Normally, the number of heartbeats in a person is in the range of 60-90 beats per minute. Nocturnal tachycardia is one of the forms of arrhythmia, which is characterized by an increase in heart rate above 90 beats/min at night. This rhythm disturbance can be either physiological or pathological.
In the first case, provoking factors for tachycardia may be physical activity, emotional stress, and abuse of caffeine-containing drinks. While the causes of the pathological form are various diseases of the cardiovascular, endocrine and other systems.
Causes of nocturnal tachycardia
Tachycardia during sleep has many causes, which can be divided into physiological and pathological groups . In the first case, the causes will be external factors affecting a person, in the second - pathological conditions in the body.
Physiological
Physiological tachycardia at night is a natural reaction of the body to external stimuli. Such provoking factors include:
- Emotional overstrain;
- Excessive physical activity the night before bedtime;
- Evening consumption of drinks containing caffeine;
- Smoking and drinking alcohol;
- Taking certain medications (glucocorticosteroids, atropine, etc.);
- Changes in climatic conditions - an increase in air temperature or humidity.
A major role in the occurrence of nocturnal tachycardia is played by sleep disturbances and prolonged insomnia.
Pathological
Nocturnal tachycardia can also occur as a result of various diseases and conditions that require treatment. Among them are:
- Pathologies of the cardiovascular system (cardiosclerosis, myocarditis, nocturnal hypertension, genetic abnormalities);
- Endocrinological diseases (thyrotoxicosis, pheochromocytoma);
- Mental pathologies (neuroses, psychoses);
- Activation of the sympathetic nervous system at night;
- Sleep apnea syndrome;
- Various intoxications;
- Electrolyte balance disorders.
Let's take a closer look at why some pathologies lead to the development of tachycardia at night.
How is tachycardia detected?
The main diagnostic method is an electrocardiogram.
If there are frequent attacks, you should consult a doctor, who will prescribe an ECG. Stress tests are also used to identify failures in the cardiovascular system.
Since heart pathologies are often caused by dysfunction of the autonomic nervous system, the patient is questioned in detail for the presence of additional symptoms and, to obtain more detailed information about his condition, the following is carried out:
- Echocardiography to assess the condition of the valve apparatus and the presence of functional changes in the organ.
- Electrophysiological study necessary to study the electrophysiological properties of the conduction system and cardiac sections.
- Coronary angiography to determine coronary artery disease, the degree of narrowing of the coronary artery and the location of the narrowing.
If the development of tachycardia is caused by pathologies of other organs, then consultation with highly specialized specialists will be required.
Decreased vagal tone
Tachycardia at night during sleep may be due to decreased activity of the vagus nerve, or vagus, which is part of the parasympathetic nervous system. It is activated at night and helps to slightly reduce heart rate and blood pressure.
When the activity of the vagus nerve decreases at night, the sympathetic department is activated, which provokes:
- Increased heart rate;
- Increased contractility of the heart;
- Increased blood pressure;
- Increased breathing;
- Increased skeletal muscle tone.
Genetic mutations, inflammatory damage to its fibers, and emotional stress lead to a decrease in the tone of the vagus nerve during sleep..
Sleep apnea syndrome
Often, an increased heart rate at night provokes sleep apnea - a disorder of respiratory function in which it stops during sleep. The causes of this pathology are:
- Obesity;
- Endocrine system disorders;
- Frequent stressful situations;
- Anatomical features (enlarged tonsils or uvula, narrow nasal passages).
Periodic episodes of apnea at night cause hypoxia and hypercapnia, which signal the brain to wake up. After waking up, breathing usually returns to normal.
Lack of oxygen at night provokes an acceleration of the heartbeat and an increase in cardiac output - tachycardia occurs at night. In addition, people experience snoring and daytime sleepiness.
In patients suffering from cardiac pathology, arrhythmia and heart failure progress, and angina attacks occur.
Heart diseases
The most common cause of tachycardia at night is nocturnal hypertension. In this case, the increase in heart rate during sleep is compensatory in nature - in order for the heart to transport blood entering it with increased force, it needs to work faster.
The main cause of hypertension at night is insufficient dosage of antihypertensive drugs taken the night before bedtime. However, there are cases of idiopathic nocturnal hypertension.
