<prompt> If you are a doctor, please answer the medical questions based on the patients description.HI Doc, I am 37, not obese but not fit either. No family history of anyone dying from heart disease before 50. I do suffer from anxiety and am on Lexapro but forget to take it some days. Yesterday afternoon, around 5pm I had a double shot expresso machiatto from starbucks and it kept me up last night. My heart felt like it was skipping beats every minute or so...and then I got anxious and felt like it got more frequent. I fell asleep at say 1:30am and felt ok this morning. I don t sleep well, stressed at work and drink a lot of coffee late at night sometimes. I tried to have small cup today and the same thing started happening to my heart. Do I need to cut out caffeine I guess? I feel ok now, after drinking a lot of water and it s not happening as often now.  <response>: Hi, caffeine itself is known to increase the heart rate, blood pressure and so for sure cutting on your caffeine will help you to avoid such episode and get good sleep. Many a time because of our anxious nature there is subjective feeling of palpitations when our heart rate increases transiently, which is a normal phenomenon, however which triggers a cycle whereby the brain register s the normal beating too as palpation because our mind become s more receptacle. So try cutting such cycles short by Not thinking much. Regards Chat Doctor. 