Shortness of Breath When Lying Down

Shortness of breath when lying down is also called "orthopnea." It can happen whether you are sleeping or awake. Orthopnea plagues people with heart and lung conditions. People with sleep apnea are also prime targets for orthopnea.

Shortness of breath when lying down is also called "orthopnea." It can happen whether you are sleeping or awake. Orthopnea plagues people with heart and lung conditions. People with sleep apnea are also prime targets for orthopnea.

Orthopnea can arise from disorders of the heart, lungs and gastrointestinal system. It can likewise occur with obesity. All orthopnea needs a comprehensive medical examination, but rapid-onset orthopnea benefits emergency medical attention.

Common Causes of Shortness of Breath When Lying Down

1. Congestive Heart Failure

The heart pumps oxygen-rich blood from your lungs to your body. Any condition that impairs the heart’s pumping function can cause a condition called congestive heart failure, or CHF. With CHF, areas in the lungs that are typically filled with air end up being congested with blood, triggering fluid leakage into these locations. This triggers shortness of breath. Shortness of breath resulting from CHF may get worse when lying flat since blood that pools in your legs while upright puts additional pressure on the heart when you rest. The pressure gets worse the heart’s pumping function and leads to extra fluid backup in the lungs.

Lots of heart disease can cause CHF, however the most typical are coronary artery disease, hypertension and conditions of the structure or function of your heart valves. Less commonly, a viral infection, chronic alcoholism or acquired illness can cause CHF.

2. Asthma

A variety of lung conditions can cause shortness of breath that worsens when resting. Some individuals with asthma experience symptoms mostly in the evening, and notice shortness of breath when resting to sleep. The factors for these nighttime symptoms are disputed, however shortness of breath during the night may suggest undiagnosed asthma. If asthma has actually already been detected, nighttime shortness of breath might indicate a have to change the timing of when asthma medications are taken so they are more effective at night.

3. COPD

Chronic obstructive pulmonary disease, or COPD, is a chronic lung disease typically triggered smoking. COPD is likewise characterized by severe episodes of shortness of breath, wheeze, and cough, which is typically efficient of sputum. As in asthma, during intense COPD exacerbations clients might complain of orthopnea, and might assume a “tripod” position, sitting up and leaning forward with their hands on their knees, in order to eliminate their shortness of breath.

So, the symptoms of COPD consist of:

  • chronic coughing
  • trouble breathing with activity
  • wheezing
  • frequent chest infections, such as bronchitis

4. Gastrointestinal Conditions

Gastroesophageal reflux disease, or GERD, is another reason for orthopnea. In GERD, acid from the stomach supports into the esophagus. This frequently triggers the characteristic heartburn that GERD patients suffer. If the stomach acid refuxes into your trachea, it can produce cough and a feeling of shortness of breath. Because reflux is more likely to occur when laying flat, GERD can be a cause of orthopnea (Harrison’s, Ch. 33: Dyspnea; Approach to the Patient: Dyspnea).

5. Sleep Apnea

Sleep apnea triggers shallow or quick pauses in breathing while sleeping. This condition usually takes place due to obstruction of the respiratory tracts. The symptoms of sleep apnea include:

  • trouble staying asleep
  • feeling fatigued throughout the day
  • snoring while sleeping
  • waking up with headaches
  • getting up with a sore throat

6. Obesity

Obesity is related to a variety of modifications in the normal physiology of respiration, consisting of smaller sized lung volumes and an increased effort needed to produce a regular rate and depth of ventilation. Obesity is also associated with shortness of breath, which is generally even worse when laying flat. This is since in order to breath, your diaphragm, the principle muscle of respiration, need to compress your stomach contents in order to expand your lungs. When standing erect, your abdominal contents hang low in your abdomen, and they are quickly compressible. When laying flat, your stomach contents redistribute, causing a greater degree of mechanical blockage for the diaphragm.

When Is Shortness of Breathing Need Medical Attention?

Breathing problem isn’t always due to a serious medical condition, however you need to talk to your doctor about any breathing problems right now.

Your physician will carry out a physical exam to help them diagnose the underlying reason for your breathing difficulties. They’ll ask you about your symptoms and case history.

Inform your doctor about every non-prescription (OTC) and prescription medication you’re taking. Certain drugs individuals consider treating pain, muscle stiffness, or anxiety can cause breathing problems.

Your doctor will pay very close attention to your heart and lungs throughout the physical exam. Extra tests may be required, such as:

  • chest X-rays to see the heart and lungs
  • an echocardiogram to see and detect possible problems with heart function
  • an electrocardiogram (ECG or EKG) to evaluate the electrical activity of the heart

How Are Breathing Issues Treated?

Treatment depends on the underlying cause of your breathing problem.

Breathing infection
If you have a respiratory infection that triggers breathing problem when you are lying down, your physician might prescribe antibiotics or antiviral medications to assist clear up the infection. However, most of the times, minor chest infections might clear up without making use of any medications.

Obesity
You can briefly ease problem breathing due to obesity by sleeping on your side rather of your back. Lying on your side decreases the pressure being placed on your lungs by the excess weight. Talk with your doctor about weight reduction and ask about diet strategies. Dropping weight can assist prevent future health concerns connected with obesity.

COPD
No remedy for COPD is readily available, however you can ease breathing difficulties with fast-acting inhalers or other medications individuals use to clear lung infections.

Sleep apnea
If sleep apnea is making it tough for you to breathe when you are resting, you may find that utilizing a mouth guard or a continuous positive airway pressure (CPAP) maker is handy.

Anxiety
If an anxiety condition is causing your breathing problems, various treatments can assist reduce symptoms. Group or individually treatment might assist you cope with anxiety. Treatment typically includes therapy combined with antidepressant or antianxiety medications. These medications are available by prescription just.

Note: All orthopnea has to be assessed by a doctor. However, if you are experiencing orthopnea that has established or progressed rapidly, look for emergency care as this might indicate a dangerous issue.


Last modified: June 28, 2018

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