The next reason that can cause nocturnal tachycardia is Brugada syndrome, a genetic pathology characterized by a disorder of the conduction system of the heart. In this case, a rapid heartbeat at rest provokes sleep or daytime rest.
Cardiosclerosis is the replacement of the heart myocardium with connective tissue due to myocardial infarction. Areas that have succumbed to scarring disrupt the normal contraction of cardiomyocytes and impair the conduction of impulses through them.
Such pathological processes lead to rhythm disturbances, including at night.
Myocarditis is an inflammatory lesion of the myocardium, most often having an infectious etiology. Less commonly, the cause is rheumatic damage to the heart muscle. Inflammatory processes disrupt the innervation of cells and the conduction of electrical impulses through them, leading to tachycardia.
Accompanying symptoms
Rapid heartbeat at night may indicate pathological processes in the heart. At the same time, a person clearly feels every heartbeat.
In normal condition, the organ should contract at a frequency of 60-90 beats per minute. If the pulse exceeds these values, then tachycardia is diagnosed.
At night and during the day, arrhythmia can appear for the same reasons, but at night a person feels a rapid heartbeat more clearly.
During periods of wakefulness, heartbeats remain invisible. A person rarely notices a rapid pulse. At night, for the body to fully rest, it must slow down, so tachycardia at this time of day is considered a serious stress for the body.
The problem appears:
- feelings of fear and anxiety for no apparent reason;
- feeling of lack of air;
- premature awakening;
- the appearance of cold sweat.
If there are no deviations in the functioning of the cardiovascular system, then the heart rhythm can return to normal in a short time without any therapeutic measures. This is possible in cases where tachycardia occurs due to physiological reasons.
In addition to the main symptoms indicating pathology, a person suffers from a deterioration in general health, dizziness and fainting.
There are cases where an increased heart rate after waking up resulted in myocardial infarction and other dangerous pathological conditions.
Also read: Consequences of ventricular extrasystole
Endocrine pathologies
Thyrotoxicosis is a disease of the thyroid gland characterized by excessive production of thyroid hormones. Increased levels of T3 and T4 in the body disrupt metabolic processes, leading to the development of tachycardia at rest (including at night).
Other symptoms of thyrotoxicosis are irritability, weight loss, hand tremors, and excessive sweating. The progression of the disease often leads to the development of thyrotoxic heart - dystrophy, myocardial hypertrophy, cardiosclerosis and heart failure.
Pheochromocytoma is one of the forms of adrenal tumor, characterized by pathological proliferation of their tissue. The enlargement of these organs leads to excess production of adrenaline, which increases heart rate. In this case, a feeling of fear, tremors of the limbs, and nausea arise.
Clinical picture
During attacks of tachycardia at night, a person usually wakes up abruptly. The following symptoms appear:
- Increased heart rate is the most common symptom of tachycardia during sleep. The sensation of heartbeat occurs due to uneven blood flow and abnormal functioning of the heart muscle. In another way, this sign is called palpitation.
- Increased peripheral pulse rate - Pulse rate in the periphery is most often checked at the radial artery. During night attacks of tachycardia, the pulse number fluctuates between 90-150 beats/min.
- Pulsation of the carotid arteries - visual pulsation of the carotid arteries occurs due to an increase in their tone and an increase in the release of blood into the aorta. You can palpate a high pulse on these vessels on the neck line formed between the chin and earlobe.
- Shortness of breath - a feeling of lack of air and increased breathing during sleep are a consequence of hypoxia, which develops during an attack of tachycardia. For the same reason, dizziness occurs.
- Discomfort in the cardiac region rarely occurs in clinically healthy people and is a consequence of ischemia due to lack of oxygen to the heart muscle.
In the presence of heart pathologies against the background of tachycardia, angina attacks, syncope, increased blood pressure, and cough may occur.
In some cases, tachycardia is associated with autonomic disorders. These include:
- Feelings of fear, anxiety;
- Increased sweating;
- Hand tremors;
- Pale skin;
- Tingling in fingers.
Autonomic disorders are most often observed in women. Their severity depends on their emotional state.
Why does heart palpitation occur?
