What causes palpitations, shortness of breath, and rapid heartbeat during sleep, and what should be done?

Feeling palpitations, shortness of breath, and rapid heartbeat during sleep may be caused by physiological factors, or could result from conditions such as hypoglycemia or hypertension. Patients should seek medical evaluation promptly and receive treatment under a doctor's guidance. Specific analyses are as follows:

1. Physiological Factors

If a person does not maintain regular eating habits and consumes alcohol, coffee, or similar beverages before bedtime, it may easily stimulate the sympathetic nervous system, leading to symptoms such as palpitations and increased heart rate. This is considered normal and typically resolves on its own without special treatment.

2. Disease-Related Factors

1) Hypoglycemia

If a patient skips dinner or eats insufficient food before bedtime, acute hypoglycemia may occur, causing shortness of breath, rapid heartbeat, and accompanying symptoms such as dizziness and nausea. In such cases, the patient should promptly consume sugary foods like biscuits or cake. If necessary, immediate medical attention is required for glucose supplementation.

2) Hypertension

If blood pressure rises before sleep, it may lead to an increased heart rate, along with symptoms such as headache, chest tightness, and difficulty breathing. In severe cases, fainting may occur. In such situations, patients should follow medical advice to take medications such as nifedipine controlled-release tablets or sacubitril valsartan sodium tablets.

Besides the common causes mentioned above, other underlying diseases—such as coronary atherosclerotic heart disease, hyperthyroidism, anxiety disorder, or heart failure—may also be responsible. Patients should seek timely treatment to avoid delays in managing their condition.