"However I awoke after a few hours wide awake. BP and respiration elevated with palpitations as usual these days"
There are similarities with what I experience.
I do not awake and stay awake but awake, fall back to sleep, awake, fall back to sleep at ever shorter intervals as the night progresses. In the morning it can be every 5 minutes or worse.
I used to have very strong respiration when these events were at worst. I was breathing like a horse. My chest felt near every morning like I was run over by a truck.
Often my hart rate goes very high late night to early morning, like 150+ bpm.
I used to have strong palpitations too, but in my case it was due to hypothermia. It was plain shivering in a very forceful way. It took some time to see that connection ;-).
"So, I tried breathing exercises but no dice. I noticed my feet were hot. My feet usually are hot when I have trouble sleeping, which has been well over 20 yrs now. I've mentioned this to lots of people, even medicos, and nobody sees any connection. So anyways, strapping a cold pack to the bottoms of my feet used to do the trick. Last night, this had no effect. As a last ditch effort, I slid one cold pack (I own 4) under my neck on the right side- side sleeper here. My heart calmed down within a minute or so. I removed the cold pack and almost immediately my heart was pounding again. Put the cold pack back and voila, heart calmed down again."
I do not have a BP meter, so I have no clue to what it is at night. But that connects to how I improved my sleep a lot. Wont help you as it involves doing circulation exercises, breathing exercises and walking around whenever waking. If you can't fall asleep soon after it that'll be a failure.
But how I got to this point is because I believed that my blood flow "stalled" during the night. And I use among others gravity to get it going again. It's the idea about "reversed POTS".
Having POTS is when you stand up and blood flow is too low towards the head and too low from the feet to the hart due to gravity. But when lying down, the opposite could happen. Blood has to flow back from the head to the hart for if not it will pile up in the head. When standing, gravity helps. Lying down helps to get the blood towards the head. But if both arteries AND veins between hart and head are affected then both the going and returning path will be affected. Lying down will make the returning path faulty. Thus blood will accumulate in the brain.
When blood accumulates in the brain, brain pressure will go up and so will cerebral spinal fluid pressure. Now research shows that many ME (and FM) patients have too high CSF pressure and that it would relate with symptom severity. Part of my attempt is sitting upright for some time to help "drain" the pooling blood from the brain. During the day I do circulation exercises to make the blood flow from hart to brain and back less restricted (by having the muscles putting less strain on the blood vessels).
Another way to reduce the increased CBF pressure is cold. It doesn't help with blood pooling that much, but it reduces the nefarious strong increase in CBF pressure. Cold often reduces swelling (and inflammation). So using a cold pack under the neck or head may help by reducing CBF pressure and the series of symptoms that produces.
As to the warm feet? The legs and feet also receive their part of "reverse POTS". When standing, blood flows very easily to the feet due to gravity. It's returning that goes poorly. In order to not having too much blood pooling when upright it's better to make the blood vessels from hart to legs/feet a bit smaller in diameter and the returning ones a bit bigger. But when lying down that means the hart has to push harder to get sufficient blood flow into the legs and feet. That could be done by raising BP.
That gets the hart into a dilemma: raising the BP will get blood flow higher in the legs but will also increase CBF to too high. Lowering BP will be better for the brain but reduce blood flow in the legs. Now I would think that getting the feed cold would let the body try and increase the blood flow to the feet in order to warm them up. But when the body sees it as too high a loss of heat, it could do just the reverse and decrease blood flow. That happens often when you get poorly dressed into the cold. So the leg thing is tricky, but the head thing might be less tricky.
Thanks for sharing your experience. I just happened to think today about maybe trying to put a cold pack in reach at night for putting under my head and see if it helps when nights are horrible. I just thought it was to "aggressive" a treatment to be able to fall asleep again. I'll reconsider for sure. Please keep reporting your experiences and good luck with it!