The first reason is tachycardia, when pulsation is felt not only in the heart, but also in the neck, head and fingers and toes. In a state of tachycardia, the pulse is higher than 90 beats per minute. With normal functioning of the heart muscle, the heartbeat should not be felt.
The second reason for a rapid heartbeat is a condition caused by colds, elevated body temperature, and emotional overload. Such attacks, when the heart beats quickly, occur in healthy people and do not carry pathological changes in the cardiac organ.
Diagnostics
If symptoms of tachycardia appear during sleep, it is recommended to consult a doctor. The specialist will collect all the necessary information and then refer you for additional research.
Clinical
Clinical diagnosis is carried out by the attending physician and includes various methods that will be presented in the table.
| Diagnostic method | Information received |
| Complaints |
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| Anamnesis of life |
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| History of the disease |
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| Assessment of general condition |
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| Assessment of body systems |
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Additional
Additional diagnostics include a number of laboratory and instrumental studies.
Laboratory methods involve various blood tests:
- Complete blood count – performed to diagnose underlying pathologies (anemia, inflammation);
- Biochemical blood test - prescribed for diagnosing diseases of blood vessels, liver, kidneys, etc.;
- A blood test for hormone levels is carried out to diagnose pathologies of the adrenal glands and thyroid gland;
- Ionogram is a blood test showing the content of microelements in it.
Preparing for blood tests includes the following rules:
- Blood is donated on an empty stomach in the morning;
- Refusal to take medications on the eve of the test (this point is agreed with the doctor);
- Avoid drinking alcohol 48 hours before the test;
- Stop smoking 3 hours before the test;
- Avoiding emotional or physical stress the day before the test.
Also, before donating blood, it is not advisable to undergo instrumental examinations or perform physiotherapeutic procedures. This may affect changes in the level of some indicators.
The main instrumental methods for diagnosing tachycardia are:
- An electrocardiogram (ECG) is a test that records the electrical activity of the heart. The essence of the method is to apply electrodes to the limbs and chest, after which the teeth, reflecting the conduction of electrical impulses, are recorded on a special film. Signs of tachycardia on the ECG are shortening of the PP and RR intervals; sinus rhythm is usually maintained.
- Holter monitoring - this method also examines the electrical activity of the heart, but the cardiogram is recorded continuously throughout the day. The study is carried out by applying electrodes and continuously recording an ECG using a portable device. During the study, the patient must note physical, emotional stress, rest and meal times in a special diary. This allows us to judge the connection between tachycardia and external factors.
- Ultrasound of the heart - ultrasound examination of the heart is prescribed to diagnose any organic lesions of the heart - congenital and acquired defects, hypertrophy, cardiosclerosis, etc.
- Electrophysiological study (EPS) of the heart - the essence of the method is to supply physiological doses of current to the heart, provoking the desired diseases and recording them on an ECG. EPI can be performed either through the introduction of an electrode into the esophagus or through large vessels.
After a comprehensive diagnosis, the specialist determines the treatment strategy for nocturnal tachycardia.
Diagnostic measures
If palpitations cause discomfort, you should consult a doctor and undergo examinations to determine the cause of the deviation.
Also read: Signs of supraventricular paroxysmal tachycardia A person can independently check the heart rate. To do this, you need to feel the carotid artery in your neck and count the pulse for a minute. The procedure must be carried out in a calm state.
If a person suffers from vegetative-vascular dystonia, then tachycardia does not cause serious discomfort against its background. But it is important to undergo a preventive examination once a year to identify abnormalities. If pathologies are detected, a more detailed diagnosis is prescribed.
The examination consists of:
- External examination and conversation with a doctor.
- Electrocardiograms.
- Echocardiography.
- Magnetic resonance imaging.
It is possible to stabilize the functioning of the heart only by finding out the cause of the disorder and eliminating it. If a person suffers from psychological disorders, then he should visit a psychotherapist’s office, who will help get rid of discomfort.
In case of tachycardia associated with disorders of the nervous system, one cannot do without the help of a neurologist, as this may indicate cardiac neurosis.
Treatment
The basis of treatment for nocturnal tachycardia is medications. Traditional medicine methods are also widely used.
