Most people don’t notice their heartbeat. But some people may experience heart palpitations, which are sensations that feel like your heart is pounding or racing.
It’s possible to experience heart palpitations at any time of day. However, some people may notice them more often or exclusively at night. Here’s what to know about heart palpitations felt at night.
Heart palpitations at night involve feeling a strong pulse in your chest, neck, or head after you lie down to sleep. While these may seem unsettling, they’re usually not a sign of anything serious.
Heart palpitations when lying down at night
If you sleep on your side, you may be more susceptible to heart palpitations at night due to the way your body bends and pressure builds up internally.
Another factor to consider when experiencing palpitations at night is that they may be happening all day without you noticing. In this case, you might notice them at night due to lower noise levels and reduced distractions while you lie in bed.
The symptoms of heart palpitations can be concerning if they’re unexpected or you haven’t experienced them before. These symptoms include:
- the feeling of an irregular pulse or that your heart stopped briefly
- a sensation of “fluttering” in your chest
- a fast or pounding heart rate
Short and infrequent palpitations at night are usually not a cause for alarm. Generally speaking, heart palpitations are usually harmless.
However, you should seek immediate medical attention if you experience heart palpitations along with any of the following symptoms:
There are several factors that can cause heart palpitations, some of which you may come into contact with every day, including:
- stimulants, such as caffeine, nicotine, over-the-counter medications containing pseudoephedrine, or drugs like cocaine or amphetamines
- medical conditions, such as anemia, low blood pressure, low blood sugar, or thyroid disease
- chocolate
- alcohol
- fatigue or lack of sleep
- depression or anxiety
- stress
- fever
- rigorous exercise
- changes in hormones due to pregnancy, menopause, or menstruation
Unless you’ve already seen a doctor and determined that you have an underlying heart condition, heart palpitations generally don’t require any treatment. Symptoms tend to go away within a few seconds.
Avoiding triggers of palpitations is the most important way you can prevent them. For example, if you’re a heavy smoker or drinker, consider quitting or cutting back your tobacco or alcohol intake.
One method of identifying triggers is to keep track of the nights that you experience heart palpitations and ask these questions:
- When did the episode occur?
- How long did it last?
- How were you feeling before and after?
- Are you excessively worried about something?
- Were you doing any activities when it happened?
- Did you participate in any unusual behavior before bed, like consuming food you don’t usually eat?
Sharing this information with a doctor can also help them identify any underlying conditions that may require treatment.
If you’re experiencing frequent heart palpitations at night, consider scheduling an appointment with a doctor. They can conduct a review of your medical history. They might recommend a physical examination and tests, such as:
If a doctor suspects you have an underlying condition, they may also need to conduct more invasive studies.
While heart palpitations at night can be concerning, they’re likely nothing serious.
If your symptoms worsen or persist for a long period of time, set up an appointment with a doctor. They can determine if you have a more serious condition or if your condition makes you more susceptible to heart enlargement.
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Medically Reviewed by James Beckerman, MD, FACC on August 20, 2022
Forget what the love songs tell you: There’s nothing exciting about your heart skipping a beat. In fact, when your heart doesn’t beat normally, its electrical system is likely out of step. When your heart beats too fast, too slow, or skips irregularly, it is called arrhythmia. If your heart’s ever skipped a beat, you’ve had what are called heart palpitations. It might feel like your heart is throbbing, pounding, or fluttering. Or you simply might not feel well. Think of a palpitation as a “hiccup” for your heart. It beats on schedule, and then hiccup! A brief pause, and you’re back to normal. Until it happens again. Luckily, for most people, these hiccups happen only once in a while. But other people can have dozens of uncomfortable palpitations each day. Some can be so strong they feel like a heart attack. Heart palpitations can happen for no reason. Other times, they’re brought on by certain triggers, including some of the following: You can’t always prepare for heart palpitations. But to head them off, you can try simple lifestyle changes, like: If you think you’re having an attack, try these to get your heartbeat back to normal:
- Breathe deeply. It will help you relax until your palpitations pass.
- Splash your face with cold water. It stimulates a nerve that controls your heart rate.
- Don’t panic. Stress and anxiety will make your palpitations worse.
