Is there any relationship between sleeping position and an episode of atrial fibrillation? And, which would the best sleeping position be for a vagal afibber?

Sleeping on your left side is a known trigger for many.

Enrique,

You might be interested in reading a discussion which took place in our Conference Room (Session 36) regarding positional triggers for afib. You can find it at [www.afibbers.org].

Hans

Enrique,
As George and Hans indicated, its very common for Afibbers to have problems laying or sleeping on their left side. It is less common, but does happen that some have a similar issue with being triggered into AFIB lying on their right side, but by far its the left side that is most often a trigger.

The conference room reference from Hans above has a long discussion of this issue.

Shannon

Enrique - you'll note in the referenced Conference Room topic, the discussion mentions gastric emptying.

One thing afibbers need to remember is not to eat or drink liquid (other than water) and then lie down to sleep. At least two hours should lapse before lying down. The emptying of the stomach is explained in that CR session and it's important to keep in mind that gastric congestion irritates the vagus nerve and can then be an initiator or culprit in bringing on PACs or AF.

Another preventive in addition to the right side sleeping is to elevate your head and neck so you are on an incline which helps prevent heartburn or GERD if prone to that as well.

Not everyone responds the same way, but many of us found that right-side sleeping helped eliminate the nocturnal AF tendency.

Jackie

One other thing to be aware of is nocturnal hypoglycemia. This can happen around 3 AM and can trigger afib. Symptoms can include waking up hot, sweaty or with a racing heart rate. This may have be an contributor to my afib and I didn't correlate the symptoms for a long time. It hasn't happened since switching to a low carb/high fat diet 5+ years ago. I never (to my knowledge) had hypoglycemia symptoms during the day.

Good you mentioned this, George. With your current high protein diet, I'm sure you don't experience hypoglycemia.

Hypoglycemia was definitely a trigger for me in the very early onset of AF. Started first during the day when I ran low on 'fuel' and didn't eat enough protein with my lunch on clinic days where there was no time between patients to stop for a preventive snack. Once I learned what caused the shaky, sweaty, rapid pulse, etc... my directives were to eat small frequent protein and healthy fat snacks (and avoid starchy, sugary carbs) to prevent the low glucose swings which were rooted in adrenal dysfunction (stress induced). The nocturnal events were mostly solved by eating a substantial protein and healthy fat snack two hours prior to bedtime.

Along with that, shoring up the critical electrolytes to maximize intracellular resources was what really helped prevent the breakthroughs the most for me.

Jackie

Hi Jackie,

Thanks, but one comment. My current diet is not what most consider "high protein." Cooking for myself, it is typically about 1g protein/kg body weight (I asked my dietician friend, who works in nursing homes and she said this was her guide when designing meals at work). This represents about 12%-15% of my daily caloric intake. Dean Ornish's low fat veg. diet, which was certainly not known as "high protein" worked out about 20% protein (and 10% fat, 70% carbs).

When I'm traveling and cooking for my vegan (except egg whites) girlfriend, I'm probably nowhere near this much protein. Cooking low carb and vegan is an interesting challenge. Especially since I also avoid wheat/gluten & soy (or most "manufactured" proteins for that matter).

If my current diet is high in anything it is fat. It is usually around 85% fat, mostly saturated.

People have learned some lessons being able to sample serum ketones accurately at home. One is that excess protein and excess carbs will cause an insulin spike. Insulin is not easy to measure at home, however ketones will not be produced in an environment with insulin levels above those that are very low. Hence elevated serum ketone levels can be used as a proxy for low insulin levels.

Cheers and Happy New Year!

George

George you are gradually getting me more interested in a high fat diet. I have been reading some on ketone diets, especially on Dr Mercolas site.

I like testing and quantifying whenever possible rather than guessing. How do you test for ketones in the blood at home, and what lessons can you learn from your levels?

Ron

Ron,

I use a meter by Precision Xtra. The bad part is the strips are expensive here in the US. I buy mine from Canada ($2US/strip in bulk). <[www.universaldrugstore.com]

I also got a free meter here: <[www.choosefreestyle.com]

Peter Atia MD has quite a bit on his eating academy site. Here is a Google search of his site: <[fficial&client=firefox-a#q=Precision+Xtra+Ketone+site%3Aeatingacademy.com&rls=org.mozilla:en-USfficial" rel="nofollow">www.google.com]

So has Jimmy Moore. Here is a search on his site: <[fficial&client=firefox-a#q=Precision+Xtra+Ketone+jimmy+moore+n%3D1&rls=org.mozilla:en-USfficial" rel="nofollow">www.google.com]

After loosing a lot of weight on a low carb/high fat diet. Moore started putting weight on slowly every year despite doing everything "right." Using a ketone meter, he was able to see he was eating too much protein, even though his carbs were very low. By keeping his ketone levels > 1, he was able to slowly loose weight again. He is obviously very carb sensitive and has to do everything "right" to keep from being morbidly obese.

