Heart palpitations at night can be caused by anxiety, caffeine or alcohol intake, strenuous exercise, hormonal changes, or autoimmune conditions. Usually, they are not a sign of a cardiovascular emergency.
Heart palpitations are uncomfortable or unusual sensations in your chest, throat, or neck. You may suddenly become intensely aware of your heartbeat, for example. For some people, this is more likely to happen at nighttime because you may have fewer distractions and less noise around you.
Heart palpitations may feel like your heart is:
fluttering
beating very quickly or racing
thumping or pounding
beating irregularly (skipping beats)
Heart palpitations may last for a few seconds or minutes or become repetitive throughout the day and night.
This article will discuss the possible causes of heart palpitations at night and what to do about them.
Heart palpitations vs. arrhythmias
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Most people experience heart palpitations at some point. The term “heart palpitations” refers to the sensation that your heart is skipping a beat or pounding in your chest or ears.
For some people, though, frequent heart palpitations are a sign of a medical condition.
Arrhythmias are, by definition, atypical heartbeats or heart palpitations. Generally, an arrhythmia means your heart is not beating as it usually does. For example, it could be beating faster or slower.
In the clinical sense, arrhythmias may mean there’s a potential issue with the electrical system within your heart, which may affect your blood flow if left untreated.
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Only a healthcare professional can accurately identify the cause of your heart palpitations, particularly if you experience them frequently. These are some of the most common causes:
Stress or anxiety
The stress response is designed to get you ready and alert to face any potential threats. But it may also be activated by your thoughts or perceptions, even when you are not in imminent danger.
Stress and anxiety can cause your body to release hormones such as adrenaline and cortisol. These, in turn, can trigger heart palpitations.
In fact, some research from 2022 suggests that heart palpitations are most commonly caused by anxiety.
Hormonal changes
Changes in hormone levels may contribute to heart palpitations in some people. These changes may be due to the menstrual cycle, pregnancy, menopause, medication side effects, or autoimmune conditions.
Lack of sleep or fatigue
Not getting enough or good quality sleep may increase your heart rate, although more recent studies are needed to understand this connection.
Research from 2008 suggests that people with sleep disorders may be more likely to have an irregular heartbeat than people who sleep 8 to 9 hours per night.
Physical activity and substance consumption
Your lifestyle habits may affect your heartbeat, according to the National Health Service in the United Kingdom.
Substances like alcohol and caffeine may cause heart palpitations, mainly if you are dehydrated or stressed.
Caffeine stimulates the central nervous system and may affect your body’s production of adrenaline and cortisol, leading to faster heartbeats. However, research from 2021 indicates that regular consumption of coffee, for example, does not increase your chances of heart arrhythmias.
Strenuous exercise, especially if you are not used to it, may also lead you to experience heart palpitations for a while after you stop moving. If you exercise late during the day, it may cause you to have heart palpitations at night.
Medical conditions
Certain medical conditions may involve symptoms like heart palpitations at night. In the same way, some asthma and thyroid medications may affect your heartbeat at times.
Health conditions that have been associated with heart palpitations include:
A 2018 study suggests that people who sleep on their left side are more likely to notice changes in their heartbeat rate and heart electrical activity. This was not the case for those who slept face up or on their right side.
Researchers have not established the link but hypothesize that lying on the left side may lead the heart to move lower in the chest cavity because the left lung is smaller. This means the effects of gravity on the heart are greater when your body is turned and lying on the left side compared with standing up or lying on the right side.
When should you worry about heart palpitations?
In most cases, heart palpitations are not a sign of a serious health challenge. However, seek prompt medical care if you experience heart palpitations with the following:
discomfort or pain in your chest
confusion or dizziness
shortness of breath
weakness or fainting
severe or unusual fatigue
swelling in your limbs
severe headache
Treatment options for heart palpitations
The treatment your health professional recommends for heart palpitations depends on what is causing them.
Your doctor may want to explore other possible symptoms you’re experiencing, as well as your family and medical history. That will help them determine the best management plan for your case.
Among the strategies your health team may recommend may be:
Routine and habit changes: If your heart palpitations at night are linked to bedtime or nutritional habits, your doctor may suggest you modify some of your routines. For example, you may want to limit caffeine intake before bedtime, sleep on your right side, or improve your sleep hygiene. Starting a daily log may help you identify some of the activities or habits associated with heart palpitations at night.
Managing anxiety and stress: If you experience heart palpitations at night after a stressful day or live with an anxiety disorder, your doctor may recommend seeing a mental health professional and taking anxiety medications like citalopram (Celexa), fluoxetine (Prozac), and sertraline (Zoloft). They may also recommend engaging in mindfulness practices. Other strategies that may help you manage anxiety and stress include eating a nutrient-dense diet, doing relaxation techniques, getting acupuncture, and undergoing hypnosis.
Atypical heart rhythm: If your doctor thinks your palpitations at night are related to a cardiovascular condition, they may want to focus on treating the root cause. This may include prescribing medications such as beta-blockers or calcium channel blockers. You may also be offered treatments such as cardiac ablation, defibrillation, or cardioversion.
Other medical causes: If your heart palpitations at night are linked to thyroid disease, anemia, low blood pressure, or other medical causes, your doctor may want to order lab and other tests before working with you to come up with a treatment plan.
Summary
Heart palpitations are when you feel your heart beating faster, pounding, or fluttering. They can occur during the day or night, but you may become more aware of them during quieter times.
Heart palpitations are common and do not typically signal a health complication. In some cases, your doctor may want to explore this symptom further to rule out thyroid disease, cardiovascular conditions, anemia, or other medical causes.
If you experience palpitations with pain, fainting, vomiting, or other severe symptoms, it is highly advisable that you seek prompt medical assistance.
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