Heart Racing at Night: Should You Worry?

By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.

One of the most universal experiences I heard in my cardiology practice was the frustration of lying down at night and not being able to sleep because of a racing heart.

The storylines were all similar. “Doc, it was just like any other night. I was trying to relax and then I started to notice that my heart was charging. When I couldn’t stop it, I started to worry—and it just got worse!”

If this has happened to you, I want you to know that your experience is common. More importantly, I want you to relax and understand that most episodes of heart racing at night are not dangerous.

Why Your Heart May Be Racing at Night


What’s going on in your life? Are you excessively worried about something? Are you trying not to worry about something? This is the first cause I explore when patients describe a racing heartbeat.

What often happens when people experience their hearts racing at night is that they’re worried about a person or a circumstance in their life, and those heavy thoughts put them into a state of “sympathetic overdrive.” They stimulate the fight-or-flight response, and the body responds by increasing respiration and blood pressure, as well as speeding up the heart. Feeling out of control ratchets up the response even more.

Even if you think you’re doing fine, I challenge you to look deeper. Our thoughts—even unconscious ones—are always revealed in the heart. It will reflect what we’re truly feeling, regardless of what our brains tell us to believe.


Whether from wine, beer, or spirits, alcohol affects the heart in many ways—some good, and some bad. Having a drink to help you relax and go to sleep? That’s a bad idea.

Alcohol is high in sugar and its metabolites are associated with many types of arrhythmias, and may well be the cause of a racing heart at night. Worse, if you have a drink because you’re worried and can’t relax, it’s like throwing gasoline on a fire. You’ve just doubled down on the number of things that can bring on this type of heart palpitation.

Research shows that one drink a day can have protective effects on the heart. If you want to have that drink, try to do so with your dinner. That way you’ll avoid setting yourself up for potential palpitations.


A third potential cause of nighttime heart racing is bedtime snacks. We know that eating too much sugar can cause heart palpitations—so hopefully you’re not eating cake or other sweets before bed. But I would also warn against something that seems more innocent, like a bowl of corn flakes.

I’ve heard a lot of patients say they do this to take advantage of the tryptophan in milk. What they miss, unfortunately, is that milk is also high in sugar, and that corn flakes are high glycemic. The glucose from them hits your bloodstream quickly and can cause racing and palpitations immediately after eating. If your body’s insulin response happens to overshoot the spike in blood sugar, you then run the risk of becoming hypoglycemic. The adrenaline bump that comes with hypoglycemia can also cause palpitations and racing. If you love a bowl of cereal at night, make sure to add nuts, full-fat milk, and even fresh berries to it, to help slow down insulin release with fat, protein and fiber.

Is a Racing Heart at Night Dangerous?

For people with good heart rate variability, a racing heart at night is not usually dangerous. Although, if it happens repeatedly, you should consult a cardiologist just to make sure you don’t have some kind of underlying cardiovascular disease.

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