Heart palpitations while sleeping: what to know

A quiet bedroom can make normal heartbeat changes feel prominent. Nightmares, waking suddenly, stress, fever, late caffeine, nicotine, alcohol, or some medicines may cause a racing or fluttering sensation. Reflux and an uncomfortable sleeping position can also draw attention to the chest.

Repeated nighttime palpitations can accompany sleep loss, dehydration, anaemia, iron deficiency anaemia, or hyperthyroidism. Snoring and repeated waking may suggest a sleep problem that deserves discussion. An irregular rhythm such as atrial fibrillation is another possibility, but the sensation cannot diagnose it. A diary helps separate a sudden rhythm change from a gradual awakening with a strong pulse.

Sit up slowly, relax your shoulders, and breathe steadily. Check whether the beat feels regular or uneven and record the time, duration, recent drinks, medicines, and other symptoms. Sip water if dehydration is possible and avoid taking someone else's heart medicine. Book an appointment when episodes repeat, disturb sleep, or are becoming more frequent.

Call emergency services for palpitations with chest pain, severe shortness of breath, fainting, blue or grey lips, or confusion. Seek urgent care for a sustained rapid or irregular rhythm, particularly with known heart disease or new swelling and breathlessness that could indicate heart failure. Do not drive yourself if you feel faint.

Ask whether an electrocardiogram, blood tests, or an overnight rhythm monitor is appropriate. Share your sleep pattern, snoring, alcohol and caffeine use, medicines, thyroid symptoms, and the exact time you wake with the sensation.