Heart Pounding After Waking

Events caused by sleep apnea and atrial fibrillation, two disorders that share many of the same risk factors and symptoms, can wake you up to a pounding heart. Unless you have an emotional condition, such as anxiety, your increased pulse rate may have these physical causes. Sleep apnea produces nighttime respiratory disturbances. Atrial fibrillation is an arrhythmia that makes your heart pump harder. These two breathing and heart problems can stand alone, but often occur together.



Shortness of breath and heart palpitations occur with sleep apnea and atrial fibrillation, and either could wake you. Loud snoring, interrupted breathing and choking can disturb your sleep when obstructive or central sleep apnea suddenly impairs your breathing at night. Inability to send enough oxygenated blood through the body because of atrial fibrillation can also cause gasping during the night or day.


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Joint Risk Factors

These two causes of nighttime heart pounding are interrelated, with each potentially contributing to the development of the other. Therefore, they may coexist. Medical and lifestyle risk factors that can raise your chances for getting either condition include advancing age, high blood pressure, heart disease, obesity, excessive alcohol use and a family history of sleep apnea or atrial fibrillation.


Sleep Apnea

Sleep disturbance is a hallmark of either type of sleep apnea. If you sit up in bed when you wake up, your rising blood pressure alone will increase your pulse. But interrupted breathing patterns also affect your heart rate and vascular condition. The long-term complications of untreated sleep apnea include blood clots, high blood pressure, stroke, congestive heart failure, heart attack and atrial fibrillation. Diagnosis and treatment with breathing machines, medications or surgery can help you tame your symptoms.


Atrial Fibrillation

Atrial fibrillation is the most common type of abnormal heart rhythm. When your heart's ventricles, or lower chambers, contract too quickly, the atria, or upper chambers, can't supply them with enough oxygenated blood. As blood circulation decreases, symptoms of pounding or palpitations arise. Medications and electrical stimulation may restore a normal heart rhythm.


Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.