Healthy Body

‘I’m a Cardiologist—Here’s Why Your Heart Races at Night (and When It’s Time To Worry)’

Photo: Stocksy/ Jimena Roquero
Have you ever collapsed into bed, ready for a good night's sleep, only for your heart to feel like it's doing gymnastics? If your heart races at night, you're likely not imagining things, and you're not alone.

Heart palpitations are sensations like unusual heart beating, fluttering, skipping a beat, or the feeling that your heart is doing a "flip" in your chest, according to the Cleveland Clinic. However, they are a common occurrence and may not be a sign that something is wrong, says Mariell Jessup MD, FAHA, a cardiologist and chief science and medical officer at the American Heart Association (AHA). So if you're a little weirded out by your rapidly beating heart, Dr. Jessup breaks down what causes bedtime palpitations, how to reduce them, and when they might be a cause for concern.

Why your heart races at night when you lie down

You may be experiencing heart palpitations throughout the day, but you're more likely to notice them when you get into bed and settle in for the night, the Cleveland Clinic says. However, there are a few bedtime-specific reasons your heart races at night. Dr. Jessup says that common causes include drinking caffeine too late in the day, smoking, stress, dehydration, and elevated blood sugar. These substances can increase your heart rate, making heart palpitations more likely to occur.

Body position also has an impact on heart rate and blood pressure. When you lay down, your cardiovascular system has to respond to the gravitational forces that shift when you change positions, whether that's standing, sitting, or laying down. It is also possible that laying on your left side can affect your heart's function, though further study is required for exact explanations, Dr. Jessup says.

Additionally, Dr. Jessup adds that mental health factors like anxiety, depression, and acute emotional reactions like anger can have a distinct impact on your heart rate. If you begin to think about your life's stressors or things troubling you when you lay down to sleep, it can cause your heart to race, says Dr. Jessup. The Centers for Disease Control and Prevention (CDC) reports that chronically unmanaged mental health disorders like anxiety and depression can lead to heart diseases, so seeking treatment for your mental health is important.

What can you do to ease your racing heart

If your heart palpitations are keeping you up at night, Dr. Jessup recommends you experiment with different sleeping positions—especially if you lay on your left side. Laying on your back, sitting up, or sleeping on your right side might help the rhythm to right itself.

Additionally, getting up to drink a glass of water is a good idea, according to Dr. Jessup, if you realize you have had a lot of caffeine or alcohol and not enough water that day. Electrolytes are heavily involved in regulating your heartbeat, according to the Cleveland Clinic. When you're dehydrated, the body has a harder time balancing its electrolytes, which can impact your heartbeat and might explain why your heart races at night.

When are heart palpitations a cause for concern

Occasional heart pounding, racing, or fluttering is pretty normal. But if you are experiencing chronic palpitations every time you go to bed, and you're hydrating, reducing stress levels, and monitoring caffeine intake—it's a good idea to talk to a doctor.

Sometimes heart palpitations can be signs of heart conditions like arrhythmia, heart valve disorders, thyroid conditions, or myocarditis. These conditions are chronic problems that require treatment, so be sure to reach out to a doctor if you feel strange heartbeats consistently. Heart attack signs include accompanying chest pain, dizziness, nausea, shortness of breath, or fainting. If you experience these symptoms in tandem with heart palpitations, it's best to seek treatment urgently.

It can be alarming to feel an abnormal sensation in your chest. It makes sense that your mind might wander to the worst-case scenarios, but rest assured that slight changes in your heartbeat when you lay down are fairly common—as long as they're not chronic and no other symptoms arise. So next time your heart is doing gymnastics when you've settled in for some sleep, rolling over or getting some water could do the trick.

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