Poor sleep can increase nervous-system activity, make the heartbeat more noticeable and contribute to premature beats or a faster pulse. For some people, lack of sleep can also act as an arrhythmia trigger. Repeatedly waking with a racing heart may also point to an underlying sleep disorder such as obstructive sleep apnea.
Yes. Not getting enough sleep can contribute to heart palpitations. Sleep normally allows heart rate and blood pressure to fall and shifts the body toward parasympathetic “rest-and-recovery” activity. Repeated sleep loss can increase sympathetic nervous-system activity and may make pounding, skipped or racing heartbeats more likely. The American Heart Association lists lack of sleep among common contributors to PACs and PVCs and notes that sleep loss can trigger SVT in some people. However, persistent, markedly irregular or worsening palpitations should not automatically be blamed on tiredness.
When Palpitations After Poor Sleep Need Urgent Attention
Seek urgent or emergency medical care if palpitations occur with:
- significant chest pain or pressure;
- severe or sudden shortness of breath;
- fainting or loss of consciousness;
- collapse;
- severe dizziness or near-fainting;
- a sustained very rapid or markedly irregular heartbeat while you feel seriously unwell;
- confusion or signs of poor circulation;
- new severe weakness; or
- rapidly worsening symptoms.
A sleepless night does not make these warning signs less important. Do not assume serious symptoms are simply caused by exhaustion.
Why Can Lack of Sleep Cause Heart Palpitations?
Sleep is an important period of cardiovascular recovery.
During normal non-REM sleep, heart rate and blood pressure generally fall and the parasympathetic nervous system becomes more dominant.
When sleep is repeatedly shortened or disrupted, this normal recovery period is reduced.
Sleep deficiency may contribute to:
- greater sympathetic nervous-system activity;
- increased stress-hormone activity;
- changes in blood-pressure regulation;
- greater emotional reactivity and anxiety;
- increased stimulant use to stay awake; and
- greater awareness of heartbeat sensations.
Some people are simply experiencing a stronger or faster normal sinus rhythm. Others may be noticing PACs or PVCs. A smaller group may have a genuine arrhythmia. The sensation alone cannot identify which rhythm is present.
Can One Bad Night of Sleep Cause Palpitations?
It can contribute, particularly in someone who is already sensitive to stress, caffeine or premature beats.
After a poor night of sleep, people may experience several triggers at once:
- greater sympathetic nervous-system stimulation;
- more anxiety or irritability;
- extra coffee or energy drinks;
- less physical recovery;
- dehydration from a disrupted routine; and
- greater attention to physical sensations.
A few skipped or pounding beats after one unusually poor night do not necessarily indicate heart disease.
Repeated Symptoms Deserve More Attention
If palpitations occur every time you sleep poorly, become frequent, continue even after your sleep improves or feel sustained and irregular, it is reasonable to discuss the pattern with your healthcare professional.
Can Lack of Sleep Cause PACs or PVCs?
Lack of sleep is a recognized trigger for premature contractions in some people.
The American Heart Association lists not getting enough sleep among common contributors to premature atrial contractions (PACs) and premature ventricular contractions (PVCs).
These premature beats may feel like:
- a skipped heartbeat;
- a pause;
- a sudden flutter;
- a strong thump;
- the heart briefly “turning over”; or
- repeated irregular sensations.
A premature beat occurs early and may be followed by a short pause. The next normal contraction may then feel stronger, creating the sensation that the heart skipped and suddenly thumped.
Occasional premature beats are common. If skipped beats occur continuously, every few minutes or are becoming more frequent, see constant or frequent heart palpitations .
Can Lack of Sleep Trigger SVT?
Yes, in some susceptible people.
The American Heart Association identifies lack of sleep as one possible trigger for supraventricular tachycardia, along with stress and exercise in susceptible individuals.
SVT often feels different from gradually becoming aware of your heartbeat while tired.
A typical SVT episode may:
- begin suddenly;
- feel very rapid;
- often feel regular rather than randomly irregular;
- continue for minutes or longer; and
- end abruptly.
Associated symptoms can include:
- dizziness;
- shortness of breath;
- chest discomfort;
- weakness; or
- near-fainting.
Sleep Loss May Be a Trigger, Not the Whole Diagnosis
If lack of sleep consistently precedes a sudden racing rhythm, that may help identify a trigger. It does not replace ECG documentation of the rhythm or explain why a person is susceptible to SVT.
Can Poor Sleep Increase the Risk of Atrial Fibrillation?
Poor sleep and sleep disorders have been linked with atrial fibrillation, but this relationship requires careful wording.
Atrial fibrillation is an abnormal rhythm in which the upper chambers of the heart beat irregularly.
Symptoms may include:
- irregular palpitations;
- racing or fluttering;
- fatigue;
- shortness of breath;
- dizziness; or
- reduced exercise tolerance.
