Irregular heartbeat at night: what should you know?

Quiet surroundings can make a fluttering, pounding, racing or skipped beat easier to notice. Lying down, emotional stress, dehydration, fever, nicotine, alcohol and caffeinated drinks can contribute. Some episodes are linked with an abnormal rhythm such as Atrial Fibrillation, but the sensation alone cannot identify its cause.

Note when it begins, how long it lasts, whether the rhythm feels regular or chaotic, and whether you have Dizziness, breathlessness, chest discomfort or fainting. An Electrocardiogram can record the rhythm, although a short test may not capture an episode that comes and goes.

Stop and rest during an episode. Avoid driving if you feel faint. Keep a record of medicines, supplements, recent illness, sleep disruption, alcohol and caffeine, and arrange a clinical assessment if the episodes recur, last longer, or disturb sleep. Do not start or stop heart medicine or Anticoagulation Management without medical advice.

Seek emergency help for an irregular heartbeat with chest pain, severe breathlessness, collapse, fainting, new confusion, or weakness or numbness on one side. Sudden speech or vision changes also need urgent assessment because they can signal Stroke or Transient Ischaemic Attack. Arrange prompt medical advice for repeated episodes or a persistently fast rhythm.

Could my symptoms be caused by a rhythm problem, medication, thyroid illness, anaemia, or a sleep-related trigger? Should I have an Electrocardiogram or longer rhythm monitoring? What symptoms should prompt emergency care?