Can Lack of Sleep Cause Heart Palpitations? Why Your Heart Races at Night

You're lying in bed trying to fall asleep when suddenly you become very aware of your heartbeat. It may feel like your heart is pounding, fluttering, skipping a beat or racing even though you're resting.

Yes, lack of sleep can contribute to heart palpitations in some people. However, poor sleep isn't the only possible explanation for a racing, pounding or fluttering heartbeat, and recurring symptoms shouldn't automatically be blamed on sleep deprivation. Understanding why palpitations happen at night, what might be triggering them and when to seek medical care can help you determine your next steps.

Can Lack of Sleep Cause Heart Palpitations?

Not getting enough sleep can contribute to heart palpitations in some people. When you're sleep-deprived, your body may remain in a more stressed and alert state instead of fully recovering. This can affect the nervous system that helps regulate automatic functions such as heart rate and may make your heartbeat feel faster, stronger or more noticeable.

Lack of sleep also often happens alongside other common palpitation triggers, including:

• Stress or anxiety
• Higher caffeine intake
• Irregular sleep schedules
• Alcohol
• Nicotine
• Certain stimulant medications

The American Heart Association identifies insufficient sleep, stress, excessive caffeine, tobacco, alcohol and certain medications as possible triggers for premature heartbeats.

Sometimes, palpitations occur because the heart produces an early or extra beat, known as a premature contraction. This may be followed by a brief pause, making the next heartbeat feel stronger and creating the sensation that your heart has skipped a beat. Lack of sleep is one of several factors that may contribute to these premature beats.

You may occasionally notice palpitations after a poor night's sleep without having heart disease. However, the timing alone cannot tell you exactly what's causing them.

What Heart Palpitations Feel Like

Heart palpitations are the feeling of becoming unusually aware of your heartbeat.

You may feel like your heart is:

• Racing
• Pounding harder than usual
• Fluttering
• Skipping beats
• Adding an extra beat
• Flip-flopping in your chest

Some people also feel the heartbeat in their throat or neck.

Palpitations don't necessarily mean your heart rate is dangerously high. You can feel a very forceful heartbeat, a skipped beat or an extra beat even when your overall heart rate isn't fast.

Why Heart Palpitations Happen at Night or When You Lie Down

Heart palpitations can happen at any time, but many people notice them the most when they're trying to fall asleep or resting in bed. Sometimes that's because the heart is reacting to a trigger. Other times, you're simply much more aware of sensations that would be easy to miss during a busy day.

You Notice Your Heartbeat More at Night

During the day, you're usually moving around, talking, working and paying attention to other things. At bedtime, those distractions disappear.

When you're lying still in a quiet room, a heartbeat that you wouldn't notice during the day may suddenly feel very obvious. Cleveland Clinic notes that people are often more aware of palpitations at night because they're resting and aren't distracted.

Certain positions may also make the sensation of your heartbeat more noticeable. And while changing positions may make you more comfortable, there isn't one sleeping position that's proven to prevent heart palpitations for everyone.

Stress, Anxiety and Racing Thoughts

It's common for stress to become more noticeable once the day slows down.

If you're lying in bed worrying, replaying the day or thinking about everything you need to do tomorrow, your body's stress response may stay active. That can make your heart beat faster or harder and make you more aware of it. Anxiety and panic can also cause palpitations.

New or recurring palpitations shouldn't be written off as anxiety. Heart rhythm problems and other medical conditions can produce similar sensations and require an evaluation.

Caffeine, Alcohol, Nicotine and Other Stimulants

Things you consume earlier in the day can still affect you when it's time to sleep. Possible triggers include:

• Coffee
• Energy drinks
• Pre-workout products
• Nicotine
• Alcohol
• Certain cold and allergy medications
• Prescription stimulant medications

Caffeine and nicotine can stimulate the nervous system, while alcohol can affect both sleep and heart rhythm. Certain decongestants and other medications may also contribute to palpitations in some people.

If palpitations tend to happen after a particular drink, medication or evening routine, that pattern is worth paying attention to.

Dehydration, Illness and Other Physical Triggers

Not every nighttime palpitation begins with stress or poor sleep. Other possible contributors can include:

• Dehydration
• Fever or illness
• Hormonal changes
• Thyroid problems
• Anemia
• Electrolyte imbalances

These conditions can affect the way your heart beats or how strongly you notice it. Some may require medical testing to identify.

Sleep Apnea or an Abnormal Heart Rhythm

Sometimes nighttime palpitations are related to an underlying sleep or heart condition. Sleep apnea repeatedly interrupts breathing during sleep and can cause changes in heart rate and blood pressure. If your nighttime symptoms occur alongside any of the following, it can be worth investigating further:

• Loud snoring
• Gasping
• Choking 
• Repeated awakenings

For a deeper look at that connection, see our resource covering How Does Sleep Apnea Affect the Heart?

Palpitations can also occur with abnormal heart rhythms such as atrial fibrillation, or AFib. However, feeling your heart flutter or skip doesn't automatically mean you have an arrhythmia. The American Heart Association notes that some people report palpitations even when heart monitoring shows a normal rhythm.

If your main concern is a high number recorded by your smartwatch rather than a sensation you can feel, see our resource covering High Heart Rate While Sleeping: Causes, Sudden Spikes and When to Worry.

