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Have you ever felt your heart beat faster than usual? Pounding in your chest or throat when lying down at night? Have you felt fluttering or like your heart missed a beat?
You could be having heart palpitations. Heart palpitations are a feeling of your heart racing or missing beats.
Your heart palpitations could be linked to sleep apnea, anxiety, too much caffeine, certain medications, or an underlying heart problem.
Read on to learn more about heart palpitations, including causes and what you can do to stop them.
Heart palpitations may feel like your heart is beating stronger than it normally does. It can be an uncomfortable awareness of your heartbeat that you usually don’t notice.
People with heart palpitations may feel the following when lying down at night:
Heart palpitations can last a few seconds or minutes. Sometimes, they last longer. They can have many causes, including anxiety, sleep apnea, too much caffeine, certain medications, or an underlying heart problem. Get medical care right away if palpitations last more than a few minutes, feel severe, or happen with chest pain, shortness of breath, dizziness, or fainting.
However, anyone with frequent palpitations should have a cardiology workup to check if these are signs of specific heart issues.
Heart palpitations can have many causes, including lifestyle factors or certain medical conditions. Even certain sleeping positions can cause them. There may also be instances when heart palpitations happen for no known reason.
The following lifestyle factors could lead to nightly heart palpitations:
Heart palpitations can also be caused by medical conditions such as sleep apnea or anxiety. Breathing pauses or lack of sleep caused by stress and anxiety can stress the heart and lead to heart palpitations at night.
Heart palpitations can also be caused by thyroid problems, anemia, and low blood sugar.
Heart problems like heart attack damage and arrhythmias, such as atrial fibrillation (AFib), can also lead to heart palpitations.
AFib causes an abnormal heart rhythm that can be both fast and irregular. During AFib, electrical signals do not work as they should, which results in your heart not pumping blood as it should.
The heartbeat you feel during AFib comes from the heart’s lower chambers pumping irregularly. This can increase the risk of stroke and heart failure.
Sleep apnea has been linked to AFib; however, the connection is not yet fully understood. Breathing pauses during sleep may lead to changes in the heart.
People with AFib are treated with medications to help control their heart rate or rhythm and reduce the risk of stroke. Certain procedures, such as catheter ablation, may also be recommended. Catheter ablation is a procedure that stops the electrical signals that can cause irregular heart rhythms.
Sleep apnea may make some AFib treatments less effective. Using continuous positive airway pressure (CPAP) therapy may lower the risk of AFib coming back after catheter ablation.
In one study, people with sleep apnea who didn’t use CPAP therapy were eight times more likely to have catheter ablation fail.
Both sleep apnea and AFib can increase the risk of stroke, so it’s important to diagnose and treat both conditions.
Your doctor will review your medical history and ask about your symptoms, diet, and medications you take. It is important to tell your doctor when, how often, and how long you experience heart palpitations. Let them know how you feel when they happen and what makes you feel better.
Your doctor may order these tests to help determine the cause:
You may also be asked to wear a heart monitor that records your heart’s activity over a period of time. These tests can help your doctor find the cause of your heart palpitations. Depending on the results of this testing, you may be referred to a doctor who specializes in heart rhythms.
Stopping nightly heart palpitations depends on the cause. If alcohol or caffeine is the trigger, cutting back may help.
Your doctor can provide testing to determine whether the underlying problem is serious and can recommend the right treatment.
You may not need treatment at all, depending on the cause. Several lifestyle changes may help prevent heart palpitations, including:
Heart palpitations caused by certain medical conditions may require treatment of the underlying cause.
If the heart palpitations are caused by a heart problem or irregular heart rhythm, your doctor may recommend a medication, procedure, or device. It is best to follow up with your doctor regularly.
People with anxiety or thyroid issues may be given medication. Those with vitamin or mineral deficiencies may be given supplements or infusions. People with sleep apnea are usually treated with CPAP.
Talk to your doctor about what treatment options may work best for you.
Nighttime heart palpitations are common, but they can sometimes be related to a serious health condition. Call your doctor if you have palpitations that get worse, happen more often, or start suddenly.
Get immediate medical attention or call 911 if you have heart palpitations and any of the following: 
On MySleepApneaTeam, people share their experiences with sleep apnea, get advice, and find support from others who understand.
Have you had heart palpitations? What did they feel like, and what helped? Let others know in the comments below.
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