Heart palpitations at night feel like your heart is racing, pounding heavily, or skipping beats. Some people experience heart palpitations lasting from a few seconds to several minutes when lying in bed or before falling asleep. They can keep you up or start during sleep, waking you and interrupting rest.
While it can be disruptive, this sensation is often benign (not harmful). However, sometimes, heart palpitations result from certain heart conditions, anxiety disorders, medication side effects, stress, or alcohol use, among other conditions.
A wide range of conditions can cause racing or irregular heartbeat at rest, with the most common including:
In many cases, palpitations happen throughout the day and night, but people only notice them when lying down to rest. Less commonly, this symptom is a sign of a more serious health issue or problem with the heart. Additional causes include:
Medications can also lead to palpitations, sometimes due to their effect on heart rhythm. Examples of such medications include:
A heart palpitation is an uncomfortable awareness of your heartbeat lasting from several seconds to several minutes or more. In nocturnal cases, palpitations set on shortly after lying down or during sleep. Many people feel symptoms in their chest, neck, or throat. Typical symptoms include:
Palpitations are sensations that may or may not be related to heart issues. They can be a sign of arrhythmia but also arise due to causes unrelated to the heart.
If you experience palpitations when you lie down or it they wake you up, certain steps you take may help ease these symptoms.
Sleeping on your left side pushes your heart closer to the chest wall and increases your sensation of the heartbeat. People who sleep supine—on their backs—are also at increased risk. Rolling over to the right or sleeping on your stomach may relieve the issue.
If you’re having heart palpitations, call a healthcare provider. Primary care physicians can diagnose the underlying cause of heart palpitations. They may refer you to a cardiologist (heart specialist) or an electrophysiologist, a specialist in heart rhythm disorders, for additional assessment and treatment. If they suspect an anxiety disorder, you may need a psychiatric evaluation.
Getting a proper diagnosis may involve several steps, such as:
If your heart palpitations are disabling, healthcare providers may prescribe beta-blockers like Inderal LA (propranolol), Lopressor (metoprolol), or calcium channel blockers like Verelan (verapamil) to ease symptoms.
In cases linked to serious heart arrhythmia, you may need treatments to correct your heart rhythm. Treatment may involve electrical therapies to change heart activity, known as cardioversion or defibrillation. In another technique, cardiac ablation, healthcare providers use electrodes to expose problem parts of the heart to heat.
Devices called pacemakers can also treat arrhythmia and manage related palpitations. Surgeons implant these small devices just under the skin, near the heart. They deliver electrical signals to the nodes of the heart, which regulate its activity.
Alongside medical therapies, managing and preventing nighttime heart palpitations primarily means making lifestyle changes to minimize risk. Steps you can take include:
Heart palpitations—the sensation of a racing or fluttering heart—often arise at night. Common causes include dehydration, caffeine, and alcohol; however, the symptoms can occur with heart problems or more severe issues. Lifestyle changes and changing sleep positions can help you manage nighttime palpitations. While most cases of heart palpitations are benign, talk to a healthcare provider about this symptom to ensure it’s not more severe.
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