Research increasingly links disturbed sleep and sleep disorders—especially obstructive sleep apnea—with AF.
The strongest clinical relationship is with ongoing sleep disturbances and conditions such as sleep apnea. A single poor night may act as a trigger in a susceptible individual, but it does not mean everyone who sleeps poorly will develop atrial fibrillation.
Why Do I Wake Up With My Heart Racing?
Waking suddenly with a pounding or racing heartbeat can have several explanations.
Normal waking response
Sympathetic nervous-system activity increases as you wake, causing heart rate and blood pressure to rise from their lower sleeping levels.
Sleep deprivation
Repeatedly fragmented or inadequate sleep can increase autonomic arousal and make the normal waking heartbeat feel stronger.
Nightmare or panic
A frightening dream or nocturnal panic episode can release adrenaline and produce sudden racing, sweating and rapid breathing.
Sleep apnea
Repeated airway obstruction and drops in oxygen can produce abrupt awakenings and marked autonomic surges during the night.
Alcohol
Alcohol can fragment sleep and is also an independent arrhythmia trigger in susceptible people.
True arrhythmia
AF, SVT or frequent premature beats can occur during sleep and may themselves wake the person.
Waking Up Because of Palpitations Is Different From Noticing Them After You Wake
If a racing or irregular rhythm repeatedly wakes you from sleep, mention that specifically to your clinician. It may influence whether rhythm monitoring or evaluation for sleep-disordered breathing is appropriate.
If your symptoms are primarily about nighttime timing rather than lack of sleep, see heart palpitations at night .
Sleep Apnea and Heart Palpitations
Sometimes the real problem is not simply too few hours of sleep. It is poor-quality sleep caused by repeated interruptions in breathing.
In obstructive sleep apnea, the upper airway repeatedly narrows or closes during sleep.
This can produce:
- repeated drops in oxygen;
- abrupt awakenings;
- surges in sympathetic nervous-system activity;
- changes in chest pressure;
- blood-pressure fluctuations; and
- cardiovascular stress.
The American Heart Association recognizes a strong relationship between sleep-disordered breathing and arrhythmias, particularly atrial fibrillation.
Clues that sleep apnea may be present
- loud regular snoring;
- witnessed pauses in breathing;
- gasping or choking during sleep;
- frequent nighttime awakenings;
- morning headaches;
- dry mouth on waking;
- excessive daytime sleepiness;
- poor concentration;
- resistant or difficult-to-control high blood pressure; or
- known AF with recurrent episodes.
“I Slept Eight Hours” Does Not Guarantee Good Sleep
Someone with untreated sleep apnea may spend many hours in bed while repeatedly waking and receiving poor-quality sleep. Frequent nighttime palpitations plus loud snoring, gasping or witnessed apnea are good reasons to discuss formal sleep evaluation.
Caffeine Can Complicate the Sleep-Palpitation Cycle
One of the most common practical problems after poor sleep is compensating with more caffeine.
The cycle may look like:
poor sleep → fatigue → extra coffee or energy drinks → stronger heartbeat or palpitations → difficulty sleeping → more fatigue the next day.
Caffeine does not cause palpitations in everyone, and individual sensitivity varies substantially.
But if symptoms appear mainly on days when poor sleep leads to unusually high caffeine intake, the combined effect deserves consideration.
Nicotine, Sleep Loss and Palpitations
Nicotine is another stimulant that can increase heart rate and blood pressure.
Someone who is sleep deprived and then uses cigarettes, vaping products or nicotine pouches throughout the day may be combining two sources of autonomic stimulation.
This can make racing or pounding heartbeats more noticeable.
See our guide to nicotine, vaping and heart palpitations .
Can Anxiety and Lack of Sleep Create Constant Palpitations?
Yes, they can reinforce one another.
Poor sleep can worsen emotional regulation and stress, while anxiety can make it difficult to fall asleep or remain asleep.
A possible feedback loop is:
lack of sleep → greater stress response → pounding heartbeat → worry about the heart → more adrenaline → more difficulty sleeping.
This can create persistent heartbeat awareness even when monitoring shows normal sinus rhythm.
Palpitations describe awareness of the heartbeat. They do not require an arrhythmia. At the same time, new persistent symptoms should not automatically be labeled anxiety without considering other causes.
How Much Sleep Do Adults Need?
The American Heart Association recommends that most adults aim for approximately 7–9 hours of sleep each night.
Healthy sleep is not only about hours.
Sleep should ideally be:
- long enough;
- restorative;
- reasonably continuous;
- regularly timed; and
- free from untreated sleep disorders.
More Sleep Is Not a Guaranteed Palpitation Treatment
Restoring adequate sleep may reduce one trigger, especially when skipped beats are linked to sleep deprivation. It does not reliably terminate AF, SVT or another persistent arrhythmia.
