Why is my heart racing when I wake up?
Usually it’s harmless, if it’s brief and you feel well. At night it’s quiet, so you notice your heartbeat more. But if it keeps coming back, see a GP, even if you feel fine.
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Is a racing heart when you wake up normal?
Usually, yes. The NHS says palpitations, when your heartbeat feels racing, pounding or fluttering, are common and not usually a sign of anything serious.
So why at night? A BHF cardiac nurse says that for most people, we are less distracted and there is less noise. So we feel our bodies more.
It’s like a fridge hum. It runs all day, but you only hear it when the house goes quiet. Noticing it more doesn’t usually mean something is wrong.
Once you’ve settled, check your pulse. Sit or lie down for 5 minutes, then count the beats for 30 seconds and double it. If it feels irregular, count for a full 60 seconds.
- Below 60 bpmCan be fine if you’re asleep, very fit or on heart medicines called beta-blockers.
- 60 up to 100 bpmNormal resting rate for adults.
- Above 100 bpmFast for no obvious reason or at rest: see your GP.
Sources: BHF: checking your pulse; BHF: your heart rate
Call 999 if it doesn’t stop, or comes with chest pain, shortness of breath, or feeling faint or fainting.
Why is my heart beating fast at night?
Night is also when worries tend to start. The BHF says stress and anxiety can make palpitations feel worse.
| Cause | Clue | What to do |
|---|---|---|
| Stress or anxiety | Racing thoughts in bed. | Try the steps in the next section. |
| Alcohol | A drink in the evening. | Cut down and see if it settles. |
| Caffeine or nicotine | Coffee, tea, cola, energy drinks or smoking later in the day. | Cut back and see if it settles. |
| Some medicines | Cold and flu tablets with decongestants, some asthma inhalers, the thyroid medicine levothyroxine. | Read the leaflet. Tell your doctor or pharmacist. |
| Menopause | Hot flushes and night sweats. | Speak to a GP. |
| Low blood sugar | Sweating and shaking, usually if you take insulin or some other diabetes medicines. | Speak to a GP or diabetes team. |
Sources: NHS; BHF; NHS: menopause; NHS: low blood sugar
Alcohol can raise your heart rate for a while and make it feel like it’s pounding. More on that in alcohol and sleep. For coffee timing, see when to stop caffeine.
Never stop or change a prescribed medicine without your prescriber. Mention any new palpitations to your doctor or pharmacist instead.
How you lie may matter too. Some experts say back sleepers and left-side sleepers may feel palpitations more. If you notice it more lying one way, try another position.
Waking up with your heart pounding
A panic attack can wake you. In one small, older study of 45 people with panic disorder, 69% had had one from sleep at some point.
Signs include a racing heartbeat, sweating, trembling, shortness of breath and a feeling of dread. The NHS says most attacks last 5 to 20 minutes. They’re frightening, but not dangerous.
If you wake in a panic
- 1
Stay put
Stay where you are, if you can.
- 2
Breathe
Breathe slowly and deeply.
- 3
It will pass
Remind yourself it will pass and isn’t life threatening.
- 4
Picture calm
Focus on peaceful, relaxing images.
Source: NHS: panic disorder
The NHS notes most of these signs can come from other conditions too. So if it’s new or keeps happening, see a GP.
Two other causes can wake you sweating with a fast heart. One is night sweats in the menopause. The other is low blood sugar, which is rare in people without diabetes.
If either sounds like you, speak to a GP.
Heart beating fast at night and can’t sleep?
If it isn’t caused by a health condition, the NHS says avoiding triggers can help.
Things to try this week
- Cut down on caffeine and alcohol, and stop smoking.
- Avoid sugary food and drinks if panic attacks are part of it.
- Keep a diary: when it happened, what you were doing and any other symptoms.
- Learn breathing exercises for stress to help ease symptoms.
- Do regular exercise to ease stress and tension.
- Check the leaflet of any medicine you take for palpitations as a side effect.
Sources: NHS; NHS: panic disorder; BHF
Your doctor can use the diary to understand what you’ve been feeling.
For breathing exercises, see relaxation techniques. In England, you can refer yourself to NHS talking therapies for CBT, a talking therapy that helps you change how you think and react.
What tests might a GP do?
The main test is an ECG. Small pads are stuck to your skin to check the electrical signals from your heart.
One ECG is a photo, not a film. If you don’t get palpitations during it, the BHF says palpitations might not show up. Your doctor may then suggest a Holter monitor, a heart trace you wear for longer.
A blood test can often help show if an overactive thyroid is to blame. See overactive thyroid symptoms and blood tests for palpitations.
For many people, no cause is ever found. Questions to take with you:
- Could any of my medicines be causing this?
- Do I need an ECG, or a heart trace I wear for longer?
- Should I have a blood test for my thyroid?
When to speak to a GP
See a GP if you feel well but:
- Your palpitations keep coming back or are happening more often.
- They last longer than a few minutes.
- You have a heart condition, or heart problems run in your family.
- Your heart is fast for no obvious reason or when you’re at rest, or you have palpitations in the menopause.
- You have diabetes and have had hypos (low blood sugar) at night.
Call 999 or go to A&E if palpitations don’t go away. The same applies if you also have chest pain, shortness of breath, or are feeling faint or fainting.
Don’t drive yourself to A&E. Ask someone to drive you or call 999 and ask for an ambulance.
If these have stopped, ask your GP surgery for an urgent appointment or call 111.
Have a fast or irregular heartbeat? The NHS also says call 999 if it comes with sweating, feeling or being sick, or fainting, dizziness or falling over. Or with a severe headache, or weakness or numbness on one side of your face or body.
Or with blurred vision or loss of sight, confusion or difficulty speaking.