HEART PALPITATIONS AT NIGHT OR BEFORE SLEEP

Heart palpitations at night feel like your heart is racing, pounding heavily, or skipping beats. Some people experience heart palpitations lasting from a few seconds to several minutes when lying in bed or before falling asleep. They can keep you up or start during sleep, waking you and interrupting rest.

While it can be disruptive, this sensation is often benign (not harmful). However, sometimes, heart palpitations result from certain heart conditions, anxiety disorders, medication side effects, stress, or alcohol use, among other conditions.

Causes of Heart Palpitations Only at Night

A wide range of conditions can cause racing or irregular heartbeat at rest, with the most common including:

Alcohol, caffeine, and substance use: Caffeine and nicotine are stimulants, so use—especially at night—can trigger palpitations, as can recreational drugs like cocaine or methamphetamines. These substances increase heart rate (known as tachycardia), raise blood pressure, and disrupt the sodium, calcium, and potassium channels.
Dehydration: Consuming insufficient amounts of water can lead to an imbalance of minerals (electrolytes) that help regulate heart activity.
Mental health conditions: Anxiety, depression, stress, and fear can trigger the body’s fight-or-flight response, affecting the heart rhythm and causing palpitations.
Obstructive sleep apnea (OSA): This sleep disorder causes snoring and breathing disruptions while you sleep and can trigger heart palpitations.

Causes of Palpitations During the Day

In many cases, palpitations happen throughout the day and night, but people only notice them when lying down to rest. Less commonly, this symptom is a sign of a more serious health issue or problem with the heart. Additional causes include:

Changes in blood potassium levels
Dehydration
Exercise
Fever
Heart arrhythmias (rhythm disorders) like atrial fibrillation (A-fib), atrioventricular (AV) block, and bradycardia (slowed heartbeat)
Heart disease
Heart valve problems, such as mitral valve prolapse
Hyperthyroidism (overactive thyroid)
Stress, fear, and anxiety

What Medications Can Cause Heart Palpitations at Night?

Medications can also lead to palpitations, sometimes due to their effect on heart rhythm. Examples of such medications include:

Acetylcholinesterase inhibitors (AChl): Exelon (rivastigmine), Aricept (donepezil), or Razadyne (galantamine)
Anticancer drugs: Tyrosine kinase inhibitors Erbitux (cetuximab) and Sutent (sunitinib), and others
Antipsychotic drugs: Versacloz (clozapine), Risperdal (risperidone), and others
Arrhythmia/heart failure drugs: Adenocard (adenosine), Multaq (dronedarone), or Corlanor (ivabradine)
Beta-blockers: Inderal XL (propranolol), Tenormin (atenolol), and others
Bronchodilators: Ventolin HFA (albuterol) and Norphyl (aminophylline)
Calcium-channel blockers: Verelan (verapamil), Norvasc (amlodipine), and others
Certain antidepressants: Prozac (fluoxetine) and Celexa (citalopram), and others
Decongestants: Suphedrine PE (phenylephrine) and Sudafed (pseudoephedrine)
Vasodilators: Attia (dipyridamole)

How Night Heart Palpitations Feel

A heart palpitation is an uncomfortable awareness of your heartbeat lasting from several seconds to several minutes or more. In nocturnal cases, palpitations set on shortly after lying down or during sleep. Many people feel symptoms in their chest, neck, or throat. Typical symptoms include:

A fluttering in the heart or the sensation that the heart is flapping or moving
A pounding or throbbing heartbeat, as if the heart is working very hard, racing heart, hearing heartbeats
A sensation of skipped or irregular heartbeats; feeling as if the heart has stopped for seconds at a time

Palpitations vs. Heart Arrhythmia

Palpitations are sensations that may or may not be related to heart issues. They can be a sign of arrhythmia but also arise due to causes unrelated to the heart.

What to Do in Bed to Slow Heart Palpitations

If you experience palpitations when you lie down or it they wake you up, certain steps you take may help ease these symptoms.

Deep breathing and relaxation techniques like meditation
Drinking a glass of water
Getting up and walking around

Sleeping Positions and Adjustments

Sleeping on your left side pushes your heart closer to the chest wall and increases your sensation of the heartbeat. People who sleep supine—on their backs—are also at increased risk. Rolling over to the right or sleeping on your stomach may relieve the issue.

How to Get Medical Treatment for Heart Palpitations

If you’re having heart palpitations, call a healthcare provider. Primary care physicians can diagnose the underlying cause of heart palpitations. They may refer you to a cardiologist (heart specialist) or an electrophysiologist, a specialist in heart rhythm disorders, for additional assessment and treatment. If they suspect an anxiety disorder, you may need a psychiatric evaluation.

Getting a proper diagnosis may involve several steps, such as:

A physical evaluation: A healthcare provider will ask about your symptoms, medications, and health history and listen to your heart.
Blood tests: A healthcare provider may order blood tests to detect anemia (lack of healthy red blood cells) or other potential causes.
Electrocardiogram (ECG or EKG): A healthcare provider may use electrical heart monitoring by placing electrodes on the skin to detect arrhythmia or other problems.
Holter monitor: A healthcare provider may ask you to wear a portable ECG for 24 hours to track your heart activity.

Medications and Devices

If your heart palpitations are disabling, healthcare providers may prescribe beta-blockers like Inderal LA (propranolol), Lopressor (metoprolol), or calcium channel blockers like Verelan (verapamil) to ease symptoms.

In cases linked to serious heart arrhythmia, you may need treatments to correct your heart rhythm. Treatment may involve electrical therapies to change heart activity, known as cardioversion or defibrillation. In another technique, cardiac ablation, healthcare providers use electrodes to expose problem parts of the heart to heat.

Devices called pacemakers can also treat arrhythmia and manage related palpitations. Surgeons implant these small devices just under the skin, near the heart. They deliver electrical signals to the nodes of the heart, which regulate its activity.

How to Minimize Symptom Intensity Before Sleep

Alongside medical therapies, managing and preventing nighttime heart palpitations primarily means making lifestyle changes to minimize risk. Steps you can take include:

Avoiding heavy meals, especially those high in carbohydrates, sugars, fats, or salt, within two hours of going to bed
Avoiding or limiting caffeine, alcohol, or nicotine (smoking, vaping, and other methods), especially in the evening or at night
Creating a cool, dark place to rest
Exercising regularly or boosting physical activity to promote sleep and manage stress
Getting enough sleep (seven to eight hours of uninterrupted sleep for adults)
Going to bed and getting up at consistent times every day
Limiting exposure to cell phones, laptops, TVs, or or other device screens in bed
Maintaining a healthy weight, as obesity and excess weight raise risk
Meditating, doing breathing exercises, yoga, or other relaxing activities to wind down
Staying hydrated, boosting daily water intake

Summary

Heart palpitations—the sensation of a racing or fluttering heart—often arise at night. Common causes include dehydration, caffeine, and alcohol; however, the symptoms can occur with heart problems or more severe issues. Lifestyle changes and changing sleep positions can help you manage nighttime palpitations. While most cases of heart palpitations are benign, talk to a healthcare provider about this symptom to ensure it's not more severe.

Read the original article on Verywell Health.

2024-09-16T20:32:22Z dg43tfdfdgfd