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"Is an increased heart rate in the morning something to be concerned about?"

ZocdocAnswersIs an increased heart rate in the morning something to be concerned about?


I am a healthy 19 year old with no known illness besides anxiety and GERD. Every morning when I get out of bed my heart rate rapidly increases to around 130. This lasts for 10-15 minutes and then starts to regulate. This is the only time of day that this happens. Also, my resting heart rate is usually in the 70s. Any other time of day when I change positions my heart rate may only increase 10 beats per minute. Is this something that I should be concerned about? I have had blood work and several EKGs that come out sinus tachycardia but no physician has seemed concerned.


During periods of increased oxygen demand on your body's various organs, your heart beats faster to keep up with this increased demand. Although a normal resting heart rate for most adults is 60-100 beats per minute, this can easily increase to the high-100s with exercise. Additionally, while asleep, increased signaling through your parasympathetic nervous system often drives one's heart rate much lower than 60. It is possible that transitioning from this high-parasympathetic tone state to being wide awake and jumping out of bed triggers a normal increase in your heart rate while remaining in an otherwise normal rhythm. However, it is possible your heart intermittently switches to an abnormal rhythm, and it is important for you to be evaluated further by a physician. Several common arrhythmias include atrial fibrillation, atrial flutter, atrioventricualr reciprocating tachycardia, AV nodal reentrant tachycardia, or atrial tachycardia. More uncommonly, patients can suffer a ventricular arrhythmia such as ventricular tachycardia, which originates in the ventricles, or bottom chambers of the heart. Given your symptoms, I recommend further evaluation by a physician to rule out an arrhythmia. After a thorough history and physical exam along with a repeat EKG, a simple test such as a 24-hour EKG or heart monitor that you place on your chest and activate when you feel symptoms may capture these episodes of a rapid heart rate. By doing so, one can easily determine whether this is a normal or abnormal rhythm. Other potential tests, depending on the results of this initial evaluation, include an echocardiogram (ultrasound of your heart) or exercise treadmill test to provoke an arrhythmia. Again, it is critical that this evaluation be undertaken under the guidance of a physician.

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