How to Reduce Heart Palpitations at Night

If you notice occasional palpitations while lying in bed and have no other concerning symptoms, try sitting upright or changing positions, breathing slowly and allowing yourself a moment to relax. Pay attention to how long the sensations last and whether they improve. If symptoms persist, worsen or keep returning, seek medical advice rather than assuming they are caused by lack of sleep.

To help reduce the likelihood of recurring nighttime palpitations, consider these habits:

• Getting enough sleep: Give yourself enough time for consistent, restful sleep instead of regularly cutting your nights short.
• Keeping a regular sleep schedule: Going to bed and waking up around the same time can help create a more predictable routine.
• Reducing caffeine later in the day: Coffee, energy drinks and other stimulants may continue affecting you into the evening.
• Limiting alcohol: Alcohol may trigger palpitations in some people and can also disrupt sleep.
• Avoiding nicotine: Nicotine stimulates the cardiovascular system and may contribute to palpitations.
• Staying hydrated: Dehydration can make the heart work harder and may contribute to symptoms.
• Trying slow breathing or relaxation: Deep breathing, meditation or another calming routine may help when stress appears to be contributing.
• Changing positions: If one position makes you more aware of your heartbeat, try rolling over or sitting up briefly.
• Tracking possible triggers: Keep note of when palpitations happen, how long they last and what you were doing, eating or drinking beforehand to spot patterns worth addressing.

If palpitations continue despite these changes, a medical evaluation may help identify other possible causes.

When to Worry About Heart Palpitations at Night

Heart palpitations are common and many aren't caused by a dangerous heart condition. However, recurring or worsening symptoms shouldn’t be ignored.

You should speak with a healthcare provider if your palpitations:

• Keep returning
• Are happening more frequently
• Last longer than they used to
• Regularly interrupt your sleep
• Affect your daily activities or quality of life
• Are new and you already have heart disease
• Occur alongside dizziness, weakness or shortness of breath
• Feel significantly different from symptoms you've experienced before

How often the episodes happen, how long they last and whether other symptoms occur can all help your healthcare provider understand what may be causing them.

When Heart Palpitations Are an Emergency

Call 911 or seek emergency medical care if heart palpitations occur with:

• Chest pain or pressure
• Severe shortness of breath
• Fainting or loss of consciousness
• Severe dizziness
• Other symptoms that suggest a possible heart attack or serious heart problem

Palpitations accompanied by chest discomfort, severe breathing difficulty or fainting require emergency attention rather than waiting for a routine cardiology appointment.

When to See a Cardiologist in Queens or Brooklyn for Heart Palpitations

If you keep experiencing unexplained racing, pounding, fluttering or irregular heartbeats at night, especially when they're becoming more frequent or affecting your sleep, it’s worth speaking with a medical professional.

Evaluation can be especially important if you have:

• Known heart disease
• A history of abnormal heart rhythms
• Dizziness or near-fainting
• Shortness of breath
• Symptoms that repeatedly wake you from sleep
• Loud snoring, gasping or other signs of possible sleep apnea

To understand what may be causing the palpitations, a healthcare provider may ask about:

• What the palpitations feel like
• When they happen and how long they last
• How often they occur
• Possible triggers such as caffeine, alcohol or stress
• Medications or supplements you take
• Your sleep habits
• Any other symptoms you experience

Depending on your symptoms and medical history, evaluation may also include:

• A physical examination
• An electrocardiogram (ECG or EKG)
• Longer-term heart monitoring, such as a Holter or other ambulatory monitor
• Blood tests
• Additional cardiovascular or sleep evaluation when appropriate

At Advanced Medical Care, our cardiology team helps patients throughout Queens and Brooklyn understand what could be behind recurring heart palpitations. Because nighttime symptoms can sometimes overlap with sleep disorders, our sleep medicine team can also help when snoring, gasping or disrupted sleep are part of the picture.

Advanced Medical Care provides care in Forest Hills, Queens and Brighton Beach, Brooklyn. If you're experiencing recurring non-emergency palpitations and aren't sure what's causing them, we can help evaluate your symptoms and determine whether further testing may make sense. Please call us at 347-571-9389 (Queens) or 929-552-2973 (Brooklyn) to schedule an appointment, or request an appointment online to get started. 

If palpitations occur with chest pain, severe shortness of breath, fainting or other emergency symptoms, call 911 rather than waiting for an outpatient appointment.

Frequently Asked Questions About Heart Palpitations and Sleep

Can one night of poor sleep cause heart palpitations?

Yes, even one poor night's sleep may contribute to palpitations in some people, particularly when combined with stress, anxiety or increased caffeine intake.

Why does my heart pound when I lie down to sleep?

You may simply notice your heartbeat more easily when you're lying still in a quiet room without daytime distractions. Stress, caffeine, alcohol, certain medications and abnormal heart rhythms can also cause a pounding or racing sensation at night.

Can anxiety make your heart race when you're trying to sleep?

Yes. Stress and anxiety can activate the body's stress response, making your heart beat faster or feel more forceful, particularly when you're trying to relax or fall asleep.

What is the best sleeping position for heart palpitations?

There isn't one sleeping position that's proven to prevent heart palpitations for everyone. Certain positions may make you more aware of your heartbeat, so changing positions may help you feel more comfortable when symptoms are mild.

Can heart palpitations wake you up from sleep?

Yes, a pounding, racing or irregular heartbeat can sometimes be noticeable enough to wake you. If this happens repeatedly, particularly without an obvious trigger or alongside other symptoms, it may be worth discussing with a healthcare provider.