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Difficulty Falling Asleep at Elevation??

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  • Difficulty Falling Asleep at Elevation??

    Hello all, I have recently developed a somewhat esoteric symptom and am wondering if anyone has experienced anything similar: difficulty falling asleep at altitude. (And if you found any cure.)

    I venture to the mountains every few weeks at about 6500 feet, and for the last several months, on the first night or two, right as I feel like I am falling asleep, I will gasp, or be startled awake. It happens repeatedly and constantly for several hours, preventing me from falling asleep. I usually eventually fall asleep in the early morning hours with the sun coming up, and then I got an OK couple of hours or sleep uninterrupted. The symptom tends to dissipate over several nights at elevation; i.e., by the 3d or 4th night I am doing better. And once I am actually asleep, my sleep seems adequate.

    I assume the mechanism for this is obviously something related to the reduced oxygen levels at elevation, and the improvement over several nights comes from acclimation. The symptom itself seems almost apnea-like. I have been tested twice for apnea (at sea level) and show no signs, but of course I guess I could have "elevation-only" apnea.

    Has anybody experienced something similar, and found anything that works? I did a pretty thorough search on this board just now and folks seem to fall into two camps for how elevation affects their HCM: "doesn't bother me at all" v. a host of symptoms consistent with altitude sickness that affect them constantly.

    My condition seems a bit weird since this sleeplessness is the only symptom I have at elevation.

    Having done several hours of research, my plan is to try to the following, in order, all of which *seem* to be associated with better sleep outcomes at elevation, depending on who is doing the measuring, and which don't seem contra-indicated to HCM or my current meds (12.5 mg metoprolol daily and 2mg melatonin at night to counteract the beta blocker):

    1. 600 mg ibuprofen (some evidence this helps climbers)
    2. Breathe-right nasal strips (seems mostly placebo-like, but what the heck)
    3. Gingko biloba (longtime folk remedy for climbers)
    4. Diamox or temazepam (validated repeatedly in scientific studies to help with altitude sickness, including sleeplessness issues).
    [last resort] 5. oxygen concentrator

    I'll report back what, if anything, works for posterity, but in the meantime, does anyone have any experience with these or other potential cures? Thanks so much.

  • #2
    Hello... I live in Denver, gave HCM and I am an RN. Ican comment on a few things.
    Trying all of those “remedies” at once... I don’t know if you will ever know which one helps you. Falling asleep is not the problem it is the symptom. The issue at altitude is oxygen, fluid volume, and heart. Ibuprophen can cause fluid retention, diamox can relieve some excess fluid.
    Since you seem to be a researcher type, your best information might come from a pulse oximeter with the capability to provide data of your oxygen saturation while you are sleeping. and nighttime oxygen might indeed be the best answer.
    The HCM Heart if thicker and requires more oxygen per heart beat than a normal heart.... put it at altitude with thinner air and it may not be happy. When you lay down to sleep any extra fluid you may have on board returns to the heart and sometimes the lungs
    which can cause you to have more difficulty breathing lying down.
    Try sleeping on some extra pillows or raising the head of your bed on blocks.
    Also check with your HCM cardiologist for advice.
    After years of symptoms:
    Officially Diagnosed HOCM 2006
    Myectomy 3/11/13 at non-COE
    Extended Myectomy 7/23/14
    At Mayo with Dr. Joseph Dearani

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