Heart palpitations at night occur when you get the feeling of a strong pulse in your chest, neck, or head after you lay down to sleep. It’s important to note that while these may be unsettling, they’re usually normal and aren’t typically a sign of anything more serious.
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.
The most common form of palpitation unrelated to your heart occurs when bending over, as there’s an increase in abdominal pressure that then transports to your esophagus, which is located behind the left atrium of your heart.
Another factor to consider when experiencing palpitations at night is that they may be occurring throughout the day, but you’re only noticing them at night due to lower noise levels and reduced distractions as you lie in bed.
The symptoms of heart palpitations can be concerning if they’re unexpected or you haven’t experienced them before. 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 generally not a cause for alarm. According to the Mayo Clinic, they’re 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 lead to 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
- fatigue or lack of sleep
- depression or anxiety
- rigorous exercise
- changes in hormones due to pregnancy, menopause, or menstruation
Unless you’ve already seen your 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 — such as consuming food you don’t typically eat — before going to bed?
Sharing this information with your 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 your doctor. They can conduct a review of your medical history. They might recommend a physical examination and tests, such as:
- blood work
- ultrasound of your heart
- exercise stress test
- Holter monitor to use for monitoring your heart’s activity over a period of time
If your 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:
While heart palpitations at night can be concerning, it’s likely nothing to be worried about.
If your symptoms worsen or persist for a long period of time, set up an appointment with your doctor. They can determine if you have a more serious condition or if your condition makes you more susceptible to heart enlargement.