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Published on: 5/6/2025

What Are the Possible Reasons for Chest Pain Occurring Only at Night?

Chest pain that occurs only at night may be due to acid reflux, musculoskeletal issues, changes in heart function during sleep, or even sleep-related breathing problems.

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Explanation

There are several reasons you might experience chest pain only at night. One common cause is acid reflux. When you lie down, it’s easier for stomach acid to flow back into the esophagus, which can lead to a burning sensation and discomfort in your chest. Musculoskeletal reasons, such as costochondritis or a strained chest muscle, can also cause pain that becomes more noticeable with certain sleeping positions or pressure on the chest wall during rest. Additionally, some heart-related conditions, like acute coronary syndrome, may sometimes present with chest pain at night. Changes in heart function and blood pressure during sleep can make these symptoms appear more prominently. Sleep disorders, like sleep apnea, can reduce oxygen levels and put extra strain on the heart, potentially leading to chest discomfort. Psychological factors, such as nighttime anxiety, may also amplify or make you more aware of chest pain. Because chest pain can have several different causes, it’s important to talk to your doctor. They can evaluate your symptoms, perform tests if needed, and help determine the most appropriate treatment so you can feel better.

(References)

  • Wouters LT, Zwart DL, Erkelens DC, Cheung NS, de Groot E, Damoiseaux RA, Hoes AW, Rutten FH. Chest discomfort at night and risk of acute coronary syndrome: cross-sectional study of telephone conversations. Fam Pract. 2020 Sep 5;37(4):473-478. doi: 10.1093/fampra/cmaa005. PMID: 31996901; PMCID: PMC7474533.

  • Faramand Z, Frisch SO, Martin-Gill C, Landis P, Alrawashdeh M, Al-Robaidi KA, Callaway CW, Al-Zaiti SS. Diurnal, weekly and seasonal variations of chest pain in patients transported by emergency medical services. Emerg Med J. 2019 Oct;36(10):601-607. doi: 10.1136/emermed-2019-208529. Epub 2019 Jul 31. PMID: 31366626; PMCID: PMC7316529.

  • Malik MA, Alam Khan S, Safdar S, Taseer IU. Chest Pain as a presenting complaint in patients with acute myocardial infarction (AMI). Pak J Med Sci. 2013 Apr;29(2):565-8. doi: 10.12669/pjms.292.2921. PMID: 24353577; PMCID: PMC3809224.

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