that I think about them during the day and they are starting to affect me psychologically.  I have a really bad recurring one about a room full of massive spiders and spider webs and I can't escape and then of course I wake up and my heart is going bonkers again.  I am wondering whether the nightmares are my body's way of waking me up because it has detected something wrong - my body being too hot maybe?

I've also had other symptoms - feeling hot all the time and having to open windows, bladder weakness, anxiety, feelings of dread, feeling depressed, the odd hot flush after eating and missed heart beats which I absolutely hate. I don't feel myself anymore and my husband is worried about me. 

I'm so sorry for the essay but I was just wondering whether anyone else has had similar symptoms at night during perimenopause and was there anything that helped?  Are my adrenalin rushes my form of night sweat but without the sweating?  Many thanks in advance, tired lady

[jedigirl]

Hi tired lady,
No wonder you are tired! Bless you, the nightmares sound awful.
Last summer I had a long spell of waking a few times a night with my heart feeling like it was coming out of my chest. I would have to sit up and breathe calmly through it till my heart calmed. The doc thought it was surges of adrenaline causing palpitations.
I started hrt last September and  don't have them now.
Your symptoms certainly sound typical of menopause whether your results show it or not.
Why don't you try some guided meditation before sleeping? There are free apps on google play store. Maybe chatting with a counsellor would help you to gain some strategies for dealing with those nightmares?

Hugs to you, x

[CLKD]

Nightmares: I could write a book  .  My phobia gave me nightmares so I was never free from the worry of it.  Is it the same dream each time?  I did ……… I got so that I DREADED going to sleep ……… >sigh<

You may find that the nightmares wake you.  You may be waking too because your body is warming up to a flush.  A real sudden combination which can cause immediate anxiety.

Betablockas can cause agitation, however there are other types on the market.  I use Rescue Remedy mouth spray as a back up.  Relaxation therapy is important, I use music too - for years I had the radio by the bed on low ….. which helped focus my mind when I couldn't sleep.

Do go back to your GP.  Another BB might help, the idea is to calm the heart rate.  She may be able to refer you to therapy.  Do you get support for your son?

[Night_Owl]

Oh TiredLady, I do feel for you, it's ghastly isn't it - I agree, the symptoms definitely sound like peri-menopausal.  I have experienced all you've described - and still do, but to a lesser extent.

The adrenaline surges at night are due to fluctuating or low estrogen.

Vaso-motor symptoms (adrenaline surges)
These are commonly known as hot flushes and night sweats as the blood vessels dilate, but also the heart rate increases (palpitations) and body temperature control becomes erratic.  Palpitations may be associated with panic feelings due to the increased adrenaline drive.  If these occur whilst asleep then deep sleep will be interrupted and the individual will sleep lightly or badly all night waking feeling unrefreshed and exhausted and may report vivid dreams due to remaining in a state of semi-wakeful, restless dreaming sleep or REM sleep (rapid eye movement sleep REM) rather than going through the normal cycle of light (REM) sleep and deep (non-REM) non-dreaming sleep.


http://www.thesurreyparkclinic.co.uk/hormones-and-menopause.php

I'd definitely go back to GP (one who knows something about meno, many do not) - or maybe the Practice Nurse, have bloods taken again.

A brisk daily walk of at least half an hour or swimming, Night Rescue Remedy, Magnesium Taurate supplements at night may help a tad - HRT often is the only real answer though.  Often I find that nightmares can be worse if I've eaten heavy during the evening.

Good luck, let us know how you get on.


Night_Owl
x

[Hurdity]

Sorry to hear about your sleep problems tiredlady. As a matter of interest what are your periods doing? Unfortunately some women experience symptoms of menopause well before anything happens to periods but if they are still regular it must be a signal that oestrogen levels are starting to decline so perhaps a low dose HRT would be helpful at this point?

Hurdity x

[PoF]

   So sorry for you Tired Lady.  Check out my post of a few weeks back ''adrenaline surges, palpitations, general panic'' (on screen three I think of this message board).

I am EXACTLY the same as you, and I know for me it is perimenopausal.   I have premature ovarian failure / early menopause (am now 45 turning 46 in August).
I totally understand what you are feeling - esp the panic in response to the racing heart.   You now doubt feel the beats, get very upset about it - as anyone would - and then your body goes into full panic mode, and then of course when all is over you totally dread the next episode, because they are horrible.   I really do sympathise as I have had that quite a bit in the last few months.

Although there are indeed lots of causes, one common explanation is menopausal symptoms.   We tend to panic I think because every one often thinks 'night sweats and hot flushes' are the only things to expect.   But the fluttery heart is indeed a nasty symptom and is the body's response to the hormone fluctuations.  Funnily enough I got this a lot before Christmas, when I first posted on this forum.   The episodes have not been too bad in the last 3 weeks  BUT, last night I had another episode where I woke up during a nightmare, heart absolutely pounding.   When that first started happening, I would go into full 100% panic mode, and get a panic attack on top of that. I would then  constantly worry about another attack, absolutely all the time and it was always on my mind.   

