What causes these problems sleeping after an all-nighter?

[Bubulinu]

Hi,

After pulling an all-nighter, I find that I fall asleep quite quickly, however, after roughly 2 hours, I always wake up, drenched in sweat, extremely confused (anxious), and with a fast heart rate. I will briefly describe all three symptoms in more detail:

1. I wake up so sweaty that I have to change my blouse, which is completely wet. The bed sheets are also completely wet from sweating.

2. The confusion manifests itself as a sense of anxiety, combined with a rapid movement of thought and an inability to identify a rational cause to it. I feel a sense of impending doom associated with something I was working on during the all-nighter: For example, if during the all-nighter I've worked on a boat design, then I may have the sense of impending doom associated with the irrational idea that the boat is too heavy. (Don't ask too heavy for what, as there is no answer, it's entirely irrational). As I am used to feelings of anxiety, I remain quite calm while this happens - nevertheless, my mind seems to have an impetus of its own, and just continues to associate the sense of impending doom with the irrational idea. Also thoughts seem to move without sense around the irrational idea - all the while I understand that this is irrational, and yet my mind still does it.

3. The tachycardia is typically around 130bpm when I first measure it, immediately upon getting out of bed, but quickly falls to around 110. Then it fluctuates between 90-110 for 30-50mins or so before returning to my normal 75-85. The fluctuations are quite large, for example it would fall to 90 in 20 seconds, and then in another 30 seconds it would increase to 110, and then repeats. It's associated with breathing - especially when I breathe in, the heart seems to start beating much faster. This is associated with an oxygen saturation of 96-98% (measured through pulse oximetry), with an average of 97% most probably. In terms of blood pressure, it is between 135/80-155/95. I've done a series of ECGs in the past, all normal (the ECGs weren't done when this event happened though). Only thing I noticed that could be abnormal was what is a slightly low QT -> around 332 uncorrected, 379 corrected at heart rate 78, or around 322 uncorrected, at heart rate 96. As my heart rate is generally not low enough, especially when I've done my ECGs, it is unclear whether my QT would prolong sufficiently with a reduction in heart rate. Other than these incidents after all-nighters, and a blood pressure which is towards the high side generally (140/80), I've had no problems with my heart.

After the symptoms calm down (roughly 40mins), then I can go back to sleep. I go back to sleep, but find it troubling to fall asleep now. My mind keeps racing through what seems to be incoherent thoughts, and I have vivid and absurd dreams regarding those thoughts. Most of the time, after falling asleep again, I would wake up after another 1hr or so, with similar symptoms outlined in 1-3 but of much lower intensity at least one more time. After the symptoms calm down again, which takes less time the second time around, I again find the same difficulty falling asleep, the same vivid dreams and incoherent thoughts racing through my mind, even though I feel extremely tired. After some time, I can fall asleep, but it's never a deep sleep, and it's relatively light.

So my question is, what causes these symptoms, are they benign, and is it common to experience similar symptoms after an all-nighter? Thanks!

[Paxiled]

Oh, and I'm not sure why the obsession over measuring your heart rate.  Perhaps you have a heart problem, but it's hard to see how this helps anything.  Heart rhythms vary through the day anyway.  It seems just to be a way to upset yourself.

[Paxiled]

Don't know what you call moderate, and it's hard to see why you would use alcohol if you want to stay awake -- it's a downer.  The caffeine, of course, would help you stay awake, but also increase anxiety possibly in someone prone to anxiety.  But staying awake all night on occasion, as opposed to someone who stays up all night regularly, is an abrupt break in your sleep patterns, and your melatonin, which sets your body clock, is probably yelling at you, hey, it's time to get up.  And since you haven't had much sleep and your mind was very active before you went to bed, it's understandable whatever you were working on before you went to bed would still be at the forefront of your mind's memory.  Now, when people aren't anxiety sufferers, disrupting normal sleep patterns can cause problems, so imagine what it might do to someone used to worrying irrationally.  I got this problem when I was still taking Paxil -- it gave me obsessive thoughts to some degree, and when I stopped working at a regular job and returned to writing fiction full time, I would fully wake up and start getting ideas right when I put head to pillow.  Not convenient.  I'd get up and write and ended up staying up all night every night.  It's not something I would worry about if all-nighters are what you need to do what you do and be who you are, but know this is disrupting your entire sleep cycle and that for an anxiety sufferer this isn't going to be as easy as it is for someone else.  Also know that for almost everyone, creativity lasts at most four or five hours and after that the quality of the work isn't all that wonderful -- it just seems like it is because it throws the brain out of whack.  You might get better work done by not pulling all-nighters and spreading the work out through the day by working in intervals.  Peace.

[Bubulinu]

Forgot to add that these all-nighters are associated either with moderate consumption of alcohol OR with moderate consumption of caffeine.