OpenHealth Q&A

Exploring Sleep Disturbances and Related Symptoms

Greetings! I hope this message finds you well. I have a situation I’d like to share and seek some perspective on, even though it’s a bit lengthy. I am a 20-year-old female with a medical history that includes postural orthostatic tachycardia syndrome (POTS), migraines, headaches, and attention deficit disorder (ADD). For my ADD, I am currently prescribed Vyvanse at a dosage of 20mg in extended release, in addition to vitamin D supplements. Family medical history includes heart disease, hypertension, brain tumors, and epilepsy. Over the past few months, I’ve been experiencing episodes of sleep paralysis starting last summer, now occurring on a weekly basis. Initially, these episodes involved standard paralysis without any accompanying auditory or visual disturbances. However, they have become increasingly intense over time. There are moments where it feels akin to an earthquake, accompanied by loud whooshing sounds and ringing that resembles a jet taking off. Recently, I encountered a particularly alarming experience. Last night, as I was lying down and not ready to drift into sleep, I began to feel numbing sensations, almost like electric jolts, occurring every thirty seconds. Normally, I experience such sensations just as I’m about to fall asleep. When the paralysis set in, I was overwhelmed by an excruciatingly loud ringing and static noise. I tried to move my finger, hoping that would help me snap out of it, but instead, my fingers involuntarily extended backward, causing a painful numbing feeling. My body stiffened, tension filled me, and I felt my back arch involuntarily as my limbs began to vibrate and shake. During this episode, my vision faded to black; I sensed my eyes rolling back painfully and saw flashes of light intermittently. Eventually, everything vanished into darkness again, this time enveloped in complete silence where I couldn’t feel my body at all—it was as if I were trapped inside my own head. A sudden bright flash jolted me back to normalcy, yet my body was still in pain, especially in my eyes, ears, and limbs. As for my vitals during that incident (according to my RingConn smartwatch): heart rate fluctuated from 67 bpm, spiking between 85-120 bpm, heart rate variability was recorded between 11 and 25 (normally around 52 to 94), and oxygen saturation was between 91% to 93%, with stress levels initially at a relaxed state of 28, rising to medium at 78. In terms of my sleep patterns, I have undergone a sleep study at home, which revealed mild sleep apnea. Additionally, I have experienced episodes of zoning out. A recent occurrence happened while I was parking my car. Just as I pressed the brake to shift into park, I felt momentarily immobilized, almost as if in a trance, compelling me to remain still. I felt my eyes twitching, accompanied by that electrical sensation, and when I opened them, everything appeared hazy. I kept mentally urging myself to shift the vehicle into park. After a while, I managed to do so but felt unusually exhausted and famished afterward. Typically, I feel drained following these extended episodes. For context, I have discussed these zoning out experiences with my doctor. They began around the age of twelve, and she attributed them to my use of SSRIs. After discontinuing those medications, I suspect what I am experiencing might be dissociation. I had an MRI at the age of ten for migraine-related issues with aura, which came back normal. This summer marked the beginning of my sleep paralysis, and I also experienced heart palpitations at night alongside migraines (Excedrin was ineffective), dizziness, swollen lymph nodes, shortness of breath, fainting spells, and general fatigue, prompting my doctor to recommend further testing. The following assessments were conducted: - ECG: revealed sinus tachycardia at 120 bpm, right conduction delay, and ST depression noted at leads V3 and V4. Subsequently, my doctor discontinued my ADD medication to investigate any potential links. - ECGs 2 and 3: captured sinus tachycardia at 135 bpm, indicating an incomplete right bundle branch block pattern and continued ST depression classification at leads V3 and V4. - Chest X-rays: appeared normal, with a mention of a radiodense structure over the neck, likely external. - Zio XT: recorded a minimum heart rate of 45, maximum at 175, with an average heart rate of 85. - Echocardiogram: results were normal. - Neck and thyroid ultrasound: findings were normal with slight swelling observed. - Blood work: indicated low levels of vitamin D (26.4 ng/ml), while all other tests (CBC, Lyme, EBV, thyroid, CMV, ANA, and mono tests) results were within normal limits. If anyone has insights or has had similar experiences, I would greatly appreciate your input!

Answers (1)

2/2/2026, 2:31:00 AM

OpenHealth AI

It sounds like you're experiencing a complex set of symptoms that are understandably concerning, including sleep paralysis, episodes of dissociation, and heart rhythm irregularities. Let’s break this down into manageable parts and address what you may be able to do next.

Main Points:

1. You’re experiencing frequent sleep paralysis with intense sensory experiences.
2. You have a history of POTS and migraines, along with concerning heart rhythm changes.
3. There have been episodes of dissociation and potential sleep apnea as indicated by your sleep study.

Explanation:

Sleep paralysis can occur during the transition between sleep and wakefulness, and it can be exacerbated by factors such as stress, sleep deprivation, or underlying sleep disorders. The sensations you described, including the loud noises and physical sensations, can be quite distressing and may relate to your overall sleep quality or anxiety levels. Your background of POTS may also play a role in how your body reacts during these episodes.

The heart rhythm changes you've noted, along with the physical symptoms after zoning out, can potentially indicate an underlying connection between your cardiac health and your neurological or psychological state. Frequent heart palpitations and variations in heart rate can be concerning, especially in the context of POTS.

Next Steps:

1. Sleep Hygiene Improvement:

   • Aim for a consistent sleep schedule, going to bed and waking up at the same time each day.
   • Create a relaxing bedtime routine that minimizes screens and bright lights.
   • Ensure your sleep environment is comfortable, dark, and quiet.

2. Manage Stress and Anxiety:

   • Consider practicing relaxation techniques such as deep breathing, meditation, or gentle yoga before bedtime. These could help reduce the intensity of your sleep paralysis episodes.
   • If you find these experiences lead to anxiety, consider keeping a journal of your episodes to help identify triggers.

3. Monitor Symptom Patterns:

   • Keep a diary detailing when sleep paralysis, dissociative episodes, and heart palpitations occur, alongside any potential triggers (like stressors or changes in routine). This could provide useful information for your health provider.

4. Address Health Concerns:

   • Follow up with your healthcare provider regarding the changes in your heart rhythm and discuss whether additional monitoring or evaluation by a cardiologist is warranted.
   • Since you have low vitamin D levels, ensure you're following your healthcare provider's guidance on supplementation—this can have broader health implications and may impact mood and energy levels.

5. Follow-Up with a Sleep Specialist:

   • Given your mild sleep apnea diagnosis and the intensity of your sleep-related symptoms, consider discussing further evaluation or treatment options with a sleep specialist.

Your experiences are significant, and it's essential that you continue to work with your healthcare team to address all dimensions of your health. If any new symptoms develop or if you feel overwhelmed by the experiences you're having, don't hesitate to seek immediate medical help. Remember, you are not alone in this, and there are pathways to better manage and understand your symptoms. Let me know if you need further specifics or have more questions!