However, after a lot of thought and research, I have now tried to at least stop the panic that comes on top of the adrenaline surges.   I get up, get something to fan myself with, open the curtains, turn on the light if it helps, pace around a little bit and just concentrate on fanning myself.   The action of the fan is I admit a bit silly, but it helps as a distraction technique.  I say 'this is going to stop soon' - I try NOT to say 'oh my goodness, what is this, it should not be happening, I am really really ill, I am going to die etc etc' and I try not to let my thoughts race.   This is hard to do I admit, but if you can stop the  extra panic on top of the heart pounding, it does go away sooner.

It is indeed, I believe, a result of 'vasomotor symptoms'. Everyone always thinks flushes and flashes and heat with vasomotor symptoms, but these adrenalin rushes are ALSO part of it all as well.  Heat may well be felt, as will chills afterwards for some women. It's so worrying because we are cruelly awoken from slumber, and that feels extremely unpleasant when it comes out of the blue.   

The trick is to try as hard as you can to just 'ride it out' and NOT add layers of pure panic on top of it if you can because that takes the fast heartbeat and merely stokes the whole thing and it's like adding petrol to a fire! I know this is hard, but it will lessen the unpleasantness if you can do that.  I have started thinking of my surges as hot flashes without the heat.  Last night for me this did work.   I awoke from a horrible nightmare to find my heart pounding like crazy.   I was able to recognise this familiar symptom, and I realised I had a choice.   I could go into full blown panic mode like I often have in the past, or I could try to get up, pick up a book, toothbrush, go to the loo, comb my hair, find my slippers ... do ANYTHING to pass the minutes of time while the beats calmed down. Obviously yes I still had the attack, but the layer of blind panic did not develop and so the attack seemed very short.   

I don't want to sound smug - obviously if given the choice I would not want to go through this at all.   But all I say to you is, 'yes, I know what it's like and it's  !!

[PoF]

http://www.thesurreyparkclinic.co.uk/hormones-and-menopause.php

I also looked at this website someone quoted above, and it's good.   I got myself an oestrogen test at the clinic (only £45 which I felt was worth it).

Day three FSH tests (follicle stimulating hormone) need to be taken over several months, as with just one reading it would be possible to get a 'normal' reading that suggests you are not necessarily menopausal, when if you took another one two months later, and then two months later again, you might get a less good reading which would suggest menopause (ie a raised level).   They are not definitive tests for menopause.  Any local fertility clinic would give you an FSH test if you wanted to pay and wanted to know what the level was (raised level > 8 could point to the transition towards menopause).   So that is why things get confusing. Perimenopause can take years and years, as things fluctuate and the body winds down from fertility and approaches the post menopausal state. It's not always an easy journey for everyone and 'the change' can be a real issue for some ladies like ourselves!  It doesn't necessarily happen overnight unfortunately. 

Adrenaline surges are a response to hormone fluctuations; horribly unpleasant, but supposedly 'harmless'.  But I agree, the issue is the associated panic and fear, and the terrible worries about when the next attack will come.   

[tired lady]

Thanks you so much ladies for all your help and advice, I really appreciate it!   It certainly seems I am not alone in my night time adrenaline rushes.  It has all just come as a shock to the system, I thought I would just get night sweats not this it is just awful and exhausting and I'm worried about the affect it is having on my body and my heart.

It is a shame that I don't really know what is going on with my periods because I'm on the Cerazette mini pill so most of my bleeding is just breakthrough bleeding and it is all over the place.  I do get the odd proper period but there is no pattern to them at all.  I would like to try something else so I can see what my natural cycle is doing but I find this pill really works for me and I'm not sure what to change to.  I don't want anymore children but I can't face going the whole hog and having a sterilization!

I had an absolutely awful night last night, terrible insomnia and then when I finally got to sleep I had 2 nightmares and woke up with my heart going bonkers!  I feel absolutely wretched today.

Pof, I'm so sorry to hear that you are going through a tough time with this too, it is just so hard to deal with isn't it. Thanks for posting the links, I will have a good read of those. I haven't had a good night's sleep for over 4 years now and I dread the thought of it carrying on for another 5 - 10 years until my periods stop completely.  I am not enjoying my 40's at all, I have never felt so awful in my life! 

I am just a bit worried about taking any form of HRT because I have mild health anxiety and worry about the blood clot risk.  I also suffer from really bad migraines (just had a 2 day one) and I remember the doctor saying something about migraines being a contraindication for taking HRT.  I just don't know what to do.  I once tried Menopace Night for a bit and felt a bit better so I might try that again.

I am just concerned that the adrenaline rushes are bad for my heart because it pounds so hard when I get them and I've also ended up with a heart health anxiety because of all the awful heart palps I've had.  Oh what a mess:(

Thanks so much again everyone for your kind words and advice, it has made me feel a lot better

[CLKD]

I don't think that the heart 'suffers' from the sudden adrenaline surge.  It's the suddenness of it in the night when 1 is fast asleep, waking suddenly always makes me queasy and shaky. 

Are the nightmares always in the same vein?

