Anxiety, habits, pregnancy, and underlying medical conditions can cause heart palpitations at night. Patients should provide as much information as possible to doctors for evaluation and treatment, which may include EKGs, heart monitors, medications, and lifestyle adjustments.
Anxiety is a very common reason people develop heart palpitations at night. People who are stressed, anxious, or have an underlying anxiety disorder may notice changes in their heart rhythms in bed, and this includes people who are excited, as well as people who are nervous or fearful. There may be other causes, including some underlying medical habit or condition. People who notice palpitations at any time should be evaluated by a doctor to see if they are dangerous.
If anxiety isn’t the cause of nocturnal heart palpitations, a potential culprit is habits. Caffeine and stimulant drugs can cause irregular heartbeats, and if people consume these things too soon before bed, their hearts can beat irregularly. People may also develop heart palpitations after eating, and if they eat just before bed or get up at night to eat, their heart rate may change. Additionally, heavy exercise can change heart rhythms, and many people work out at the end of the day, causing them to have palpitations at night.
Pregnancy is associated with heart rhythm changes, as well as some other underlying conditions. Thyroid abnormalities, structural heart problems, and some other diseases can cause palpitations. Patients tend to notice heart rhythm changes more at night due to the quiet and, as a result, may think they have palpitations only or mainly during the evening hours.
When seeking treatment for nocturnal palpitations, it helps to provide as much information as possible. Patients should describe any associated symptoms such as shortness of breath, dizziness, or disorientation. If possible, the duration of the palpitations should be noted. Doctors may also find it helpful to know what people did during the day, to gather information that can help them find out why a patient’s heartbeat is irregular. Someone who mentions drinking black tea before bed, for example, might simply change their tea drinking habits and experience an improvement in their palpitations at night.
Evaluating palpitations may include ordering an EKG to check for abnormal heart rhythms, as well as conducting a study in which a patient wears a monitor for a specified amount of time to record the patient’s heart activity. This can be useful for things like palpitations, which often don’t happen on command and therefore are difficult to study in a controlled setting like a cardiac lab. Doctors may recommend medications, diet and lifestyle adjustments, and other steps to treat the abnormal heart rhythm.
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