What Can You Do if Poor Sleep Seems to Trigger Palpitations?
If there are no emergency warning signs, practical steps include:
- Aim for a regular sleep and wake schedule.
- Allow enough time for approximately 7–9 hours of sleep if you are an adult.
- Reduce late-day caffeine if it interferes with sleep.
- Avoid relying heavily on energy drinks after a poor night.
- Avoid nicotine close to bedtime and consider stopping nicotine use entirely.
- Limit alcohol if it disrupts sleep or triggers palpitations.
- Keep the bedroom dark, quiet and comfortable.
- Reduce bright screens and stimulating activity immediately before bed.
- Maintain reasonable hydration.
- Record whether symptoms improve after several nights of better sleep.
Improvement With Better Sleep Is Useful — But Not Proof
Palpitations may stop spontaneously or because several triggers changed at once. If episodes remain frequent, irregular or otherwise concerning, identifying the actual rhythm is more reliable than assuming sleep was the sole cause.
Should You Take a Sleeping Pill to Stop Palpitations?
No sleeping medicine should be used as a direct treatment for an unknown heart rhythm.
Sleep medicines have their own indications, side effects and interactions, and insomnia may require assessment of its underlying cause.
Likewise, melatonin or other supplements should not be presented as treatments for AF, SVT, PVCs or unexplained palpitations.
Do Not Sedate Yourself to Ignore Persistent Palpitations
A sustained very rapid or irregular heartbeat, especially with dizziness, breathlessness, chest discomfort or fainting, deserves medical assessment rather than attempting to sleep through it.
How Are Sleep-Related Heart Palpitations Evaluated?
Evaluation depends on whether the main problem appears to be sleep loss, an intermittent arrhythmia or an underlying sleep disorder.
Medical history
Your clinician may ask:
- how many hours you normally sleep;
- whether sleep is repeatedly interrupted;
- whether palpitations follow nights of poor sleep;
- whether the rhythm wakes you from sleep;
- whether you snore loudly;
- whether anyone has noticed pauses in your breathing;
- whether you wake gasping or choking;
- how much caffeine you consume;
- whether you use nicotine;
- alcohol intake;
- medicines and supplements;
- whether the heartbeat feels regular or irregular;
- how long episodes last; and
- whether chest pain, breathlessness, dizziness or fainting occurs.
12-lead ECG
An ECG can identify sinus tachycardia, PACs, PVCs, AF, SVT or another electrical abnormality when the rhythm is present during the recording.
If the symptoms occur only after a poor night or wake you intermittently, a Holter, patch or event monitor may have a better chance of recording the rhythm.
See heart palpitations despite a normal ECG .
Ambulatory ECG monitoring
Monitoring may be useful when symptoms recur.
- Daily symptoms: a Holter or continuous patch may be useful.
- Less frequent symptoms: a longer event monitor may be considered.
Sleep study
If sleep apnea is suspected, a clinician may recommend a home sleep-apnea test or an overnight sleep study depending on the clinical situation.
Blood tests
If poor sleep does not adequately explain the symptoms, testing may also look for:
- anemia;
- thyroid disease;
- electrolyte abnormalities; or
- other conditions suggested by the history.
Dr. Albana’s Note
When a patient tells me, “My heart skips whenever I don’t sleep enough,” I first look for a repeatable pattern. Did the symptoms start after one unusually poor night, or is the patient chronically sleeping four or five hours and relying on coffee or energy drinks throughout the day? I also ask whether the palpitations themselves wake the patient from sleep and whether there is loud snoring, gasping or witnessed pauses in breathing. Lack of sleep can certainly contribute to premature beats and a faster heartbeat, but recurring nighttime symptoms may also be the first clue to sleep apnea or an intermittent arrhythmia. If the symptoms keep returning, documenting the rhythm is more useful than simply telling the patient to sleep more.
When Should You Make a Medical Appointment?
Arrange medical evaluation if:
- palpitations repeatedly follow nights of poor sleep;
- they occur every day or are becoming more frequent;
- the heartbeat feels persistently irregular;
- episodes repeatedly last several minutes or longer;
- palpitations repeatedly wake you from sleep;
- you have loud snoring, gasping or witnessed apnea;
- you have excessive daytime sleepiness despite spending enough time in bed;
- you experience dizziness, weakness or breathlessness;
- symptoms occur during exercise;
- you have known heart disease or a previous arrhythmia; or
- palpitations continue despite improving your sleep.
For general risk guidance, see when to worry about heart palpitations .
Urgent Warning Signs
Seek urgent or emergency medical care for palpitations with:
- significant chest pain or pressure;
- severe or sudden shortness of breath;
- fainting or loss of consciousness;
- collapse;
- severe dizziness or near-fainting;
- a sustained very rapid or markedly irregular heartbeat while feeling seriously unwell;
- confusion or signs of shock;
- new severe weakness; or
- rapidly worsening symptoms.
