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Heart Palpitations when Lying Down

Palpitation is an awareness of the abnormal beating of the heart. It may occur in people with or without heart problems. Heart palpitations when lying down is not a common occurrence and can be caused by various factors. Let's focus on the causes of heart pounding when lying down and how to deal with them in this article.

Some people may get heart palpitations for only a certain time but others may feel it from time to time. Some feel them whenever or only when they lay down on the bed in which the heart starts beating very fast. It is often most noticeable when you are at rest and there is nothing to distract or draw your attention. The more you fixate on it, the worse it will get. When your heart races, you may feel so nauseated, or even like you are going to die. Many have gone to the emergency room because of this. When you are about to fall asleep, you may wake up suddenly with a horrible sensation due to the heart palpitations. This can happen up to 30 times in 15 minutes. It may be getting to a point where you have to sit up to breath.

Knowing why your heart flutters when lying down will help you a lot in managing them. Below are various possible causes of heart palpitations when lying down.

Heart disease
When lying down, the heart will have to work harder to pump the blood throughout the body. This is why most heart disease patients will experience a certain degree of heart palpitations at rest especially when laying down since their heart has a defect already. Moreover, palpitations when lying down on the left side may indicate congestive heart failure since this puts excessive pressure on the heart.

Heart flutters when lying down may be caused by dehydration. Many things can cause dehydration such as drinking too much alcohol the night before or exercising excessively that day. Staying hydrated helps your body keep the blood volume in normal level. Try to drink lots of Gatorade and lay off the caffeine, alcohol and tobacco.

Stress and anxiety
Most heart pounding when lying down or sitting is caused by stress and anxiety especially when the results of EKG test, CBC and other blood test are all normal. Fear going to bed because of having palpitations and loss of sleep also leads to more palpitations. Stressing about the palpitations is the worse. Learn to control stress and anxiety can help to get rid of or at least minimize anxiety palpitations symptoms although does not always eliminate the problem.

Mitral valve prolapse
Mitral valve prolapse is a valvular heart disease in which one of the heart's valves doesn't work properly. Patients of this disorder may complain about getting heart palpitations at rest, right after lying down on the back or on one side of the body especially the left side. It may also occur when laying down watching television.

Eating too much food
Some get more frequent palpitations when resting after eating too much food or get full.

Hypersensitive electrical systems
Many people who get frequent elevated heart rate at rest just have very sensitive electrical systems in which changing position puts pressure on various parts of the heart muscle where the nerve systems located and cause the palpitations.

Extra nerve pathways
Extra nerve pathways in the heart sends out a little electrical pulse which will make an extra beat (feels like a skipped beat) and after a few more strong beats, the heart return to normal. The heart may also send off an extra beat when the vagus nerve, which basically connects/affects everything, gets stimulated. This is not problematic but can be annoying as they can trigger palpitations.

High physical activities
Excess of physical activity especially just before bedtime may cause heart palpitations when lying down. Exercising and trying to lose weight hard may make you get palpitations more often.

Mineral deficiencies
Calcium, magnesium and potassium deficiencies can also affect heart rhythm and cause rapid heart beat at rest.

Abnormal thyroid function
An underactive (hypothyroid) or overactive thyroid (hyperthyroid) intensify heart palpitations at rest. Palpitations combined with rapid heart rate (>100 bpm) are typical signs of hyperthyroidism. Get a thyroid (TSP) test and if your thyroid is not functioning correctly, that could be the cause. A beta blocker like atenolol or propanolol usually helps relieve the palpitations. Heart flutters when lying down from uncontrollable anxiety or abnormal thyroid level usually can be controlled with a very benign dose of prescription toprol XL which will slow your heart rate and thereby decrease the number of palpitations you feel. Related reading: Complete Symptoms of Hypothyroid / Low Thyroid Functioning.

Hypoglycemic and anemia
Hypoglycemic and anemia also exacerbates heart pounding when lying down. Learn further Signs and Symptoms of Hypoglycemia in Non Diabetics and Diabetics.

Hormone changes
Elevated heart rate at rest can and do occur for some due to hormone changes. PMS, perimenopause and menopause all add up to heart palpitations episode. Estrogen depletion also can affect heart palpitations. It the palpitations are hormones related, using progesterone cream helps some sufferers. Read also Menopause and Heart Palpitations.

Internal inflammation
If you do not have any physical issue with your heart, then heart palpitations when lying down may be a problem related to internal inflammation. Internal inflammation is especially caused by too acidic diet such as cola, hot dogs and other acid foods and drinks. The build up of acid in your system is a slow process where our body can balance the acid/alkaline ratios and starts to manifest the signs after many years, commonly in your mid 40's or 50's.

High blood pressure
Some people with high blood pressure and an enlarged heart get heart 'skipping' or flipping episode and a feeling of being out of breathe along with anxiety in the middle of the night. It may continue with other symptoms, such as numbness, in the morning. Fortunately, this is often reversible within 3 to 6 months by taking blood pressure medication along with proper dieting and regular exercising. Read further about this topic at Physical Symptoms of High Blood Pressure: Palpitations, Headache, Dizziness.

