Palpitations just before falling asleep may be due to physiologic or pathologic causes. Physiological causes: due to the process of sympathetic nerve inhibition and vagus nerve excitation during sleep. If the patient consumes substances that excite the sympathetic nerves before going to bed, such as coffee and strong tea, the patient will feel palpitations when going to sleep. This situation does not require treatment, and can be improved naturally after rest. Pathological causes: When patients have arrhythmia, they may feel palpitations when they fall asleep. It is recommended that the patient consult a cardiovascular surgeon to treat the arrhythmia with medications such as mesylate and metoprolol succinate, or with surgery such as radiofrequency ablation. Patients who experience palpitations just as they are about to fall asleep are advised to rest and stop drinking stimulant beverages. If the symptoms do not improve or occur for a long period of time, patients are advised to seek medical attention.