Heart Palpitations at Night

What are heart palpitations at night?

Heart palpitations feel like your heart is pounding, racing or beating quickly. It can also feel like your heart is skipping a beat or like you have an extra heartbeat. Palpitations make you aware of your heart rate. You may feel your heart beating in your chest, but it’s also common to feel it beating in your neck or throat.

Heart palpitations can happen anytime, including at night or when you’re resting during the day. They can be scary, but they aren’t usually dangerous. Many people have the same heart palpitations during the day but don’t notice because they’re busy.

Less commonly, heart palpitations at night can be signs of a serious health condition, such as arrhythmia (abnormal heart rhythm). If your heart often races when you lie down, you should see your provider for an examination. Get help right away if you have palpitations and trouble breathing or chest pain.

How common are heart palpitations at night?

Heart palpitations are very common. They happen to many people throughout the day. But you’re more likely to notice heart palpitations when you aren’t distracted. You might sense them when you’re sitting still, resting or lying down.

What are the symptoms of heart palpitations at night?

When you lay down you may feel:

• Fluttering. Some people describe this sensation as a flapping or fluttery feeling in the chest. Your heart may feel like it’s doing flips.
• Irregular heart rate. It might feel like your heart is beating out of rhythm, skipping a beat, or speeding up and slowing down. It can also seem like your heart stops for a second or two.
• Pounding. You might feel like your heart is beating very hard or forcefully. Some people who have heart pounding say they can hear it beating in their ears.

What causes heart palpitations at night?

Usually, heart palpitations are harmless and don’t result from an underlying health problem. They happen when the heart beats out of rhythm or contracts (beats) too soon. Providers call this a premature ventricular contraction (PVC) or premature atrial contraction (PAC). Nearly everyone has a PVC or PAC from time to time. But not everyone feels them.

Some people get heart palpitations when lying down because of the position in which they sleep. Sleeping hunched over on your side can increase pressure inside your body, causing palpitations. Many other common causes of heart palpitations include:

• Anxiety, stress and depression. Heart palpitations are common during a panic attack.
• Dehydration and electrolyte imbalances. Electrolytes are minerals in the body. They control your heart’s rhythm.
• Drugs, including diet pills and nasal decongestants that contain pseudoephedrine. Nicotine can also cause heart palpitations.
• Extra weight and obesity. People who carry extra weight have a higher risk of abnormal heart rhythms and heart disease.
• Fever.
• Hormonal changes during menopause and changes that happen to the body during pregnancy. Heart palpitations during pregnancy are very common and usually harmless.
• Some food and drinks, including alcohol, caffeine and chocolate. Foods that are high in carbohydrates, sodium (salt), sugar or fat can lead to heart palpitations.

Less commonly, heart palpitations result from a health condition or disorder, including:

• Anemia (low red blood cell count).
• Heart disease, including heart attack, heart failure or cardiomyopathy.
• Heart rhythm problems (arrhythmias) including atrial fibrillation (Afib), tachycardia (fast heart rate) and bradycardia (slow heart rate).
• Hypotension (low blood pressure) or hypoglycemia (low blood sugar).
• Metabolic syndrome.
• Myocarditis, inflammation of the heart’s muscles that results from a viral infection.
• Thyroid problems, such as hyperthyroidism.
• Structural problems in the heart, including valve disease.

How do healthcare providers diagnose heart palpitations at night?

Your provider will ask about your symptoms and listen to your heart. They may recommend a blood test (complete blood count or CBC) to look for anemia or infection. A blood test can also show signs of a vitamin deficiency or a problem with your thyroid.

To monitor your heart rate, they may do an electrocardiogram (EKG or ECG). This test measures your heart rate using sensors that attach to your skin. They may ask you to lie down during the test, which usually takes about 15 minutes.

Many times, an EKG doesn’t detect heart palpitations. You might not have an irregular heartbeat during the test. If this happens, your provider may recommend an ambulatory electrocardiogram such as a Holter monitor. You wear this device for up to a week as you go about your daily activities. It records your heart rate (and any irregular heartbeats) and stores the information for your provider to review.

How do I manage heart palpitations at night?

Most of the time, heart palpitations at night don’t require treatment, especially if they only happen occasionally. You may be able to relieve heart palpitations at night yourself. If your heart is racing at night, you should:

• Breathe deeply: Try pursed lip breathing techniques, which involve long, deep breaths. You can also meditate and try other relaxation techniques to reduce stress.
• Drink a glass of water: If you’re dehydrated, your heart has to work harder to pump blood.
• Roll over or get up and walk around: A change of position might be all you need to relieve heart palpitations. Try rolling over in bed, sitting up or going for a short walk around the room while taking deep breaths.

If a health condition is causing palpitations, your provider will treat the condition. Treatments vary depending on the cause. Sometimes, providers prescribe a type of medicine called beta blockers to treat palpitations. These medications slow the heart rate and reduce palpitations.

Can I prevent heart palpitations at night?

You may not be able to prevent heart palpitations at night, but you can lower your risk. You should:

• Avoid drinking too much alcohol or caffeine, especially before bed. If you smoke, talk to your provider about a plan to quit smoking.
• Don’t eat a big meal (especially foods that are high in fat, carbs, salt or sugar) right before you go to bed.
• Get treatment for anxiety or depression. Talk to your provider about antidepressant medication and therapy.
• Take steps to reduce stress on a daily basis. Try meditation, yoga, diaphragmatic breathing and other relaxation techniques.
• Maintain a healthy weight. If you carry extra weight or have obesity, ask your provider about a weight loss plan.

What is the outlook for people with heart palpitations at night?

Most people with heart palpitations at night don’t require treatment. If palpitations happen from time to time, they aren’t usually dangerous. Many people find relief from heart palpitations at night after making changes to their diet or lifestyle. These changes may include avoiding alcohol and managing stress.

If you have heart palpitations that result from a heart problem, thyroid disease or other health condition, talk to your provider about your prognosis. To relieve your symptoms, your provider will treat the condition that’s causing them.

When should I see my healthcare provider about heart palpitations at night?

If you have frequent heart palpitations when resting or lying down, you should schedule a visit with your provider. Most of the time, heart palpitations at night aren’t harmful. But it’s important to see your provider to be sure they aren’t signs of a serious health problem.

Get help right away if you have heart palpitations and:

• Chest pain or discomfort.
• Difficulty breathing, shortness of breath or other breathing problems.
• Dizziness or confusion.
• Loss of consciousness or fainting (syncope).
• Severe swelling (edema) in your limbs, especially your legs, ankles and feet.
• Unusual or sudden fatigue.

You should also seek medical attention if your fitness device alerts you to a heart rate over 100.

A note from Cleveland Clinic

If you often have heart palpitations at night, talk to your provider. Although most heart palpitations aren’t dangerous, you should schedule an evaluation. You can lower your risk of heart palpitations at night by eating right, avoiding alcohol and nicotine, and staying away from caffeine before bed. Try yoga and meditation to reduce stress and help you relax. Get help right away if heart palpitations happen along with chest pain, dizziness or shortness of breath.