Heart palpitations waking you up

A quiet room makes internal sensations easier to notice, and a change in position can make a normal heartbeat feel more prominent. Alcohol, caffeine, nicotine, vivid dreams, stress, fever, dehydration and low blood sugar may also trigger an episode. Night-time palpitations can occur with anaemia, an overactive thyroid or an abnormal rhythm such as atrial fibrillation. Waking suddenly with breathlessness or needing extra pillows is a different pattern that should be discussed promptly.

Sit upright, breathe slowly and notice whether the beat feels steady or irregular. Record the time, possible trigger, associated symptoms and how the episode ended. Avoid taking extra prescription medicine unless your clinician has given you a plan. Arrange a review if episodes recur, disturb sleep, or occur with daytime dizziness, fatigue or reduced exercise tolerance. Your clinician may check your pulse, medications, thyroid and blood count, and may use an electrocardiogram or ambulatory monitor.

Call emergency services if palpitations come with chest pain, severe breathing difficulty, fainting, collapse or confusion. Seek urgent advice when an episode does not settle, feels markedly irregular, or is accompanied by new weakness or severe dizziness. Do not wait for a routine appointment when these symptoms are present.

Ask whether sleep disruption, medicines or stimulants could be contributing, whether you need rhythm monitoring, and which symptoms should prompt emergency help. Mention snoring, panic-like awakenings, alcohol use and any recent illness because they can change the assessment.