[PoF]

I agree about the heart not 'suffering' when the adrenaline surges. 

think about it - it's a totally NATURAL response because your body is totally designed to respond to adrenalin; it's a built in safety mechanism that was designed millions of years to keep us safe.   PLus, even though it probably feels like it's about to burst through your chest (I know what you mean) that's just a perception of your mind and an interpretation.   I totally get what you mean though - same thoughts go through my mind.    But if you recover after a few mins, and there is no prolonged very bad pain, or prolonged worsening breathlessness etc then you are not having a heart attack and it's merely a normal, natural response.

the reason why it is SO frightening is because it COMES OUT OF THE BLUE!!!  Normally when we get adrenaline rushes, we KNOW why we got them because there was some terrible danger we can see .   Thus, it is equally nasty, but we can see the threat so we understand why we feel that way. Our menopausal panics seem to come out of the blue, because we can't see what our hormones are doing.

it's possible your panic comes from the fact that these come out of the blue -in sleep, which is doubly annoying - and you are wrenched from seeming peace and quiet and it feels very surprising and weird!!  I know - they are particularly unpleasant aren't they.  But I understand your irrational fears - I thought the exact same thing. 

Does it help much to know that millions of women, since the beginning of time, have experienced menopause and lived to tell the tale?  I suppose it does not - but that's what I tell myself.   Palpitations and adrenaline surges are a menopausal thing, and they can not 'kill' you  - they are just responses to change in the body.

having said all that, I too get all the same jitters and worries but I continue to tell myself keep plodding on, one foot at a time.   

[CLKD]

Things are worse in the early hours ………..

[honorsmum]

I'm new to the forum, and joined precisely because I'm going through exactly what you describe.
My heart has started racing at odd times. At first, it was in the daytime when I was relaxing - lying on the sofa or in the bath. Then it started to wake me up at night - I'd be dreaming and suddenly, I'd wake up with my heart pounding, shallow breathing, hot, frightened.
At its worst, it happens several times a night and after the last time at 5am (that seems to be a regular time), I am then awake until it's time to get up, with it still thumping and my thoughts racing - awful.

When it first started happening, I saw a GP to get it checked out. She ordered an ECG, which showed tachycardia so she referred me to cardiology. I had tests last week, which included an ECHO scan, ECG, and 24 hour monitor. I've had blood tests and tried to discuss he idea of perimenopause with my GP (I'm 45) but she has dismissed it and is trying to insist I have an a anxiety disorder.
My periods are all over the place - anywhere between 21 and 28 days -my hair has gone dry and is suddenly greying at the temples, my skin has got very dry, I can't sleep, I'm having bouts of low blood sugar at night (which makes the palpitations even worse), I have mood swings, terrible fatigue, night sweats, the odd hot flush...and yet my GP is now testing me for a rare adrenal tumour, rather than considering peri!

What has helped with the palpitations is mindful meditation, Self Help for Your Nerves by Claire Weekes, peppermint tea at bedtime, lavender baths, Night Remedy, drinking plenty of water, and magnesium tablets/sprays/baths (Epsom salts). I also walk my dogs every day and get to bed by 10.30pm.
I am pretty sure my heart tests will show a normal, healthy but excitable heart (I've just come back from a weekend of walking/claiming the Black Mountains and although my heart was pounding at times, it didn't suffer!), So I try not to panic when it starts going bonkers - not easy! I feel for you - I gave days when I think I will go insane if I can't sleep through just one night.

[Millykin]

I'm 44 and this time last year was going through the same as you. I've heart health anxiety now because of it. I was diagnosed peri meno few months before that all happened. It used to start late at night, would feel my heart jump then pound rapidly for up to an hour and then would be left feeling cold and shaky. Trip to AE 3 times! Had checks, monitors and just showed palpitations and few extra beats. Docs say anxiety I say hormones! It is really frightening but it happens to loads of women our age. I started HRT in April and it has calmed things down, before that I was on cerrazette and had headaches but now I barely get one if I do its not as bad and lasts half the time. I do still get odd heart feeling but not as bad or long and I think you learn to control it or go with it and it passes. Hope you feel better soon x

Honorsmum
Is that the 24hr urine test thing for adrenal tumour?
X

[honorsmum]

Millykin - yes, 24 hour urine collection for VMAs.
I broached the subject of adrenal fatigue with my GP, but she apparently puts it in the same bracket as CFS, M.E, thyroid problems - "a dumping ground for people whose blood tests don't reveal anything, but who can't accept a diagnosis of anxiety." 

Because a FSH test in October was normal,seemingly my symptoms can't be hormonal... Before I had the blood test, my GP said that if they showed menopause, we'd have to have "a serious talk about HRT", which made it sound like she only considered it as a last resort. She even told me to stop taking St John's Wort.

[Millykin]

Honorsmum
I had that test too. Seems we had same symptoms only my bloods showed peri meno but GP said I had anxiety as well after other tests ruled out anything serious. I just don't get why GPs won't accept these other symptoms as peri meno when so many ladies suffer from them. I mean how many ladies out there get to a certain age and start suffering all these things? It's got to be hormones if other tests are normal. GPs should also know FSH tests can be unreliable too, more should take the physical and mental symptoms of someone even if in our 40s as a good sign it's peri meno
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