Medication
Drug therapy is aimed at treating the underlying disease, preventing the occurrence of new attacks, as well as preventing possible complications.
If nocturnal tachycardia occurs due to hypertension, appropriate antihypertensive therapy must be adjusted. If a person takes any medications, the specialist increases the dosage of the evening dose.
In the absence of antihypertensive therapy, the doctor prescribes the following drugs:
- ACE inhibitors (Enalapril, Enap 2.5-5 mg 1 time per day) or angiotensin receptor blockers (Losartan, Lozap 50 mg 1 time per day).
- If necessary, diuretics are added (Indapamide, Indap 2.5 mg once a day).
If tachycardia at night is provoked by mental disorders (neuroses, depression), the use of sedatives is indicated:
- Synthetic drugs - Afobazol 30 mg 3 times a day, Grandaxin 50 mg 2-3 times a day;
- Herbal preparations – “Novo-passit” 1 t. 3 times a day, “Dormiplant”, 1 t. 2 times a day, “Persen” 2 t. 2-3 times a day.
If a rhythm disturbance occurs due to sleep apnea, it is recommended to normalize your weight, sleep in a position on your side, and consult an ENT doctor. A good effect is achieved by using special devices that prevent blockage of the airway and snoring.
To prevent the occurrence of new attacks, the following medications are prescribed:
- Beta blockers (Bisoprolol 2.5-5 mg per day, Metoprolol 50-100 mg 2 times a day) - block receptors responsible for sensitivity to adrenaline;
- Calcium channel blockers (Diltiazem - 90 mg 2 times a day, Verapamil 40-80 mg 3 times a day) - block ion channels, preventing an increase in heart rate.
To prevent thrombosis, medications from the group of antiplatelet agents are prescribed (Aspirin Cardio, Thrombo Ass); in case of high cholesterol, taking statins (Atorvastatin, Liprimar) is indicated.
Folk remedies
You can also cope with nocturnal tachycardia using traditional medicine methods. Let's take a closer look at the recipes for some of them.
- Infusion of valerian root and motherwort herb. Take 100 g of each plant, pour 300 ml of boiling water and leave for 60 minutes. Then cool, strain and drink 100 ml 3 times a day. It is recommended to take the infusion over a course of 1 month.
- An infusion of mint, chamomile and caraway fruits. Take 5 g of each raw material, grind it and add 200 ml of hot water. Infuse for an hour and consume before bed for three weeks.
- Tea with hawthorn and rosehip. Take a teaspoon of green tea, a tablespoon each of rose hips and hawthorn. Mix the ingredients, pour 0.5 liters of boiling water and leave for half an hour. Take 2 times a day for 20 days.
- Nuts with honey. Take a walnut, chop and mix with one tablespoon of honey and the juice of a lemon wedge. Take the mixture orally with a small amount of water before bedtime.
- Melissa tincture. Take 100 g of dried raw materials and pour 40% alcohol or vodka into a glass. Leave for 10 days and take 5 ml several times a day, after diluting it in 50 ml of water.
- Zyuznik tincture. Take a 500 ml jar, fill it halfway with dried zyuznik herb and fill it with 40% alcohol or vodka. Let it brew for three weeks. Then strain and take 20 drops diluted with water 2 times a day for a monthly course.
- Infusion of white willow flowers. Take the flowers of the plant (10 g), pour 200 ml of boiling water and leave for an hour. Then strain and drink a quarter glass 4 times a day.
Traditional recipes are recommended to be taken in conjunction with prescribed drug therapy.
Treatment methods
Rapid night heartbeat is treated depending on the cause that provoked it. To rid a person of unpleasant symptoms, medications and folk remedies are used.
Tachycardia at night is eliminated:
- Sedatives. They practice the use of drugs based on medicinal plants in the form of infusions of motherwort and valerian, Novo-passit. They are produced in the form of drops, tablets, and infusions.
- Antiarrhythmic drugs. These tablets are designed to normalize the heartbeat. They have a number of contraindications, so the attending physician must select the medicine.
Tachycardia is also eliminated with cardiac glucosides, beta blockers, antioxidants, and sedatives.
