Sleep on the left side

Has it been up to discussion earlier, if the triggering effect of sleeping on the left side can be a result of pressure on the Sinus Coronary vein
[en.wikipedia.org]
or the Coranary Circumflex artery?

[www.clevelandclinic.org]

Hans indicates 6% survey respondents said that lying on the left side would set off an episode.

This 'pressure' issue might be of concern if the heart also was crammed into the rib cage with gobs of adipose tissue that overcrowded the heart, but the design of the body with the heart inside the rib cage and well protected from external damage or jarring, it doesn't make sense to me that just lying in bed could cause enough pressure to trigger afib.

Otherwise, undue pressure in contact sports like wrestling or football where there is both impact and one or more bodies on top of another crammed onto a hard floor or hard turf would be putting these athletes in afib just from that physical insult.

Remember that two thirds of the heart already lies on the left-of-center-side of the chest so it’s not like when we lie on the left, the heart flops over to a new position. Plus, it’s a compact or tight muscle that is about the size of a closed fist and it's not just dangling in the chest cavity bobbling around loosely. In some cases, perhaps it would be possible for pressure to trigger afib in someone sleeping on the left side but I think it's more to do with what Patrick Chambers, MD said in his Magnesium post in the Conference Room Session 14A [www.afibbers.org]

Some VMAFers (vagally mediated atrial fibrillation) associate their episodes with GERD. Curiously, many of them prefer to sleep on their right side. Vagal tone is increased when lying in the right lateral decubitus position (lying on one's right side)(67). This is because the heart is slightly higher (v. the left side position) relative to the carotid baroreceptor. This pressure receptor in the neck senses more hydrostatic pressure and signals the vagus nerve to increase tone (bad for a VMAFer). However, the preference may be because and this position promotes gastric emptying and possible relief for a GERDer.

Further, there is evidence to suggest that in cases of mitral valve prolapse (MVP), symptoms of irregular heart beat and palpitations are more prevalent when lying on the left side.

It would be interesting to know how many people who are intolerant of left-side sleeping also have some degree of MVP or in the case of PC's contribution, GERD.

I’ll signify that I had a trivial amount of MVP that was clinically insignificant, but was unable to tolerate left-side sleeping without going into afib.

Jackie

Hi Gunnar,

Many cardiologists opine -for normal people at least- that the position in which you sleep has no impact on health. And that may be true for 'normal people', ie, people with no overt cardiac or vascular disorder. But note the excerpt below from this classic work on angina:

[www2.umdnj.edu]

Pectoris Dolor [Angina]

published in:
Commentaries on the History and Cure of Diseases
By William Heberden, MD
London (1802)
reprinted from:
Heberden W. Some account of a disorder of the breast.
Medical Transactions 2, 59-67 (1772) London: Royal College of Physicians.

Writing in respect of angina Dr Heberden said:

'After it has continued a year or more, it will not cease so instantaneously upon standing still; and it will come on not only when the persons are walking, but when they are lying down, especially if they lie on their left side, and oblige them to rise up out of their beds.'

Hi Mako,
that is very interesting, Doesn't that verify that there is some special load on the heart, when on the left side.

According to my last echo I have no signs of MVP.
I do not have any GERD symptoms.

Laying on the left side is not a problem all the time. After an attack of AF the left position is not a problem for several days, but will be so when it is time for AF. The same is true with alcohol. For a some of days after AF I can have a couple of glassed of wine in connection with food, otherwise a glass of wine is enough.

Last New Years I had 2 glasses of champagne, which has not happened for several years. I then took 40 mg of Sotalol first and that made that experience possible.