Although you may be alarmed to feel your heart racing at night just as you’re trying to get to sleep, these palpitations are actually quite common and may or may not be a reason for concern. It all depends on the cause.

At Northwest Houston Heart Center, Dr. Adnan Aslam and Dr. Roy Norman diagnose and treat heart palpitations at their four Texas locations. Many patients ask why their heart seems to beat abnormally fast at night; here’s what the doctors have to say.

What are heart palpitations?

Heart palpitations – an abnormal rhythm – are common and only rarely indicate an underlying health problem. If you feel your heart racing at night, it may be caused by many different factors, ranging from heart problems to your sleeping position. In some cases, doctors can’t determine a cause.

If you have heart palpitations, you may notice one or more of these sensations:

• Rapid heart rate
• Irregular heart rhythm
• Missing or extra heartbeats
• Fluttering in the chest
• Flip-flopping sensations
• Pounding in the chest, neck, or throat

You may notice these symptoms at night even though they occur during the day, as well. That’s because you’re probably focused on other things during the day, while at bedtime things are quiet and you become more aware of the issue.

Common reasons for heart palpitations

You may have heart palpitations at night for a number of reasons. The following are not directly  related to your heart:

Alcohol consumption

Heavy alcohol users have a greater risk of cardiomyopathy, a condition that enlarges the heart and increases the risk of arrhythmias. Since most people drink alcohol after 6 p.m., and alcohol interferes with sleep, they may be more likely to notice alcohol-induced heart palpitations at night.

Caffeine

Caffeine elevates the heart rate and may add extra beats into the mix. Since caffeine’s effects can last eight hours, if you consume it in the afternoon or evening, you may notice palpitations when you’re trying to sleep.

Dehydration

Not drinking enough water can cause the heart to beat fast and forcefully, and if you go to bed dehydrated, you may have a greater chance of palpitations. Dehydration also shortens your sleep time, so you may notice palpitations as you lie awake in bed.

Electrolyte imbalances

Irregular heartbeats can result from low levels of electrolytes like potassium and magnesium. If you don’t eat enough nutrients during the day, you’ll feel the effects when you go to bed at night.

Sleep position

If you sleep on your back or on your left side, you’re more likely to have heart palpitations. When you’re on your left side, it shortens the distance between the heart and the chest wall, making you more aware of sensations.

Stress, anxiety, and sleep apnea are additional causes of heart palpitations. None of the reasons listed here is a medical emergency.

Heart-related reasons for palpitations

A number of reasons for palpitations are heart-related and more serious. These palpitations tend to be more noticeable when a person is lying down and usually require treatment.

Premature beats

This is the most common type of abnormal heart rate, and it’s generally harmless. It’s most common among those without another heart problem. While it feels like a skipped heartbeat, it doesn’t actually cause the heart to skip a beat.

Atrial fibrillation (AF)

This is an abnormal heart rhythm that’s rapid and irregular. In addition to palpitations, AF can cause chest discomfort, lightheadedness, and shortness of breath. Because the condition increases a person’s risk of blood clots, it often requires treatment.

Ventricular tachycardia (VT)

Most people’s hearts beat between 60 and 100 times per minute, but those with VT have periods when the rate is above 120 and is not due to physical exertion. Doctors treat VT when episodes last over 30 seconds or are accompanied by chest discomfort, weakness, or lightheadedness.

Heart failure

Heart failure may occur after a heart attack or an extended period of a very rapid rate. Treatment is essential, since the heart isn’t sufficiently supplying the body with needed blood. Other symptoms include shortness of breath, coughing or wheezing, swelling in the legs or feet, fatigue, lack of appetite, confusion, and sudden weight gain.

If your heart races at night, and you can’t identify the cause, Northwest Houston Heart Center can help. To schedule, give us a call at one of our locations — in The Woodlands, Magnolia, Cypress, or Tomball, Texas — text us at 832-402-9518, or book online with us today.