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Sleep arrhythmias

Sleep tachycardia is a significant increase in the heart rate, and it is a condition that occurs during the night.


In more detail, tachycardia during sleep is a symptom that can be associated with various conditions, both pathological and non-pathological.

Contrary to what one might think, in fact, nocturnal tachycardia is not always associated with heart disease, and disorders that have various causes can also occur.

In the course of this article, the main causes of nighttime tachycardia, the associated symptoms, and possible treatments that can be taken to address this problem will be analyzed.

What is an arrhythmia during sleep?

Tachycardia at night is a symptom that can arise from various disorders and diseases not necessarily related to the cardiovascular system.

In this regard, it is good to remember that in adults one can have tachycardia when the resting heart rate exceeds 100 bpm.

Tachycardia during the night can awaken an individual who may feel anxious or panicked, further exacerbating the problem, and feeling an increased heart rate.

Although, as will be seen in the article, nighttime tachycardia is not in many cases a serious problem, the symptoms should not be underestimated, especially if it tends to occur for several nights in a row or if it is associated with other symptoms. Being an indication of an underlying serious condition. In such cases, a doctor’s advice is essential.

What are the causes of an irregular heartbeat during sleep?

As mentioned, arrhythmia during sleep is a symptom that can occur due to causes that may be normal or abnormal. These reasons include:

  • Conditions affecting the heart: heart rhythm disturbances (pathological arrhythmias), damage to heart tissues (for example, due to a previous myocardial infarction ), or heart failure.
  • Anxiety disorders, panic attacks and stress: In many cases, tachycardia may be due to anxiety and particularly severe stress conditions, as well as it can be a sign of panic attacks.
  • Hyperthyroidism: The excessive production of thyroid hormones that characterize hyperthyroidism also affects the cardiovascular system, resulting in an increase in the heart rate and an increase in the strength of the heart contraction.
  • Anemia: Suffering from anemia can have negative repercussions on the heart, causing tachycardia due to disease. In the case of anemia, various organs and tissues receive less oxygen. Therefore, the heart tries to compensate for this condition by doing more to ensure the correct supply of oxygen to all parts of the human body.
  • Dyspepsia and GERD: Sometimes, nocturnal tachycardia can be caused by poor digestion – for example, by eating a large and “heavy” meal – or by the occurrence of esophageal reflux.
  • Addiction to alcohol and smoking: All addictions, such as alcoholism and tobacco smoking, can affect the heart rate, causing tachycardia, even at night.
  • Taking some types of drugs: Nocturnal tachycardia can manifest itself as a side effect of medications taken before going to bed or in the evening hours. Examples of these medications include: anti-asthma, anti-hypothyroid drugs, ephedrine, decongestants, and adrenaline.
  • Hormonal changes: Nocturnal tachycardia may also appear in response to hormonal changes and imbalances. Therefore, it is not surprising that many women experience these symptoms just before their period or during menopause .
  • Take stimulants before bed, such as caffeinated beverages.
  • Take drugs.
  • Episodes of nocturnal tachycardia can occur as a result of nightmares and negative emotions.

Associated manifestations and symptoms

What are the manifestations and symptoms associated with an arrhythmia during sleep?

The nocturnal tachycardia manifests itself in a clear and sudden manner, causing the individual to awaken and raise fears. Palpitations are a direct result of the tachycardia at night.

However, depending on the cause of the symptoms in question, different or more serious symptoms are likely to occur, and their severity may vary from patient to patient. These symptoms include:

  • Feeling of chest tightness and chest pain (these symptoms can either be caused by severe heart disease or gastroesophageal reflux).
  • Difficulty breathing or shortness of breath.
  • Cold sweats.
  • Edema.
  • Pain and burning in the stomach.
  • Nausea and vomiting.
  • Dizziness
  • fainting.
  • Vision disturbances.
  • A sense of anxiety (a typical symptom of anxiety that may also arise from a bad nightmare).
  • Nervousness.
  • weakness.
  • Hot flashes (a typical symptom of the menopause).


Of course, these are just some of the symptoms that can occur in association with tachycardia at night. In fact, symptoms can vary a lot from one individual to another, not only according to the cause of the nighttime tachycardia, but also according to its severity and pathological or non-pathological nature.

When should you worry and go to the doctor?

Fortunately, in most cases, nocturnal tachycardia tends to regress spontaneously within a short period of time. If symptoms appear intermittently, if they tend to go away within a few minutes and if a possible unsatisfactory cause can be identified (for example, excessively large evening meals, drinking coffee before bedtime, medication, alcohol or drug use, And so on), then it is not necessary to be disturbed because in all likelihood this does not hide pathological causes. However, for more peace of mind, medical advice can still be sought.

Conversely, when nocturnal tachycardia occurs frequently, lasts for a long time, and / or is associated with “suspicious” symptoms, a doctor’s consultation is essential. If the symptoms are of particular concern (for example, fainting, chest tightness etc.), it would be a good idea to call medical help or go to the nearest emergency room.

The importance of diagnosis in the event of an arrhythmia during sleep

In the event of a nighttime tachycardia, a correct diagnosis by a doctor is necessary to determine the presence of any medical conditions that may be causing the symptoms.

When a patient comes to the doctor, it is the duty of that healthcare professional to gather all possible information about the problem that has occurred and the symptoms reported by the patient (medical history). On the basis of the data collected, the doctor can determine the initial diagnosis that can be confirmed by performing blood tests (hematocrit and other more detailed and specific analyzes), as well as diagnostic tests (for example, electrocardiogram, echocardiogram, endoscopy, and ultrasound) Thyroid gland, etc.) and special conditions (such as heart disease, digestive system, endocrine, psychiatric, etc.) can also be evaluated.

Treatment and care

The treatment of nocturnal tachycardia is dependent and is closely related to the treatment of the underlying cause. Therefore, the importance of making a correct diagnosis must be emphasized.

In general, when nocturnal tachycardia is caused by non-pathological conditions, it is not necessary to intervene with specific treatments, but some simple behavioral measures are sufficient, such as:

  • Avoid eating huge meals in the evening and not eat foods that are difficult to digest.
  • Avoid taking stimulants before going to bed, such as coffee or some soft drink.
  • Avoid consuming alcohol during the evening.
  • Avoid smoking.
  • Stop taking medications that can cause nocturnal tachycardia (however, it should be noted that interruption of ongoing therapy should only be done if the doctor explicitly suggests so).
  • Reduce stress and anxiety as much as possible.

Pharmacological treatments

In the event of nocturnal tachycardia due to pathological causes, drug therapy may be necessary. It is clear that drug treatment must be determined by the doctor or specialist, after making an accurate diagnosis, based on the type and severity of the disease that led to the symptoms. Among the possible drugs that can be used to combat nocturnal tachycardia and its causes, we mention, for example:

  • Beta blockers in the presence of heart rhythm disturbances.
  • Heart failure medications.
  • Antacids for gastroesophageal reflux.
  • Medicines to treat hyperthyroidism for patients with a thyroid disorder.
  • Drugs that help stop smoking.

For more detailed information about all available treatments for the possible causes of nocturnal tachycardia (such as heart disease, hyperthyroidism, anemia, anxiety, panic attacks , alcoholism, smoking, GERD), you can read the articles on this website.



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