What It Means When You Hear Your Heart Beat Before Falling Asleep

You put your head on your pillow and close your eyes. Then, you hear it: a thumping sound that seems to coincide with the rhythm of your heartbeat. It's a strange sensation — and after it happens a couple of times, you start to wonder if it could be a symptom of a bigger issue.

As it turns out, the phenomenon of hearing your heartbeat (or at least the pulsing of blood through your veins) is known in the medical community as "pulsatile tinnitus." As WebMD explains, pulsatile tinnitus is rare. However, it's not something to take lightly. That's because pulsatile tinnitus can be caused by a number of factors, including some serious, albeit manageable, health conditions.

According to StatPearls, pulsatile tinnitus has been connected with a buildup of cholesterol in the arteries, abnormally shaped arteries, excess fluid creating pressure on and around the brain, abnormalities within the structural makeup of the ear, and weakened or misshapen bones (often associated with Paget's disease.) And those aren't the only potential reasons for your sensation. MedicalNewsToday adds hypertension to the list. Therefore, although you might be able to ignore the sounds of your heartbeat, you probably should make an appointment with your healthcare provider to get a diagnosis and, if necessary, take steps toward treating the problem.

However, there's no need to worry every time you lie down and hear your heart beating. Some temporary factors could cause pounding in your ears at night.

For example, if you work out intensely right before bed, your blood still might be rushing through your body faster than normal, as noted by MedicalNewsToday. All that rushing could make it seem like you're able to hear your heart until your system recovers. Or, if you're having trouble hearing in general, you simply may be more in tune with the sounds coming from inside your body than from the ones coming from outside. 

It might also just be something you ate or drank. In a MedicineNet question-and-answer post from 2017, a doctor acknowledged that while hypertension could cause a pounding sound in the ears while in bed, overconsumption of caffeine could be a culprit as well.

Of course, as with all unusual or unnerving physical experiences, you'll probably want to see a provider to rule out anything suspicious and perhaps get a referral to a specialist. For instance, audiologists can test for the source of your pulsatile tinnitus using a wide array of diagnostic and imaging devices like X-rays, ultrasounds, and MRIs, as described by the Cleveland Clinic. Once an audiologist figures out why you're having difficulty, he or she then can recommend the right course of treatment to get you a better night's sleep.

It's worth noting that although pulsatile tinnitus isn't generally an emergency, a pounding sound in your ears could be a critical clue that you're experiencing something more urgent. In an article from the American Academy of Audiology, the authors mention that cardiovascular problems can sometimes affect the overall health of the ear. In other words, the pounding you hear could be an indicator that something else is happening inside you. 

Consequently, if you lie down and have other symptoms along with hearing your heartbeat, think about going to an urgent care or emergency room. Those symptoms include a tightness in your chest, a squeezing or pressure-fueled feeling in your upper body, unusual pain in the jaw or neck region, stomach upset, and dizziness. They're all hallmarks of a heart attack according to the American Heart Association. Though they don't always mean that you're undergoing a critical heart issue — panic attack symptoms as described by WebMD can be very similar — they deserve immediate attention.

What can you expect in terms of treatment if you find out you have pulsatile tinnitus? The treatment you receive will be based on why you're hearing your heartbeat. For example, if your doctor feels that your symptoms are due to elevated cholesterol, you might be advised to take cholesterol-lowering drugs and change the foods you eat. The Mayo Clinic explains that drugs called "statins" are often relied upon to help people bring down elevated cholesterol counts. Alternatively, if consistently high blood pressure seems to be exacerbating the pulsing effect in your ears, taking measures and medications to manage your blood pressure could offer you relief.

Interventions that involve surgery could be beneficial, too. A 2021 review from Neurosurgery noted that in some cases of vascular pulsatile tinnitus (that is, pulsatile tinnitus related to problems involving blood vessels,) the condition could be cured through the application of measures like stents. The word "cured" is an important one within the context of tinnitus, since other forms of the condition can only be managed.

Worried that you'll need more invasive medical treatments just to catch your zzzs? Your provider may think you could benefit from holistic or natural forms of treatment for your pulsatile tinnitus instead of ones that involve surgical measures. 

Healthline outlines several non-drug solutions that can be helpful for patients with pulsatile tinnitus. These include undergoing behavioral therapy, playing white noise in your bedroom, exercising more frequently than you currently do, adopting a low-sodium diet, and reducing or curtailing your dependence on tobacco products.

What's the final thought on all that thumping, whooshing, or pounding that seems to be connected to your heartbeat? Unless the experience happens just once in a while, you should probably check in with a medical professional to start the diagnosis and treatment process. That way, you can get the uninterrupted rest you deserve and find out exactly why your heart seems to be keeping you awake at night.