Heart racing in the middle of the night: what to know

Palpitations are sensations such as a fast, pounding, fluttering, or skipped heartbeat. Waking abruptly can make a normal change in heart rate feel especially noticeable. Stress, nightmares, fever, caffeine, nicotine, alcohol, some medicines, dehydration, and low blood sugar can all contribute.

Sometimes nighttime palpitations reflect an underlying problem. Atrial Fibrillation can cause an irregular, racing pulse. Hyperthyroidism, Anaemia, and Iron Deficiency Anaemia may increase the workload on the heart. Dehydration and Hypoglycaemia can also produce shakiness, sweating, or a fast heartbeat. These symptoms do not identify a single cause on their own.

Sit or lie somewhere safe and take slow, comfortable breaths. Notice whether the rhythm feels regular or uneven, when it began, how long it lasted, and what you had consumed or taken beforehand. Sip water if you may be dehydrated. Avoid caffeine, nicotine, alcohol, and strenuous activity until the sensation settles.

Arrange a primary-care appointment if episodes recur, interrupt sleep, last longer than usual, or occur with tiredness, breathlessness, dizziness, or an irregular pulse. A clinician may review medicines and check your heart rhythm, blood count, thyroid function, and other possible triggers.

Seek emergency help now if heart racing comes with chest pain or pressure, severe shortness of breath, fainting, new confusion, or marked weakness. Get urgent assessment for a very fast or persistently irregular heartbeat, especially if you have known heart disease or symptoms of Heart Failure such as breathlessness when lying down or sudden swelling.

Ask whether your symptoms could relate to a medicine, thyroid problem, anaemia, dehydration, or a heart rhythm change. Take a record of episode timing, duration, pulse pattern, associated symptoms, sleep disruption, and recent caffeine or alcohol use.