I am fine during the day, but as soon as I lie down my heartbeat echoes into the pillow. Why is it worse lying down? (45, self-employed)

Question

Accepted Answer

Palpitations standing out when lying down is a very common complaint, and three things overlap.

First, once the noise and activity of the day are gone, internal sounds seem louder by comparison. Second, lying on the left side brings the heart physically closer to the chest wall. Third, the moment before sleep is when tension unwinds and the autonomic nervous system shifts, so heart-rate variability itself increases.

Usually it settles by changing position (turning to the right, raising the upper body slightly) or simply with time. But if it returns every time you try to fall asleep, or repeatedly wakes you at night, sleep apnoea and thyroid problems should also be reviewed.

💡 Korean Medicine Clinic Perspective

Palpitations that worsen at night rather than during the day are often read in Korean medicine as dryness inside with heat floating upward — the tension held down all day rising at night. Such patients often struggle to fall asleep, dream heavily, and have a dry mouth. Rather than forcing the body to sleep, we work in the direction of replenishing what is lacking so it can settle, using herbal medicine matched to the constitution and acupuncture to bring the upward pull back down.

Heart Palpitations

Q I am fine during the day, but as soon as I lie down my heartbeat echoes into the pillow. Why is it worse lying down? (45, self-employed)

Detailed Answer

Korean Medicine Clinic Perspective

Related FAQs

Heart Palpitations is not just a simple symptom