Resting heart rate of 45 while sleeping

If you have questions or concerns about your heart rate, check in with your doctor.

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Your sleeping heart rate may be lower than your resting heart rate, according to the Cleveland Clinic. It may drop below 60 beats per minute. For most people, that is not a problem. However, bradycardia is a heart rate below 60 while you're awake and active, and that could be a problem.

"Your heart rate slows down during sleep. A normal resting heart rate for adults is anywhere between 60 to 100 beats per minute. During sleep, the normal rate can be anywhere from 40 to 100," says Peter Santucci, MD, professor of cardiology at Loyola University Medical Center in Maywood, Illinois.

Bradycardia: How Low Is Too Low?

While a normal sleeping heart rate can dip below 60, the Cleveland Clinic explains that a sustained heart rate below 60 when you're not sleeping or resting may be a medical condition called bradycardia.

Bradycardia is a condition that increases with age. It's most common in men and women over age 65, Cleveland Clinic says. Although healthy and fit young people and trained athletes can have heart rates down into the 40s without any symptoms, bradycardia may cause symptoms for other people. These can include:

• Fatigue.
• Dizziness.
• Chest pain.
• Shortness of breath.
• Heart palpitations.
• Confusion.
• Weakness.

The most common cause of symptomatic bradycardia is a problem that develops with the heart's natural pacemaker, called the sinus node, Cleveland Clinic notes. There may also be a block of electrical signals between the upper and lower chambers of the heart, called an AV block. Another common cause is a heart or blood pressure medication that slows down the heart, it says.

"Symptoms of bradycardia may only be felt during activity. You could have a heart rate of 50 at rest without any symptoms, but if you get up and active, even a heart rate of 60 or 65 could be too slow and cause symptoms. If you have symptomatic bradycardia, you may need treatment," Dr. Santucci says.

Mayo Clinic recommends letting your doctor know if you're not a trained athlete and your resting heart rate is under 60. This is even more important if you have symptoms of bradycardia.

The Cleveland Clinic also warns that a heart rate that drops into the 30s might mean that you're not getting enough oxygen to your brain. This may cause other symptoms such as fainting, lightheadedness or shortness of breath, or allow blood to back up in the heart. Checking in with your doctor for evaluation is key, as there are treatments that can help.

Tachycardia: How High Is Too High?

"A resting heart rate that is frequently over 110 or occasionally over 140 can lead to heart damage or heart failure and may need to be treated," Dr. Santucci says. According to the American Heart Association, the medical term for a heart rate above 100 is tachycardia. Symptoms may include:

• Passing out.
• Dizziness.
• Palpitations.
• Pounding pulse.
• Chest pain or pressure.
• Fatigue.
• Shortness of breath.

Although the range of normal for a resting and sleeping heart rate is wide, the Mayo Clinic says to let your doctor know if your resting heart rate is consistently above 100, especially if you have any symptoms of tachycardia.

Benefits of Sleep for Heart Health

According to the Centers for Disease Control and Prevention (CDC), getting enough sleep is very important for heart health. During sleep, both your heart rate and your blood pressure go down. Most adults need at least seven hours of sleep to allow the body to rest and repair.

The CDC says that lack of sleep may raise your risk for heart disease, heart attack and stroke. Lack of sleep is also linked to health problems, such as type 2 diabetes and obesity, which can contribute to heart disease.

A person’s heart rate may become dangerous if it is too high or too low. However, many factors can affect when a heart rate is dangerous.

The heart rate changes throughout the day to accommodate the demands of the body. It is higher during times of intense activity and lowest when a person relaxes or sleeps.

The heart rate also changes during pregnancy, fever, and times of anxiety.

Identifying a person’s usual heart rate pattern can help them understand what a dangerous heart rate is for them personally.

This article will explain ideal heart rates, taking into account factors such as medication use and age. It will also explain some methods a person can try to raise or lower their heart rate.

A person should undergo regular checks to determine their heart rates at rest and while exercising. This could help them understand if there are any changes in their heart rate that could be dangerous.

People can learn how to check their pulse here.

At rest

According to the American Heart Association (AHA), a normal resting heart rate is 60–100 beats per minute (bpm) for most adults.

However, some people have heart rates outside of these ranges and are still perfectly healthy. For example, an elite athlete might have a very low resting heart rate of 40 bpm.

While exercising

The heart rate greatly increases when a person is very active or exercising.

The highest rate a person’s heart can safely reach is their maximum heart rate. This declines with age. The ideal heart rate, or target heart rate, for exercise also declines with age.

In general, for most adults, the target and maximum heart rates are as follows:

A person’s heart rate increase during exercise depends on many factors, including how intense the workout is and how fit they are.

A very sedentary person might find that their heart rate increases when walking from one room to another.

People who exercise regularly may need very intense workouts to get their heart rate up.

If a person’s heart rate is temporarily outside of these numbers during exercise, it is not usually a medical emergency. According to the AHA, a person can push themselves a little more or less depending on their heart rate target.

While sleeping

For most people, their sleeping heart rate will fall to the lower end of the normal resting heart rate range of 60–100 bpm.

In deep sleep, the heart rate may fall below 60 bpm, especially in people who have very low heart rates while awake.

After waking, a person’s heart rate will begin increasing toward their usual resting heart rate.

In children

Children, especially young children, tend to have higher heart rates than adults.

Like adults, factors such as anxiety, fever, and heat may influence their heart rate.

This table shows the ideal heart rate ranges for children during wakefulness and sleep:

Many different factors can influence a person’s heart rate.

In most cases, having a very high or very low heart rate is only dangerous when there is not an obvious explanation.

