A heart palpitation is the sensation of a racing or irregular heartbeat. Palpitations can occur at any time, but people may be more aware of their heartbeat when lying down at night.

This article will explore what heart palpitations are, why they may occur at night, and what causes them. It will also explore treatment options, the difference between heart palpitations and arrhythmias, and how a doctor diagnoses heart palpitations.

a woman lying in bed awake at night possibly due to heart palpitationsShare on Pinterest
External factors or an underlying health condition may cause heart palpitations at night.

People with heart palpitations typically experience one or more of the following sensations:

Heart palpitations may occur at any time, including during the day or at night. They can last from a few seconds to a few minutes.

Palpitations are common and a frequent complaint of people visiting emergency departments and primary care doctors.

People who sleep on their side, particularly on the left side, may be more prone to heart palpitations at night. This is because the heart is right next to the chest wall, and the sensation reverberates.

A 2018 study found that participants who slept on their left side experienced changes in their heart’s rhythm and electrical activity. In comparison, participants who slept on their right side did not experience these changes.

A person who has nightmares may also experience an increased heart rate. They may therefore have the sensation of a racing heartbeat if they wake up in the middle of the night due to a nightmare.

Heart palpitations may also be more noticeable at night because there are fewer distractions and lower noise levels when lying in bed.

There are several possible causes of heart palpitations, including external factors and some underlying health conditions.

Some common causes include:

Some underlying conditions may also cause heart palpitations. These include:

A 2022 review reported that in one study, 43% of palpitations had cardiac causes, 37% had a psychiatric origin, and around 10% were miscellaneous (e.g., induced by causes such as medication, caffeine, cocaine, anemia, amphetamine, and an over-active thyroid).

An arrhythmia occurs when the rate or rhythm of the heartbeat is too slow, too fast, or irregular. There are many different types of arrhythmias, and some forms may be life threatening.

Heart palpitations can sometimes be a symptom of arrhythmias. However, not everyone with an arrhythmia will feel the sensation of their heart beating irregularly.

Occasional heart palpitations do not necessarily require medical advice or treatment. However, a person should see a doctor if they experience the following symptoms:

Heart palpitations occur randomly. Due to this, they may not happen during a consultation with a doctor or while wearing a heart monitor, which can make the diagnosis more challenging.

To diagnose heart palpitations, a doctor will ask questions about:

  • when the palpitations occur
  • what sensations they cause
  • how long they last
  • how frequently they occur
  • what factors trigger the palpitations, such as medications, caffeine, or heavy meals
  • what lifestyle factors could contribute
  • what underlying conditions a person has

The doctor will then perform a physical examination. They may also order one or more tests, including:

  • Holter monitoring for 24–48 hours to show how the heart typically functions
  • an electrocardiogram (EKG), which reports the heart’s rhythm
  • an echocardiogram, which is an ultrasound of the heart to examine its structure using soundwaves
  • a continuous-loop event recorder, which is an implanted device that looks for abnormalities in heart rhythm over time
  • a stress test, such as a treadmill exercise, to determine the heart’s health
  • blood tests to check for underlying conditions, such as anemia, thyroid imbalance, or low potassium

Treatment for heart palpitations will vary depending on the underlying cause.

A person may not require any treatment if the palpitations are not causing harm or any other symptoms. However, a doctor may recommend lifestyle changes to reduce the frequency of palpitations, such as:

  • avoiding activities that cause stress or performing activities that reduce stress
  • stopping smoking
  • avoiding or reducing caffeine intake
  • avoiding or reducing alcohol intake

A doctor may also review a person’s medications and supplements to determine whether they are causing or contributing to palpitations. If a known underlying condition is the cause, a person should follow medical advice to treat the condition.

If a doctor diagnoses an abnormal heart rhythm, some common treatments include:

  • Cardiac ablation: A doctor threads small wires through the legs into the heart to find the location of the arrhythmia. They then use energy to destroy the area of heart tissue responsible.
  • Defibrillation: Doctors implant a device to regulate the heartbeat through electrical pulses.
  • Cardioversion: Electrical shocks help return the heart to a normal rhythm.
  • Medications: Medications, such as beta-blockers or calcium channel blockers, help the heart return to a normal rhythm.

Here are some answers to frequently asked questions about heart palpitations.

Occasional palpitations do not affect a person’s general health. However, if a person is experiencing frequent or consistent palpitations, they should speak with a doctor, as there may be an underlying cause.

Heart palpitations are common and can occur in many circumstances. For example, a person may experience heart palpitations after physical activity or in different emotional states, such as stress, anxiety, panic, or fear.

However, heart palpitations may be abnormal if a person is experiencing them frequently or the palpitations increase.

It may not always be possible to stop heart palpitations. However, in most cases, they go away on their own.

Certain actions may help reduce heart palpitations, such as the Valsalva maneuver. This maneuver is a deep breathing exercise that mimics routine activities such as straining during defecation or blowing up a balloon. This maneuver may help reduce a person’s heart rate.

If none of the above methods work, a person should contact emergency medical services. The palpitations may be the result of an underlying heart condition.

A heart palpitation is the awareness of the heart beating either irregularly or quickly. Heart palpitations may occur at any time of day, including at night.

There are numerous possible causes and triggers, such as taking certain medications or consuming too much caffeine.

Heart palpitations can also occur due to one of several underlying health conditions, which range in severity and include dehydration and heart disease.

Heart palpitations may be a symptom of an arrhythmia. However, not every person who has an arrhythmia will have heart palpitations.

Heart palpitations should go away within a few seconds to a few minutes. If they do not, or sensations of confusion, chest pain, or trouble breathing accompany them, a person should seek emergency medical attention immediately.