In my case, I do it for more info. After being very active (running high altitude races like 13 miles & 7,800' elevation gain, ending at 14k'), I was fit, but still overweight. Playing with a glucometer, I learned to eat so I did not spike my blood sugar. Exercising much less, I dropped ~40 pounds and have remained weight stable for five or six years. Urine ketone strips have issues: 1) you are testing excess, 2) they don't test the ketone you care about the most and 3) they don't always correlate well with serum tests. That being said, if you are showing some ketones in your urine, you are probably at a pretty low insulin level. I track all three: serum glucose, serum ketones and urine ketones. I now infrequently test the serum ketones as I can predict fairly closely what the answer will be from the serum glucose and urine ketone tests which are much less expensive. This correlation is certainly limited to an individual and would be different for others.

Recently, Dr. Rocky Patel, a family doc from AZ, said he screened people for their glucose an hour after ingesting 70 g's of glucose on a fast. If it was over 120 mg/dl (6.66 for those outside the US), it indicates their system has a problem that needed to be investigated further. It indicates insulin resistance and forecasts diabetes, perhaps years in the future. Not knowing what I was doing, I tried this 6 or 7 years ago. My one hour test - 180, two hours 56. I did not know what this really meant at the time, I just knew it wasn't good, so I acted by learning to eat to not spike my glucose. Patel screens all his patients with this test (or as he says - sends them to IHop for a pancake breakfast, then tests them). He says 80% fail!

Later I learned that fasting glucose is the least sensitive indicator. It will be the last indicator to tell the story when you are headed toward diabetes.

There are more low carb/high fat references in CR73: <[www.afibbers.org]

Let me know if you have more questions.

George

God Bless you guys but I'd rather shoot myself if I get to this point of testing and elaborate dieting to stave off the beast.
Between my day job in IT, then running my small business afterward, taking care of mom, then finding 3 days to exercise a week, I barely have time to do what bears do in the woods.......

Thank You Dr Natale

Happy New Year to All,

McHale



Edited 1 time(s). Last edit at 12/31/2013 05:39AM by McHale.

Sorry George - I may not have kept up with your latest dietary refinements... last I recall was that you were eating a large amount of grass fed beef for breakfast and not a lot more after that. I like that you have a better blend and especially the higher fat content. Ron Rosedale would be vigorously nodding with approval!

Happy New Year to you, too.

Jackie

Jackie,

Somebody observing me would probably think it is high protein, because the fat isn't as obvious. I'm still a bit higher than Rosedale suggests, but not by too much. As I recall, he suggests around 0.8g/kg body weight.

George

McHale
For the Life of me I do not know why you would
Risk an unnecessary surgery to not be on a diligent
Diet regimen? Obviously people who are going to need an ablation
Would have no choice. I have had 2 short episodes in 10 years
I would rather do anything and I mean anything than put my body
Through a surgery that still is not 100 guaranteed !
I see far to many success stories of diet and supplementation
Working for a large percentage of people. I have been supplementing
2 months now and knock on wood haven't even felt a PAC! This forum has been
Beyond helpful! Happy New Year to all!

Joey1974,
I was being a bit facetious about killing my self if I had to follow a strict dietary regimen and avoid all triggers etc...
To me not being able to enjoy the finer things in life and watching everything is just not worth it IMHO. I eat very healthy, fish 3x a week, chicken and some lean meat once in a while, workout diligently 3-4 a week. No way I was going to let someone burn holes in heart either!!!!
Glad you are able to manage afib for 10 years by adjusting diet and avoiding triggers. In hindsight I was getting some afib for 10-15 years prior without knowing what it was and if I knew about the condition I had and this site I would have attributed the few outbreaks to dietary success supplements etc.... However, since my TIA in Sept 2012 it was my Wake up call to get this condition corrected as best as I could and not fool myself with into thinking I finally find the right combination of trigger avoidance and diet....;been there too many times and got smacked right upside the head down to reality. Even exercise at the end become a trigger and at the same time it was able to stop an episode.
Afib seems to take on a life of its own as it progresses and keeps us guessing how to best control this beast. I wish that my efforts to control and avoid triggers was as effective as yours. For most experimenting with dietary and supplemental changes may work but the majority never do find the answers. Getting obsessed with finding triggers that the process itself was becoming a stressor. I believe that for many patients Afib does just happen, that something on a cellular level changes in and around the atria. How this comes about is anyone's guess as many top EP's have tried to figure out.

Unnecessary surgery.....no way as I've taken a major step in controlling this beast that will get many in the end as you age.
When you get a chance to get ablated by one of the best in Natale you take a leap of faith. His success rates are near 80-90% now and to me that's good enough.

Happy New Year,

McHale



Edited 2 time(s). Last edit at 01/03/2014 06:09AM by McHale.