If you’re short of breath, dizzy, have chest pains, or faint, talk to your doctor right away. These could be signs of serious heart disease.
The normal heart averages between 60 and 100 beats per minute. When your heart beats faster than this, you have a condition called tachycardia.
When your heart races, it’s working too hard. It doesn’t have enough time to fill with blood or pump it to the rest of your body. You might have heart palpitations or chest pain. You may also feel dizzy or faint.
If you have heart disease or some types of lung disease, your chances of having tachycardia could be higher than normal. If you were born with an abnormal heart structure, this is called a congenital heart defect, and it might increase your odds as well. Other factors, like fever, dehydration, or drinking too much caffeine, can also make your heart race. Your doctor may suggest medical treatment if your heart races too often or it lasts too long. In the meantime, they might recommend the following things to slow it down: If you faint, have trouble breathing, or have chest pain that lasts longer than a few minutes, talk to your doctor right away or call 911. Sometimes our hearts beat slower than 60 beats per minute. This is called bradycardia. For some people, like athletes and healthy, young adults, this heart rate could be normal. But for others, it could cause your brain and other organs to not get enough oxygen to function like they should. If that’s the case, you may feel faint, dizzy, weak, or short of breath. You might also have chest pains, memory problems, or tire easily. Bradycardia is caused by a problem with your heart’s electrical system. Your heart simply isn’t getting the signal to beat properly. This can happen for some or all of the following reasons: There are really no home treatments for a slow heartbeat. Your doctor will likely need to fix the underlying cause in order to ease your symptoms and raise your heart rate so your body gets the blood it needs. Treatments could include medications or a pacemaker.
Seek medical help right away or call 911 if you faint, have a hard time breathing, or have chest pain that lasts more than a few minutes.
Most of the time you won’t notice your heartbeat, but if you suddenly become aware of it, this may concern you or come as a surprise. The feeling of being aware of your heart beating is described as a palpitation.
Palpitations can range from simply being aware of your heart’s activity to the sensation of it beating faster and harder than usual. It can sometimes feel like your heart is missing beats or you have a heart flutter.
Changes to your heartbeat are usually not serious. But always see your doctor if you have palpitations or feel you have an irregular heart beat.
Dial triple zero (000) if you have heart palpitations along with these symptoms:
- severe shortness of breath
- chest pain or tightness
- dizziness or light-headedness
- fainting or blackouts
What are the symptoms of heart palpitations?
You might feel like your heart is racing, thumping or skipping beats. You might feel this when you are sitting still or moving slowly.
You may also feel faint, breathless or experience chest pain.
CHECK YOUR SYMPTOMS — Use our dizziness and lightheadedness Symptom Checker and find out if you need to seek medical help.
What causes heart palpitations?
There are many causes of palpitations and it’s common to experience them when you feel:
- nervous
- emotional
- anxious, including panic attacks
- stressed
This is due to a rise in adrenaline levels, which can cause your heart to beat faster.
Palpitations and irregular heartbeat can also be caused by:
How are heart palpitations diagnosed?
Your doctor will talk to you about how the palpitations start (gradually or suddenly), how long they last, how often they happen and any other symptoms you may have and your family history.
They may send you for further testing, including an electrocardiogram (ECG) to measure your heart’s electrical activity. This may be done by wearing a Holter monitor, a device that you wear for 24 hours while going about your normal activities.
How are heart palpitations treated?
Treatment of heart palpitations depends on what is causing them. Usually, there will be no treatment as the palpitations aren’t serious.
If you have a heart condition like an arrhythmia or atrial fibrillation, you may be sent to a specialist for treatment with medications, surgery or an implantable device.
How are heart palpitations managed?
If you have heart palpitations, or irregular or rapid heartbeats, there are a number of things you can do:
- Try to sit down and relax or find somewhere quiet to rest.
- Keep yourself calm and in a comfortable position.
- Try not to panic as this can make your symptoms worse.
- You may find it helpful to loosen any restrictive (tight) clothing that can affect your breathing, such as your collar button and tie.
- Avoid any stimulants that could make your palpitations worse — this includes caffeine, nicotine, alcohol and recreational drugs.
If you are concerned about your heart palpitations, please consult your doctor.