Do not delay urgent care because you believe the episode was caused by missing sleep.
Most Asked Questions
Can lack of sleep cause heart palpitations?
Yes. Lack of sleep can increase sympathetic nervous-system activity and is a recognized contributor to premature contractions such as PACs and PVCs. It may also make normal heartbeats more noticeable.
Can sleep deprivation cause skipped heartbeats?
Yes. The American Heart Association lists not getting enough sleep among common contributors to premature contractions, which may feel like skipped beats, pauses or strong thumps.
Can lack of sleep cause PVCs?
Lack of sleep can act as a trigger for premature contractions in some people. Frequent PVCs should still be documented and evaluated rather than assumed to be caused only by sleep loss.
Can lack of sleep trigger SVT?
Yes. The American Heart Association lists lack of sleep among possible SVT triggers in susceptible people. SVT typically produces a sudden rapid rhythm that may begin and end abruptly.
Can poor sleep cause atrial fibrillation?
Disturbed sleep and sleep disorders are associated with increased AF risk, particularly obstructive sleep apnea. This does not mean one poor night’s sleep automatically causes AF.
Why does my heart race after only a few hours of sleep?
Sleep deprivation can increase autonomic arousal, anxiety and stimulant use. A fast heartbeat may represent sinus tachycardia, but persistent or clearly irregular episodes should be evaluated.
Why do I wake up with my heart racing?
Possible causes include the normal waking sympathetic response, nightmares, anxiety, sleep apnea, alcohol, premature beats or a true arrhythmia. Repeated episodes that wake you from sleep deserve assessment.
Can sleep apnea cause heart palpitations?
Sleep apnea is associated with cardiovascular stress and arrhythmias, particularly atrial fibrillation. Loud snoring, gasping, witnessed pauses in breathing and daytime sleepiness are reasons to discuss sleep evaluation.
Will getting more sleep stop my palpitations?
Better sleep may reduce palpitations when sleep deprivation is a genuine trigger. It does not reliably terminate an established arrhythmia such as AF or SVT.
How much sleep should I get to reduce palpitations?
The American Heart Association recommends that most adults aim for about 7–9 hours of sleep each night. Individual needs vary, and sleep quality and regularity also matter.
Can too much caffeine after a bad night’s sleep cause palpitations?
Yes. People often compensate for poor sleep with extra coffee or energy drinks. In caffeine-sensitive individuals, this can make racing, pounding or premature heartbeats more noticeable.
Can anxiety and lack of sleep cause palpitations all day?
They can contribute to persistent heartbeat awareness and sinus tachycardia. However, frequent all-day palpitations should not automatically be attributed to anxiety or tiredness without considering premature beats, arrhythmias and other medical causes.
Can a normal ECG miss palpitations caused by lack of sleep?
Yes, if the palpitation was not happening during the short ECG recording. When symptoms recur, a Holter, patch or event monitor may help document the rhythm.
When should sleep-related palpitations worry me?
Seek urgent care for palpitations accompanied by significant chest pain, severe shortness of breath, fainting, collapse, severe dizziness or a sustained very rapid or markedly irregular rhythm while you feel seriously unwell.
Related Heart Palpitation Guides
Medical References
- American Heart Association. Premature Contractions — PACs and PVCs. Last reviewed September 24, 2024. American Heart Association .
- American Heart Association. Tachycardia: Fast Heart Rate. American Heart Association .
- American Heart Association. Sleep Disorders and Atrial Fibrillation. Last reviewed June 20, 2024. American Heart Association .
- American Heart Association. Sleep-Disordered Breathing and Cardiac Arrhythmias in Adults: Mechanistic Insights and Clinical Implications. Circulation. 2022. American Heart Association .
- American Heart Association. Obstructive Sleep Apnea and Cardiovascular Disease. Circulation. 2021. American Heart Association .
- American Heart Association. Life’s Essential 8: How to Get Healthy Sleep. American Heart Association .
- National Heart, Lung, and Blood Institute. Why Is Sleep Important? NHLBI .
- National Heart, Lung, and Blood Institute. Sleep Deprivation and Deficiency: How Sleep Affects Your Health. NHLBI .
- American Heart Association. How Serious Are Heart Palpitations? Causes, Symptoms and When to Worry. Published February 9, 2026. American Heart Association .
About the Medical Team
Dr. Albana Greca, MBBS, MMedSc
Family Physician / General Practitioner
Dr. Albana Greca has more than 20 years of experience in primary care, general medicine, chronic disease management, prevention, patient education and digital health.
Dr. Benard Shehu, MBBS, MS
Cardiologist
Dr. Benard Shehu has more than 19 years of cardiovascular experience, including clinical experience relevant to arrhythmias and cardiovascular disease.