What causes a sudden jolt or thump in the chest upon falling asleep, and what should be done about it?
Nov 20, 2025
Source: Cainiu Health
Dr. Zhang Baohua
Introduction
In general, waking up suddenly with a jolt or palpitation during sleep may be caused by improper sleeping posture, excessive mental stress, arrhythmia, gastroesophageal reflux disease (GERD), coronary heart disease, or other reasons. If symptoms occur frequently, it is recommended to seek timely medical evaluation and treatment at a reputable hospital. In daily life, maintain a regular sleep schedule and avoid staying up late; eat a light, low-fat diet and reduce intake of high-salt and high-sugar foods.
Generally, waking up suddenly with a jolt or palpitation during sleep may be caused by improper sleeping posture, excessive mental stress, arrhythmia, gastroesophageal reflux disease (GERD), or coronary heart disease. If symptoms occur frequently, it is recommended to seek timely medical evaluation and treatment at a reputable hospital. Detailed explanations are as follows:
1. Improper Sleeping Posture
Prone sleeping or placing hands over the chest can compress the heart and thoracic cavity, impairing blood circulation and causing abnormal cardiac pulsation, leading to discomfort and sudden awakening. Adjust to a supine or lateral sleeping position, ensure the bedroom is comfortable and well-ventilated, and avoid eating too much before bedtime.
2. Excessive Mental Stress
Chronic anxiety and tension can overactivate the sympathetic nervous system. The brain remains active during sleep, making it easier to experience cardiac discomfort and sudden awakening. Listening to soothing music, soaking feet before bed, avoiding exposure to stimulating content, and maintaining emotional stability can help.
3. Arrhythmia
Disorders in the heart's electrical activity can cause sudden changes in heart rate during sleep, resulting in palpitations or a "jolt" sensation, sometimes accompanied by chest tightness. Medications such as metoprolol tartrate tablets, propafenone hydrochloride tablets, or amiodarone tablets may be used under medical guidance. Regular heart rate monitoring is advised.
4. Gastroesophageal Reflux Disease (GERD)
During sleep, relaxation of the lower esophageal sphincter allows stomach acid to reflux into the esophagus, causing discomfort behind the breastbone and radiating to the cardiac area, leading to sudden awakening. Medications such as omeprazole enteric-coated capsules, rabeprazole sodium enteric-coated tablets, or domperidone tablets may be taken under a doctor’s supervision. Avoid eating within two hours before bedtime.
5. Coronary Heart Disease
Narrowing of the coronary arteries leads to insufficient blood supply to the myocardium. During sleep, slower blood flow can worsen myocardial ischemia, causing chest tightness and palpitations that result in awakening. Medications such as aspirin enteric-coated tablets, clopidogrel hydrogen sulfate tablets, or atorvastatin calcium tablets may be used as prescribed. In severe cases, coronary stent implantation may be required.
In daily life, maintain a regular sleep schedule and avoid staying up late; eat a light, low-fat diet and reduce intake of high-salt and high-sugar foods; engage in moderate exercise to improve physical health, but avoid strenuous physical activity.
