You go through the day feeling fine, but when nighttime rolls around and you lie down to sleep, your heart starts beating rapidly.

If this sounds like you, then you may be relieved to know that nighttime heart palpitations (the feeling that your heart is skipping a beat, fluttering, or racing) are common and usually don’t signal a major health problem. If you don’t think any of their common causes apply to you, it may be best to talk to your health care provider.

Heart Palpitations at Night

Heart palpitations are actually quite common and can occur at any time of day. Heart palpitations are usually not a sign of anything serious, but can seem quite unsettling when they occur. You may not notice the symptoms of heart palpitations during the day or when you’re active, but heart palpitations at night are very noticeable when you’re lying still.

Heart palpitations when lying down

Your body position may be a factor in heart palpitations. Lying down on your side in a hunched position can increase the pressure in your body and create heart palpitations. Try lying flat on your back or sitting up, drinking water, and focusing on breathing.

What Causes Heart Palpitations?

Most people have heart palpitations from time to time. Some common causes include:

  • Hormones: Fluctuating hormones can speed up your heart rate during the menstrual cycle, pregnancy, and menopause.
  • Nicotine use: Recently smoking tobacco products, especially on an empty stomach, can lead to heart palpitations.
  • Stress: Anxiety, depression, and stress can affect your heart rate.
  • Alcohol or caffeine: Having either of these stimulants close to bedtime can cause your heart to race and make it difficult for you to sleep.
  • Low blood sugar: Even if you do not have diabetes, your heart can react with palpitations when your blood sugar is low.
  • Bedtime snacks: What you eat also affects your heart. Sugary foods, chocolate, and super salty foods or those with monosodium glutamate (MSG) can make it feel like your heart is racing.
  • Medicines: Certain prescription and over-the-counter medicines, including those taken for allergies, can cause heart palpitations.

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How Can I Keep My Heart From Racing at Night?

Consider if any of these common causes of nighttime heart palpitations could be affecting you and try to address the issue.

If you think your eating habits may be responsible, watch what you eat and drink late in the day and early evening and opt for healthier snacks or herbal tea.

If stress is the problem, add some relaxation techniques to your bedtime routine. Try deep breathing, meditation, stretching, journaling, or reading. Regular exercise also can help you maintain a normal heart rate.

How do I stop heart palpitations when lying down?

Heart palpitations often will pass on their own after a few minutes, but the effects of heart palpitations can be reduced by:

  • Focusing on breathing: Inhale deeply through the nose, hold the breath for a moment then slowly exhale. Repeat this for a few minutes.
  • Drink water: Drinking a glass or two of water can help normalize your heart rate.
  • Change position: If you are sleeping in a hunched position on your side, you might be at an increased risk of experiencing heart palpitations. Try lying on your back.
  • Eat less before bedtime: Sometimes eating a large meal just before going to bed can result in heart palpitations. Try eating a few hours earlier or having a smaller meal at dinnertime.

When Is a Racing Heart Serious?

Occasional heart palpitations or changes in heart rate shouldn’t be cause for alarm. But if they’re happening frequently, you might want to make an appointment with your health care provider to determine if there is an underlying medical problem. Thyroid issues, low blood sugar, and low blood pressure all can cause your heart to race.

If you experience dizziness, chest pain, fainting, or shortness of breath, seek medical help immediately. These could be signs of a more serious problem.

Diagnosing Heart Palpitations

There are numerous tests your provider might order to diagnose the cause of your heart palpitations. To start, your provider may suggest an electrocardiogram (ECG or EKG), which is a painless test to measure the electrical activity of the heart. Another may be an echocardiogram, which is a noninvasive exam that uses sound waves to monitor the heart and blood flow. Another option is Holter monitoring, which is a portable ECG device to check the heart’s activity over a day or two. If the heart palpitation event does not occur while wearing the Holter monitor, your provider may suggest an event recorder, which is similar to the Holter, but only is activated when the wearer presses a button as the heart palpitation event occurs.

Editor's Note: This article was originally published on , and was last reviewed on .

About Heart and Vascular Institute

The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.