High heart rate

Some factors that may cause a high heart rate include:

• Anxiety: People who are experiencing intense anxiety may have heart rates higher than 100 bpm, especially during a panic attack.
• Pain: Pain can cause the heart rate to climb much higher.
• Pregnancy: A person’s heart rate increases if they are pregnant. Normal activities also require more cardiovascular effort, so a person may find that relatively easy activities such as climbing stairs or taking short walks can cause the heart rate to climb much higher than usual. Pregnancy may also cause heart palpitations or an irregular heart rate.
• Fever: A fever can sometimes cause a higher heart rate. A person may also have a higher heart rate in intense heat.
• Caffeine: Caffeine increases both heart rate and blood pressure. If a person has recently had caffeine and notices a higher heart rate, this might be why.
• Medications: Some medications, such as serotonin or attention deficit hyperactivity disorder drugs, may also change the heart rate. Call a doctor if the heart rate suddenly changes after taking a new medication.

It is important to keep in mind that panicking about having a high heart rate may cause it to become even higher. Taking a few deep breaths and trying calming exercises may help a person assess whether or not their heart rate really is dangerous.

If there is an obvious cause of a heart rate change, such as pain or a fever, try addressing that first to see if the heart rate returns to normal.

Postural orthostatic tachycardia syndrome

A person with postural orthostatic tachycardia syndrome (POTS) may experience an increased heart rate upon standing up. They may also experience dizziness and a drop in blood pressure.

POTS is a condition of the autonomic nervous system. It happens because this system does not properly regulate bodily functions such as blood pressure, heart rate, or breathing.

Learn more about POTS here.

Low heart rate

In general, the lower a person’s resting heart rate, the healthier their heart muscle. However, a very low heart rate in those who are not athletic or healthy can be a sign of a condition affecting the electrical system of the heart.

A sudden drop in heart rate far below a person’s usual resting heart rate may indicate sepsis (a potentially life threatening systemic infection), a brain bleed, or the electrical system of the heart failing.

In a person with any symptoms of illness, excessive bleeding, a recent serious injury, fainting, or dizziness, a low heart rate is an emergency.

According to one 2020 article, the following factors may lead to a person experiencing a low heart rate:

• chest trauma
• heart disease
• heart attack
• treatment for congenital heart disease
• sick sinus syndrome
• radiation therapy
• amyloidosis
• pericarditis
• Lyme disease
• rheumatic fever
• collagen vascular disease
• myocarditis
• muscular dystrophy

The following medications could also cause a low heart rate:

• beta-blockers
• calcium channel blockers
• digoxin
• ivabradine
• clonidine
• reserpine
• adenosine
• cimetidine
• lithium
• amitriptyline
• narcotics
• cannabinoids

Determining the cause of a low heart rate means that a doctor can treat it accordingly. This may involve treating an underlying condition or changing the person’s medication.

Having a heart rate that is consistently outside of the ideal ranges above could lead to complications.

Low heart rate

Without appropriate treatment, a low heart rate can cause:

• dizziness
• fatigue
• confusion
• fainting

Over time, both high and low heart rates may damage the heart.

Having a very low heart rate can also damage the heart and other organs. This is more commonly associated with low blood pressure or other signs of shock.

High heart rate

Without proper treatment, a very high heart rate can lead to:

• stroke
• heart damage
• organ failure
• cardiac arrest
• feeling dizzy or faint
• chest pain

Underlying conditions

For most people, having a heart rate that is consistently too high or too low may signal an underlying condition, such as:

• damage to the heart’s valves or electrical system
• heart disease
• chronic or systemic infections
• issues with the thyroid
• anxiety disorder
• congestive heart failure
• anemia

It is not an emergency if the heart rate briefly falls outside of the recommended range or if a person has a shift in heart rate that improves with relaxation or deep breathing.

However, a person should contact a doctor if they:

• notice that their resting heart rate suddenly changes
• have a change in heart rate that causes anxiety
• experience a heart rate change after taking a new medication
• often have an irregular heart rate

A person should go to the emergency room if they:

• have shortness of breath and a change of heart rate
• feel very dizzy, faint, lightheaded, or confused
• have chest pain and a high or low heart rate
• have an infection and a low heart rate
• are bleeding and have a low heart rate, which might be the case if a person who has recently given birth experiences a change in heart rate

If a person’s heart rate is too low or is only low temporarily, treatment might not be necessary.

If medication is causing the low heart rate, a person can discuss changing medications with a doctor.

Having a pacemaker might also help a person’s body regulate their heart rate in some cases.

If a person’s high heart rate is due to stress or exercise, taking steps to reduce these can help lower their heart rate.

Learn about some ways to treat and manage stress here.

If the high heart rate is due to an underlying cause such as sepsis or hypoxia, treating this will also help regulate the heart rate.

To lower a high heart rate at home, a person can:

• Sit down and take some slow, deep breaths.
• Try a relaxation technique such as progressive muscle relaxation or thinking calm thoughts. A person having a panic attack can remind themselves that panic can cause increases in heart rate.
• Drink a glass of water.
• Lie down.
• Take a medication to reduce pain or fever.

A person can also try the Valsalva maneuver, which increases pressure in the chest and can lower a person’s heart rate. The Valsalva maneuver involves holding the breath and bearing down.

Learn more about the Valsalva maneuver here.

If these measures do not work and a person’s heart rate is consistently high, they should contact a doctor.

Learn about more ways to lower the heart rate here.

The heart responds to the pressures the body faces, and it may change its rhythm based on the muscles’ demand for blood and oxygen.

However, when heart rate changes appear to be random, are long-term, or occur with other symptoms, it may signal an underlying medical problem.

Only a doctor can diagnose the issue and treat it accordingly.

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