You may have a pounding heart at night due to some health conditions, including anxiety and low blood sugar, or after having substances like caffeine or alcohol.
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:
- an electrocardiogram
- blood work
- an ultrasound of your heart
- an exercise stress test if there’s accompanying chest pain
- a Holter monitor to monitor your heart’s activity over a period of time if you might have an irregular heartbeat
If a doctor suspects you have an underlying condition, they may also need to conduct more invasive studies.
In rare instances, heart palpitations may be a sign of more serious heart or thyroid conditions. These may include:
- an overactive thyroid gland (hyperthyroidism)
- an irregular heart rhythm (arrhythmia)
- an unusually fast heart rate (tachycardia)
- an unusually slow heart rate (bradycardia)
- heart attack or heart failure
- cardiomyopathy
- heart valve disease
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.