Heart Racing at Night? Common Causes and How to Calm It

Quick answer: A racing heart at night is often linked to stress, caffeine, alcohol, heavy meals, dehydration or some medicines, but it can also signal a heart rhythm, thyroid or sleep problem. Slow breathing may help you calm down. Call 911 if you have chest pain, fainting or trouble breathing, and see a doctor if it keeps happening.↗ Share on X

A fast heartbeat at night is often caused by everyday things: stress or anxiety, caffeine or alcohol late in the day, a heavy dinner, dehydration, a bad dream, or some medicines. You can often calm it with slow breathing, a cool room, and changes to your evening habits. But a racing heart can also point to a heart rhythm problem, a thyroid issue, or sleep apnea, so it is worth telling your doctor, especially if it keeps happening. If it comes with chest pain, fainting, or trouble breathing, call 911 or your local emergency number right away.

This article is for general information only. It does not replace a visit to a doctor.

When is a fast heartbeat at night an emergency?

READ ALSONighttime Racing Mind: Why It Happens and How to Slow It Down →Too Hot to Sleep? 9 Ways to Cool Down and Fall Asleep →Can't Sleep at Night? 7 Checks to Make Before Trying Pills →

Start here, because this part matters most. Call 911 (or your local emergency number) if your racing heart comes with any of these:

• chest pain, pressure, or tightness
• pain that spreads to your arm, neck, jaw, or back
• trouble breathing or shortness of breath
• fainting, or feeling like you are about to faint
• sudden confusion, weakness, or trouble speaking
• a heartbeat that stays very fast and does not slow down when you rest

Do not drive yourself to the hospital if you feel this way. Wait for help or have someone else drive.

What is a normal heart rate?

Your heart rate is the number of times your heart beats in one minute. For most adults at rest, a normal rate is between 60 and 100 beats per minute. During sleep, it usually drops lower than your daytime resting rate.

People who exercise a lot may have a resting rate below 60, and that can be normal for them. A heart that beats faster than 100 times per minute while you are at rest is called tachycardia (a medical word for "fast heart"). It is not always dangerous, but it is a good reason to check with a doctor if it happens often.

How to check your pulse:

1. Place two fingers (not your thumb) on the inside of your wrist, below the thumb, or on the side of your neck.

2. Count the beats for 30 seconds.

3. Multiply by 2.

4. Notice whether the beats feel steady or irregular (skipping, fluttering, or uneven).

Write down the number, the time, and what you were doing. Your doctor will find this very useful.

What are the common causes of a racing heart at night?

READ ALSOCan't Sleep at Night? Check These 7 Things Before Pills →Waking Up at 3am Every Night? Here's Why It Happens →Why You Wake Up at 3am and How to Get Back to Sleep →

Many causes are harmless and easy to change. Others need medical attention. This table gives an overview:

Why does anxiety feel worse at night?

During the day, work, people, and noise keep your mind busy. At night, it is quiet. Worries get louder. When you feel anxious, your body goes into "fight or flight" mode. Your heart beats faster, your breathing gets quicker, and you may feel hot or sweaty.

Some people wake up suddenly with a pounding heart, fear, and shortness of breath. This can be a nighttime panic attack. It is frightening, but it usually passes within minutes. Still, the symptoms can look like a heart problem, so a doctor should check you the first time, and anytime you are not sure.

How can you calm your heart right now?

If you are not having any of the emergency signs above, these steps may help your body relax:

1. Sit up slowly and put your feet on the floor.

2. Breathe out longer than you breathe in. Breathe in through your nose while you count to 4. Breathe out slowly through your mouth while you count to 6. Repeat for 2 to 5 minutes. A longer breath out helps signal your body to slow down.

3. Cool down. Splash cool water on your face or hold a cool cloth to your face or neck.

4. Drink a glass of water if you think you may be dehydrated.

5. Ground yourself. Name 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell, and 1 you can taste. This pulls your attention away from your heartbeat.

6. Check your pulse again after a few minutes and write it down.

You may have read about other tricks to slow the heart, such as bearing down or putting your face in ice water. These are sometimes taught by doctors for specific rhythm problems. Only use them if a doctor has shown you how and said they are safe for you.

If your heart does not slow down, or you start to feel worse, get medical help.

What evening habits can help prevent it?

Small changes to your evening can make a real difference for many people.

Other helpful habits:

• Keep your bedroom cool, dark, and quiet.
• Go to bed and wake up at about the same time every day, even on weekends.
• Write down your worries on paper before bed, with one small next step for each. It helps some people let go of them for the night.
• Drink enough water during the day, then slow down in the evening so you are not up to use the bathroom.

When should you see a doctor?

Make an appointment, even if it is not an emergency, if:

• your heart races at night more than once in a while
• your heartbeat feels irregular, skips, or flutters
• you snore loudly, or someone has noticed you stop breathing during sleep
• you also feel very tired, dizzy, or short of breath during the day
• you have lost weight without trying, feel shaky, or feel hot all the time
• you have heart disease, high blood pressure, diabetes, or thyroid problems
• you recently started a new medicine or supplement

What will the doctor check?

Knowing what to expect can make the visit less stressful. Depending on your symptoms, your doctor may:

• ask about your sleep, caffeine, alcohol, medicines, and stress
• listen to your heart and check your blood pressure
• order an ECG (a quick, painless test that records your heart's electrical signals)
• give you a wearable heart monitor to record your heartbeat for a day or longer, since night symptoms often do not show up during a short visit
• order blood tests for thyroid function, blood count, and minerals like potassium
• suggest a sleep study if sleep apnea is possible

Bring to your appointment:

1. Your pulse notes (number, time, what you were doing).

2. A list of all medicines and supplements you take.

3. How much caffeine and alcohol you usually have.

4. Any heart problems in your family.

If you use a smartwatch that tracks heart rate, bring those readings too. They are not a diagnosis, but they can help your doctor see a pattern.

Your next step

Tonight, move your last caffeine to before noon, finish dinner at least 2 to 3 hours before bed, and practice the 4-in, 6-out breathing for 5 minutes before you lie down. Keep a small notebook by your bed to write down your pulse and the time if your heart races. If it happens again this week, or if you notice any irregular beats, call your doctor and bring your notes.

FAQ

What is a normal resting heart rate?

For most adults, 60 to 100 beats per minute at rest. It usually drops lower during sleep.

Can anxiety make my heart race at night?

Yes. Stress hormones can speed up your heart, and nighttime panic attacks can wake you with a pounding heart. A doctor should rule out other causes.

When is a fast heartbeat an emergency?

Call 911 if it comes with chest pain, trouble breathing, fainting, confusion, or a very fast rate that does not slow down with rest.

Educational content, not medical advice. Talk to your doctor before making health decisions.