Heart racing and unable to sleep: what should you know?

Quiet surroundings make normal heartbeat sensations easier to notice. Worry about sleep can then increase stress hormones and intensify the feeling. Caffeine, nicotine, alcohol, a heavy meal, fever, or dehydration may add to it.

Other contributors include anaemia, low blood sugar, an overactive thyroid, and atrial fibrillation. Heart failure can cause nighttime breathlessness or a need to sit up, rather than palpitations alone. The timing of a symptom does not establish its cause.

Sit up, relax your shoulders, and use slow breathing with a longer out-breath. Keep the room cool, take small sips of water, and avoid checking the clock repeatedly. Do not use alcohol or extra medication to force sleep.

Record what happened before bed, including drinks, medicines, meals, stress, and illness. Arrange a medical appointment if this keeps happening, leaves you exhausted, or is accompanied by daytime symptoms.

Seek emergency help for chest pain, severe breathlessness, fainting, confusion, sudden weakness, or a heartbeat that remains very fast and feels irregular. Ask someone to stay with you if you feel faint.

Get prompt advice if nighttime episodes are prolonged, repeatedly wake you, or occur with swelling, fever, vomiting, or dizziness. A clinician may use an electrocardiogram or a portable monitor to capture the rhythm.

Ask whether your sleep pattern, medicines, caffeine, thyroid, blood count, or heart rhythm should be checked, and what bedtime symptoms require urgent action.