You should get rid of strong heartbeat at home with the help of mint, lemon balm, St. John's wort, chamomile, motherwort and others. An infusion is prepared from these plants. An effective remedy for tachycardia is a decoction of valerian root, yarrow and lemon balm.
Take a teaspoon of all components, add boiled water and simmer in a water bath for 40 minutes. Then cool, filter and drink.
If tachycardia bothers you at night, experts recommend adjusting your lifestyle. It is important to avoid stress and excessive loads. It is necessary to ensure that a sufficient amount of vitamins enters the body. Omega-3s are of great benefit to the body. These acids are found in fish.
In the evening before going to bed, you should not think about your problems. Since sometimes the heart rate increases under the influence of medications, it is necessary not to take them in the evening and report this adverse reaction to your doctor.
Prevention
To prevent the development of tachycardia or reduce the frequency of its night attacks, the following rules must be followed:
- Limit physical activity in the evening;
- Avoid stressful situations during the day;
- Reduce evening time spent watching TV or computer;
- Avoid consumption of caffeine-containing and alcoholic beverages;
- Avoid heavy dinners and snacks before bed.
Along with excluding the above factors, it is necessary:
- Control body weight;
- Eat rationally (exclude fatty, fried foods, eat little and often);
- Engage in active activities (swimming, skiing, table tennis), if available
- Contraindications to sports: walking daily, doing Nordic walking;
- When increasing emotional lability, train the nervous system with yoga and meditation.
People with heart disease are advised to monitor their blood pressure and heart rate daily and regularly attend preventive medical examinations.
What a heart it was
When interpreting, you need to take into account whose heart it was:
- its own - illness. You need to take it seriously and treat it from the very first days, as the disease can be fatal;
- a stranger - you are worried a lot, you have lost harmony with yourself. You need to calm down and restore this balance, otherwise health problems will begin;
- a familiar person - something is wrong in your relationship with the hero of the dream, so you constantly think about him. You just need to take a step towards reconciliation.
You dream about your heart being sick.
If you remember what your heart looked like, be sure to take this into account when making your prediction:
- alive - you have to fight with ill-wishers, but you will definitely emerge victorious;
- sick - financial losses, troubles in love;
- dead - collapse of hopes;
- torn out of the body - you have an enemy, and he is very strong, so in the near future you should sit quietly. Another interpretation of the dream is quarrels with a loved one;
- bloody - an adventure that will leave only negative emotions;
- artificial - it will be difficult to make an important decision;
- white - a bright future full of joy;
- black - obstacles on the way to the goal. If you received a black heart as a gift, then someone has been manipulating you for a long time. Take a close look at your surroundings and you will understand who it is;
- wounded - an unpleasant situation;
- broken - collapsed dreams, disappointment in life. Remember that the black streak will not last forever, look for something good in the current situation.
Possible complications of tachycardia during sleep
Rare attacks of tachycardia, accompanied by a dull clinical picture, have virtually no effect on the functioning of the body. However, a frequently occurring rhythm disturbance is fraught with the development of hypoxia, ischemia, or circulatory disorders in individual organs.
Often recurrent tachycardia during sleep can lead to the following consequences:
- Ischemia of the heart muscle, which is reversible (angina attack) or irreversible (myocardial infarction) in nature;
- Acute cerebrovascular accident (stroke or transient ischemic attack);
- Acute heart failure (cardiac asthma or pulmonary edema);
- With ventricular tachycardia - ventricular fibrillation followed by asystole.
In addition, progressive tachycardia, if left untreated, can lead to chronic heart failure, which is manifested by shortness of breath, swelling of the extremities, and heaviness in the liver area.
Symptoms
Since nocturnal attacks of tachycardia are accompanied by a panic attack, after sleep a person can explain them as disturbing dreams and not attach any significance.
This approach to assessing health status is justified only when attacks are isolated. If night palpitations constantly cause sleep disturbances, after waking up the rhythm does not normalize, shortness of breath appears, and subjectively tachycardia is felt as an attempt by the heart to jump out of the chest, then a trip to the doctor cannot be postponed.
Characteristic signs that tachycardia during sleep is serious and it is necessary to sound the alarm are pain and a feeling of tightness in the chest, dizziness, and fainting.
