Common causes of rapid heartbeat and panic at night include heart failure and certain paroxysmal arrhythmias. In heart failure, nocturnal paroxysmal dyspnea may occur in the middle stages, usually without difficulty falling asleep, but with dizziness, chest tightness, and shortness of breath during the night after falling asleep and being forced to sit up. Dyspnea on exertion, during sleep and at rest is an early sign of left heart failure and may be accompanied by tidal breathing, sweating, weakness, wheezing, dry cough or coughing up bloody sputum. The sudden onset and dyspnea during sleep at night in patients with left heart failure is caused by increased excitability of the vagus nerve and other reasons, except for the unfavorable effect of changing from a sitting position to a flat position during sleep, where the dyspnea occurs at night and to a greater degree. In the course of treatment, the airway should be kept open, antispasmodic and wheezing, and the cause should be addressed.