Shortness of Breath at Night When Lying Down

Orthopnea is a medical word that describes shortness of breath while lying down. Shortness of breath at night when lying down can be caused by a variety of medical disorders, including heart failure, obesity, and obstructive sleep apnea. Treatment will be determined by the underlying reason.

People with orthopnea may require multiple pillows to prop themselves up so they do not lie flat. Some people prefer to sleep upright on a couch or chair because it allows them to breathe more easily.

What Causes Shortness of Breath at Night

Causes of Shortness of breath at night when lying down are variable, Here are some medical causes:

Heart Failure

• Causes heart failure when the heart fails to pump blood, leading to increased pressure and fluid accumulation.
• Symptoms include: exhaustion, shortness of breath, swelling, and coughing or wheezing.

COPD

• Characterized by emphysema and chronic bronchitis, often found in smokers.
• Main symptoms include: persistent cough, shortness of breath, excessive mucus production, and difficulty breathing deeply.

Obesity

• Changes the form and function of the respiratory system and tissues, affecting diaphragm movement and lung adaptation.
• Can cause inflammation, causing lung tissue damage.

Obstructive Sleep Apnea

Causes breathing difficulties, including snoring, delayed breathing, and producing gasping and choking sounds.

Diaphragmatic Paralysis

A condition where the diaphragm muscle is unable to contract, often due to nerve or muscle damage.

Lung Conditions

• Pleural effusion: Fluid accumulation in the pleural cavity surrounding the lungs, caused by infection, malignancy, or pulmonary embolism.
• Pneumonia: A lung infection causing shortness of breath and symptoms like shallow breathing, coughing up phlegm, fever, chills, and confusion.

Ascites

Fluid accumulation due to liver dysfunction, obesity, alcohol consumption, pancreatic problems, Type 2 diabetes, and cancer.

Panic Disorder

• Symptoms worsen when lying down in a dark room, causing breathing trouble.
• Nighttime anxiety is particularly common.

Breathing Issues While Lying Down at Night

Shortness of breath at night when lying down might range in severity and underlying reason. Here are some common breathing-related concerns people can have while in a prone position:

• Dyspnea: Difficulty breathing or insufficient airflow, especially when lying down.
• Obstructive Sleep Apnea: Airway collapse during sleep, causing intermittent breathing.
• GERD: Causes stomach acid to flow back into the esophagus, causing dyspnea and chest tightness.
• Congestive Heart Failure: Causes fluid accumulation in the lungs, causing shortness of breath when resting flat (orthopnea).
• Asthma: Worsens at night, leading to wheezing, coughing, and trouble breathing.
• Pneumonia and chronic respiratory conditions: Cause difficulty breathing when lying down due to fluid buildup or decreased lung function.
• Obesity: Causes hypoventilation syndrome, causing difficulty breathing deeply while lying down.

Identifying the Causes of Nighttime Breathlessness

Shortness of breath at night when lying down can be caused by a variety of problems. To determine the cause, a doctor will often take the following steps:

Medical History

The doctor will inquire about your symptoms, when they appear, and any other medical conditions you may have.

Physical Examination

The doctor will look for indicators of heart or lung disease, such as abnormal lung sounds or fluid retention.

Diagnostic tests

such as chest X-rays, echocardiograms, pulmonary function tests, and sleep studies may be required to determine the cause.

Reference

Breathing difficulty – lying down: MedlinePlus Medical Encyclopedia. (2018). Medlineplus.gov. https://medlineplus.gov/ency/article/003076.htm

Mukerji, V. (2018). Dyspnea, Orthopnea, and Paroxysmal Nocturnal Dyspnea. Nih.gov; Butterworths. https://www.ncbi.nlm.nih.gov/books/NBK213/

Shortness of breath when lying down: 9 causes. (2019, June 24). Www.medicalnewstoday.com. https://www.medicalnewstoday.com/articles/325539#obesity