Do you know the feeling every time you’re about to doze off, your heart starts beating very hard, and you can’t sleep? You may also feel a pulsating sensation in your throat or chest; it’s almost as if a bunch of bees are flying around in your chest.
This experience is commonly known as heart palpitations, and quite a few people are having them before they try to fall asleep. Or you might have less trouble falling asleep but wake up after a few hours drenched in sweat with a racing heart.
In this article, we look at the crucial interplay between palpitations and insomnia and what you can do to reduce the impact of palpitations on your sleep.
What are possible causes for heart palpitations?
Heart palpitations can start at any time of day and last from a few seconds to a few minutes. Although palpitations are quite common and generally considered harmless by doctors, they can be especially frightening if they occur at night when you’re lying down to sleep.
Some possible causes or triggers of palpitations are:
- Exercise or other physical activity
- Certain medications, such as asthma inhalers, cold medications, or thyroid tablets
- Stress or other strong emotions
- Recreational drug use
- Nicotine use
- Eating high-fat foods or foods high in monosodium glutamate (MSG), fat, or sugar
Palpitations can be a sign of an underlying condition
Sometimes heart palpitations are a sign of an underlying health condition. For example, they are a common complaint in patients who visit the emergency department, with causes ranging from benign to life-threatening. Underlying conditions that can cause palpitations include
- Low blood pressure
- Low blood sugar
- Depression and anxiety
- arrhythmia (improper heartbeat)
Especially the last two points, arrhythmia and depression and anxiety, seem to be closely related to palpitations. Scientists found in a study involving over 600 people that cardiac arrhythmias most commonly cause palpitations. And another study revealed that in about 30% of the participants, their palpitations had psychiatric causes like depression and anxiety.
Why do I have heart palpitations at night?
The reason why you experience palpitations more often or only at night is not fully known, but one could be that there are fewer distractions at night and the noise level is much lower. If you are lying awake in bed, in the dark, with nothing else to think about, you will notice them more.
Some people also report that they are more prone to palpitations when they sleep on their side, especially the left side. In this position, your heart is directly against the chest wall, and the heartbeat sensation reverberates.
Can palpitations cause insomnia?
Palpitations usually don’t cause insomnia, but they can trigger worries and anxiety, which then keep you awake. On the other hand, worry and anxiety could be the cause of both, your insomnia and your palpitations.
Again, the dark, quiet bedroom environment adds to the problem because this is also when troubling thoughts and feelings such as stress, anxiety, and panic have an easier time. We’re often just too busy and distracted during the day, but once we’re lying quietly in bed in a dark room, the unpleasant thoughts and feelings can overwhelm us and keep us awake forever.
This is, of course, even more challenging when these internal experiences are coupled with the onset of palpitations. In other words, anxiety, together with palpitations, is a recipe for insomnia.
How can I manage the anxiety caused by palpitations?
If your palpitations are bothering you, it’s a good idea to see a doctor and determine if it’s caused by an underlying disease. You may even get a Holter monitor, a type of portable electrocardiogram (ECG) which monitors your heart for at least 24 hours. Chances are that it will turn out fine, and your doctor tells you there’s nothing to worry about. That might help you feel less anxious at night.
If you then still feel anxious and can’t sleep, it’s necessary to seek a mental solution to your sleep problem, which might reduce the palpitations. I’ve written a blog post on how to better deal with racing thoughts at night.
However, please resist the urge to take sleeping pills right away; they are rarely a suitable long-term remedy, either for your anxiety or for your sleep.
Is it possible to stop heart palpitations?
In most cases, palpitations disappear on their own, and it’s best just to wait until this happens. Forcefully trying to stop palpitations may only increase your tension, and thus the beatings get worse.
Remember, it’s often the stress response, your body’s tendency to go into a state of “fight-or-flight” to deal with potential threats that often exacerbate certain conditions.
So when you have palpitations, try to gain greater awareness of what’s going on in your body. Locate where you feel the discomfort and then slowly breathe into these parts. This is simple awareness and breathing technique that often helps alleviate the symptoms.
When should I consult a doctor?
Occasional palpitations do not necessarily require medical advice or treatment. Remember, even healthy people can have them.
However, if the following symptoms occur, you should seek medical attention:
- Tightness or pain in the chest
- Difficulty breathing
- Feeling faint
In all these symptoms an early detection and treatment is key to managing the underlying condition.
How to get the right diagnosis for palpitations?
If you want to get a medical check for your palpitations, it’s good to be prepared before visiting your doctor. Keep a journal and write down your experiences because your doctor will most likely ask the following questions:
- When do the palpitations occur?
- What are the sensations that cause it?
- How long do the palpitations usually last?
- How often do they occur?
- What are suspected triggers of the palpitations, such as medications, caffeine, or a heavy meal?
The doctor may also ask a few questions about your lifestyle; if you exercise regularly and what kind of sports you do, about your diet, and if there are any known underlying medical conditions.
However, the problem with palpitation is that they usually only occur randomly (at night). Therefore, for the right diagnosis, the doctor may also order some more thorough testing, including Holter monitoring, a portable device to monitor your heart for 24 or more hours to see if there is any irregularity in your heart’s rhythm.
The doctor may also do blood tests to detect underlying conditions such as anemia, thyroid dysfunction, or low potassium levels.
What are the treatment options for palpitations?
Treatment for palpitations depends on the cause. If a known underlying condition is the cause, you need to follow medical advice to treat the disease. Your doctor can also advise if you should take any medications, such as beta-blockers or calcium channel blockers, that help the heart return to a normal rhythm.
However, in most cases, palpitations are harmless. So if you have ruled out any underlying condition, the usual approach is to make lifestyle changes, such as
- quitting smoking and avoiding secondhand smoke
- reducing or abstaining from caffeine and alcohol consumption
- drinking enough water or other liquids
- eating regular meals
- sticking to a regular sleep schedule
You may also ask your doctor to review your medications and supplements to determine if they are causing or contributing to the palpitations. For some people taking magnesium supplements helped with their palpitations and sleep, while in others taking melatonin worsened the symptoms. So it’s crucial to find out what works for you.
Palpitations can occur at any time of the day or night and are, in most cases, nothing to be concerned about. If you have them frequently, rule out possible causes and triggers, such as certain medications or consuming too much caffeine.
However, palpitations can also occur due to underlying health conditions that vary in severity. Especially if the palpitations don’t go away or are accompanied by feelings of confusion, chest pain, or shortness of breath, you should seek medical attention.
Heart palpitations in themselves don’t trigger insomnia; it’s usually the associated anxiety and worry that keeps you awake. Although it may seem counterintuitive, the best approach to regaining restful sleep is to accept the palpitations and difficult thoughts and feelings as you lie awake in bed rather than fighting them.