A racing heart on waking can be caused by anxiety, dehydration, caffeine, or sleep apnea. See a doctor if it is frequent.
Common causes
- Anxiety or panic.
- Dehydration.
- Caffeine or alcohol the night before.
- Sleep apnea.
- Low blood sugar.
- Hormonal conditions like hyperthyroidism.
- Arrhythmia.
Normal
Heart rate rises slightly on waking (the cortisol awakening response).
What helps
Get up slowly, drink water and cut caffeine.
See a doctor
If racing is frequent or comes with chest pain, dizziness or fainting. Call 911 for chest pain.
Normal morning rise
Heart rate rises in the early morning due to cortisol and adrenaline surges, as the body prepares to wake. Sudden awakening, alarm clocks and anxiety can add to the effect.
Common causes
- Anxiety, panic attacks and nightmares.
- Caffeine or alcohol the night before. Alcohol raises heart rate during the night.
- Dehydration.
- Low blood sugar.
- Sleep apnea, which stimulates stress hormones.
- Standing up quickly (orthostatic changes or POTS).
- Thyroid overactivity.
- Anemia.
- Medications such as decongestants, asthma inhalers and stimulants.
- Fever or infection.
- Arrhythmias such as supraventricular tachycardia or atrial fibrillation.
- Pregnancy.
Normal range
A resting heart rate of 60 to 100 beats per minute is normal for adults. Athletes can have 40 to 60.
What helps
- Stay in bed for a minute, breathe slowly and sit up gradually.
- Drink water.
- Avoid caffeine and alcohol late in the day.
- Keep a regular sleep schedule.
- Practice relaxation or meditation.
- Eat a balanced breakfast.
- Check your pulse by counting for 30 seconds and doubling.
Wearable data
Smartwatches can track resting heart rate and detect irregular rhythms, though they are not diagnostic.
See a doctor if
Racing heart is frequent, lasts more than a few minutes, or comes with chest pain, shortness of breath, dizziness, fainting or confusion. Call 911 for chest pain or fainting. An ECG, Holter monitor and blood tests can find the cause.
Morning heart rate
Heart rate rises in the hour before waking due to cortisol and adrenaline surges. A normal resting heart rate for adults is 60 to 100 beats per minute, according to the American Heart Association. Stress, caffeine or alcohol the night before, dehydration, anxiety, sleep apnea, thyroid problems and some medicines can cause morning palpitations.
What to check
Track resting rate with a wearable or by counting pulse for 30 seconds and doubling. Reduce caffeine and alcohol, hydrate and manage stress. Seek urgent care for racing heart with chest pain, fainting or severe shortness of breath. A doctor may order an ECG, thyroid tests or a heart monitor to look for atrial fibrillation or supraventricular tachycardia.
Based on data from the American Heart Association and the Mayo Clinic