Sensitivity to changing blood pressure
Heart palpitations when changing position, i.e. sitting down or lying down, is usually due to blood pressure or blood volume changes. Having poor circulation may also lead to heart palpitations when lying down.

SVT (Supraventricular tachycardia)
Heart pounding when changing position i.e. go from standing to lying down could also be a sign of SVT. SVT is a type of heart rhythm disorder, technically referring to any tachycardia rhythm (rapid heartbeat) originating above the ventricular tissue in the atria. During an episode of SVT, the heart's electrical system doesn't work right, causing the heart to beat very fast or skip beats. You may feel a choking sensation in your chest and throat. If this is what you have, prescription drugs such as Inderal, adenosine, adenocarb, etc. to revert the heart rate back to sinus rhythm may be quite helpful. It could also be a manifestation of panic attacks, in which medications like Zoloft may be helpful.

PVCs (Premature Ventricular Contractions / PACs (Premature Atrial Contractions)
PVCs are extra, abnormal heartbeats that begin in one of the ventricles while PACs are a common cardiac arrhythmia characterized by premature heartbeats originating in the atria. The palpitations can vary from one person to another. PVCs / PACs can occur as soon as you lie down at night time or sometimes even just leaning comfortably to one side they start. They may not stop until you roll over or sit up. Some experience them especially when they lie on their back or left hand side. While others found that lying on their back, or sitting up does help. Bending over can also cause them to start. Having acid reflux, caffeine, certain medications, MSG, low levels of potassium stress and anxiety may trigger and increase PVC's/skipped beats/heart flutters/thumps symptoms.

A brisk walk of 5 to 10 minutes may help to shut off the PVCs. Also, take a walk after meals to pre-empt the PVCs. PVCs frequency can also be reduced by eating smaller, balanced meals, taking a multi-vitamin and mineral every day as well as reducing carbohydrates and sugary foods in the evening.

Post operation / OHS (Open Heart Surgery)
OHS is a surgery in which the patient's heart is opened and surgery is performed on the internal structures of the heart. After an OHS procedure, some patients felt pronounced heart beating in the throat, or ears or in the chest when they are relaxing such as when laying down at night, or when leaning back on a chair or sofa. Some felt their heart thump when breath in deeply. Occasionally, some may get the palpitations when they did not get enough sleep the night before. Possible causes of heart palpitations when lying down after OHS:

  • During the heart surgery, the pericardium is removed, repaired and then put back onto the heart thus may disrupt the heart's natural insulation.
  • If the OHS involved aortic valve replacement, the failing aortic valve will be replaced with an alternate healthy valve. Artificial heart valve does not have the natural aortic material to absorb pulses from the heart beating that is transmitted throughout the chest cavity.

Caffeine, alcohol, tobacco, aspartame, MSG and certain medications
Caffeine, alcohol and tobacco may act like adrenaline / stimulant and exasperate flushing and rapid heart rate at rest. Also, some people are extra sensitive to caffeine. Reduce the stress level and stop all caffeine, alcohol and tobacco especially before the bedtime should ease the symptoms. MSG, OTC medications such as pseudoephedrine and aspartame in diet soda or other products may also lead to heart flutters.

The hormonal changes and increased demand of blood and nutrients may cause some pregnant women to experience heart palpitations at rest. This is normal, but if you are concerned you can consult with your doctor to rule out any possible underlying problem.

Lack of sleep
Missed getting appropriate sleep is another trigger elevated heart rate at rest.

Heart palpitations when lying down on left side
Some people experience the sensation of heart palpitations while lying down on their left side, which is the same side as the heart. This is because lying down on left side may cause physical contact between the heart and the chest which will irritate the heart causing it to beat faster. Also, the pressure to the heart, lung and stomach while you are lying on left side may stimulate the right vagus nerve and cause the rise in heartbeat.

Staying physically fit is important since it not only keeps your heart healthy, but also makes you feel better emotionally. If you have a healthy heart and are allowed to do exercise, then do it and stop worrying about going into cardiac arrest. It may not be easy and need some times but it will change your reaction towards heart palpitations once you get fit.

When palpitations come, take a deep breath and exhale several times in a row to increase oxygen supply in blood. Also, try to tense every muscle in your body and then relax.

Not all heart flutters when lying down are related to heart problems or other illnesses. If the heart is beating between 70 to 80 beats per minute this is considered to be a normal heart rate. But, if you are concerned you can consult a doctor and a series of tests can be done to check the normality of your heartbeat during palpitations episodes as well as determine the causes. The tests may include standard blood test (thyroid test etc), EKG, Echo, 24 hours holter (heart) monitor, chest x-ray, heart scan and stress tests. Heart palpitations when lying down may or may not resolve on its own but, if it becomes severe or very frequent, then you should consult with your doctor to get proper diagnosis and treatment. If you have chest pain, tightness, shortness of breath and numbness, then go check it out with doctor as soon as possible.

Disclaimer: This information is not presented by a medical practitioner and is for educational and informational purposes only. It is not intended to be a substitute for professional advice, diagnosis, or treatment.