Feeling Strong Pulse Before Sleep: Is It Normal or a Health Concern?

When lying in bed to sleep, you may feel a noticeable pulse beating!

Hello, recently I have been experiencing a noticeable pulse in my upper body (abdomen, neck, back, etc.) before or during sleep, which makes it difficult for me to fall asleep and negatively affects my sleep quality.
I occasionally drink coffee and tea, and initially thought it was due to palpitations.
However, I underwent an electrocardiogram and blood tests at a cardiology clinic, and the results did not show any abnormalities or signs of hyperthyroidism.
The doctor prescribed me medication to stabilize my heart rhythm and assist with relaxation, and I felt better for a while after taking it, but recently these symptoms have returned.
I would like to know if this is a normal physiological condition or if it could be related to autonomic nervous system issues.
Are there any ways to improve this? Thank you.

Ricky, 20~29 year old female. Ask Date: 2022/01/18

Dr. Li Shengkai reply Cardiology

Hello, since I cannot conduct a direct examination, I can only provide advice based on the information you provided.
Firstly, the symptoms you describe are known as "palpitations." The heart beats approximately 100,000 times a day, and generally, we do not feel its beating; feeling the heartbeat is referred to as "palpitations." There are many causes of palpitations, ranging from identifiable conditions such as hyperthyroidism, anemia, or certain arrhythmias, to less clear causes like anxiety, panic attacks, or autonomic nervous system dysregulation.
Treatment typically involves the use of relaxants and mild sympatholytics; however, it is also recommended to make lifestyle changes: avoid alcohol and strong tea, steer clear of spicy foods, maintain a regular sleep schedule, avoid staying up late, manage stress, and keep a positive mindset.
Modern life can be stressful, and it is common to encounter patients in the clinic with symptoms similar to yours, many of whom do not have any identifiable abnormalities.
I hope this information is helpful to you.

Reply Date: 2022/01/18

More Info

Feeling a strong pulse or palpitations before sleep can be concerning, especially when it interferes with your ability to fall asleep and affects your overall sleep quality. While it’s good to hear that you’ve already consulted a cardiologist and received normal test results, it’s understandable to still feel uneasy about these sensations. Let’s break down your concerns and explore potential causes and solutions.

Understanding Palpitations and Strong Pulse Sensations
Palpitations are often described as the feeling of having a fast-beating, fluttering, or pounding heart. They can occur due to various reasons, including anxiety, caffeine consumption, stress, or even hormonal changes. Given that you mentioned occasionally drinking coffee and tea, it’s worth noting that caffeine is a known stimulant that can increase heart rate and potentially lead to palpitations, especially if consumed later in the day.

Possible Causes
1. Caffeine and Stimulants: As mentioned, caffeine can significantly affect your heart rate and may lead to feelings of palpitations. If you consume caffeinated beverages in the afternoon or evening, consider reducing or eliminating them to see if your symptoms improve.

2. Anxiety and Stress: Emotional factors can play a significant role in how your body responds physically. Anxiety can lead to heightened awareness of bodily sensations, including your heartbeat. If you find yourself feeling anxious about your health or sleep, this could exacerbate your symptoms.

3. Autonomic Nervous System: The autonomic nervous system regulates involuntary bodily functions, including heart rate. An imbalance in this system can lead to sensations of palpitations. Stress or anxiety can trigger the sympathetic nervous system (the fight-or-flight response), leading to increased heart rate and awareness of your pulse.

4. Sleep Environment: Sometimes, the environment in which you sleep can contribute to feelings of discomfort. Ensure your sleeping area is conducive to relaxation—consider factors like temperature, noise levels, and comfort of your bedding.

Recommendations for Improvement
1. Lifestyle Modifications:
- Caffeine Reduction: Try to limit your intake of caffeine, especially in the hours leading up to bedtime. Opt for herbal teas or decaffeinated options instead.

- Relaxation Techniques: Incorporate relaxation techniques into your nightly routine. Practices such as deep breathing exercises, meditation, or gentle yoga can help calm your mind and body before sleep.

2. Sleep Hygiene:
- Establish a consistent sleep schedule by going to bed and waking up at the same time every day.

- Create a calming bedtime routine that signals to your body that it’s time to wind down. This could include reading, taking a warm bath, or listening to soothing music.

3. Consultation with a Specialist: Since you’ve already seen a cardiologist, consider discussing your symptoms with a mental health professional. Cognitive-behavioral therapy (CBT) can be particularly effective for managing anxiety and improving sleep quality.

4. Monitor Your Symptoms: Keep a journal of your symptoms, noting when they occur, their intensity, and any potential triggers. This information can be valuable for your healthcare provider in determining the best course of action.

5. Medication Review: If you are currently taking medication for heart rhythm stabilization or relaxation, discuss with your doctor whether adjustments are needed, especially if symptoms have returned.

Conclusion
While it’s understandable to be concerned about the sensations you’re experiencing, many factors can contribute to palpitations, and they are not always indicative of a serious health issue. By making some lifestyle changes, practicing relaxation techniques, and continuing to monitor your symptoms, you may find relief. If your symptoms persist or worsen, don’t hesitate to seek further medical advice. Your health and peace of mind are paramount, and addressing these concerns proactively is essential for your overall well-being.

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