7 Causes of Shortness of Breath at Bedtime - Amerisleep (2023)

Orthopnea is the medical term for the feeling of shortness of breath when lying down. Other times, a person may experience paroxysmal nocturnal dyspnea or wake up suddenly gasping for breath.

While symptoms can vary, people with shortness of breath may feel like they are suffocating, cannot get enough air, experience tightness in the chest, and discomfort when breathing.

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Orthopnea and paroxysmal nocturnal dyspnea can prevent you from getting enough sleep, damaging your overall health. Our article looks at what could be causing your shortness of breath when you're lying down. Although this is not a medical emergency, if you regularly experience shortness of breath, it's a good idea to talk to your doctor.

1. Sleep apnea

7 Causes of Shortness of Breath at Bedtime - Amerisleep (2)Sleep apneait is one of the most common reasons why people experience shortness of breath while lying down. Often mistaken for simple snoring, obstructive sleep apnea (OSA) causes shallow breathing or pauses in breathing during sleep. The throat muscles relax and obstruct the airway, especially when you are lying on your back.

Sleep Specialist Dr. Nayantara Santhi says: “One of the most common symptoms of OSA is excessive daytime sleepiness. Why it happens? OSA involves a decrease or complete stop in airflow, resulting in an abrupt drop in blood oxygen saturation. The brain responds by causing a brief awakening from sleep that restores normal breathing. Because this can happen hundreds of times in one night, sleep becomes fragmented, leading to excessive daytime sleepiness.

People with sleep apnea may experience snoring, difficulty staying asleep, waking up with a dry mouth or sore throat, and fatigue during the day. If you experience any of these additional symptoms, we suggest that you speak to a doctor about the possibility of undergoing asleep studyto rule out or diagnose sleep apnea and any other sleep disorder.

Simple nasal decongestants may be enough to resolve sleep apnea, although some people's symptoms may respond better to breathing devices, such as a mouthpiece or mouthpiece.continuous positive airway pressure (CPAP) machine.

2. Heart failure

7 Causes of Shortness of Breath at Bedtime - Amerisleep (3)Congestive heart failure often causes shortness of breath when lying down. With this condition, the heart is unable to pump blood efficiently and relax normally. Heart failure is often caused by other health conditions and diseases, such as high blood pressure, a heart attack, or heart defects.

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Heart failure is unpredictable and gets worse over time. The disease causes shortness of breath, fatigue, fluid buildup in the feet, legs, and abdomen, coughing, and loss of appetite.

Heart failure is a very serious condition and can become fatal, but it is possible to live with the condition. There are effective medications and surgeries used to extend your lifespan or address the underlying causes.

3. Obesity

7 Causes of Shortness of Breath at Bedtime - Amerisleep (4)If you are carrying excess weight, it may be difficult for you to breathe normally. When lying down, your abdomen and chest may be compressed and unable to fully expand. Although obesity can be caused by lifestyle choices, certain diseases, medications, and class and socioeconomic issues are also linked to obesity.

Obesity is commonly related to other health conditions such as hypertension, high blood pressure,diabetesand certain types of cancer. Losing weight by following a healthy diet and exercise regimen can relieve symptoms, but always talk to your doctor to discuss a weight loss plan.

4. Panic disorder

7 Causes of Shortness of Breath at Bedtime - Amerisleep (5)Panic disorder is a type of anxiety in which a person experiences anxiety or panic attacks, feeling a loss of control, extreme fear, and detachment. Panic attacks are sudden and can last for several minutes, making a person feel short of breath or unable to breathe normally.

Along with the psychological symptoms of an anxiety attack, a person may experience sweating, tremors, retching, dizziness, tingling. If you have a panic disorder, seek counseling, cognitive behavioral therapy, or psychotherapy.

5. Chronic Obstructive Pulmonary Disease (COPD)

7 Causes of Shortness of Breath at Bedtime - Amerisleep (6)Chronic obstructive pulmonary disease (COPD) is a group of lung diseases, such as emphysema or chronic bronchitis, and is usually caused by poor air quality. In a patient with COPD, the air sacs in the lungs are damaged and the airways are narrowed, making it difficult to breathe properly.

Without treatment, COPD gets worse over time. Treatment will not reverse lung damage, but inhalers, surgery, and rehabilitation may improve symptoms.

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COPD symptoms include chronic cough or wheezing, shortness of breath when completing regular activities, frequent respiratory infections, and fatigue.

6. Pregnancy

7 Causes of Shortness of Breath at Bedtime - Amerisleep (7)During pregnancy, the growing uterus puts pressure on the organs, particularly the diaphragm and lungs, reducing lung capacity. Also, the body releases a hormone called progesterone, which makes the brain breathe faster. As the pregnancy continues, the body needs to pump more blood to accommodate the growing fetus.

Feeling short of breath during pregnancy is completely normal and usually goes away after birth. Along with shortness of breath, pregnant women may experience chest pain, palpitations, and fatigue.

7. Respiratory infections

7 Causes of Shortness of Breath at Bedtime - Amerisleep (8)Respiratory infections such as the common cold, mild flu, or sinus infections are a common cause of shortness of breath. They only last between 3 to 14 days, so the shortness of breath should pass with the disease itself.

There are two types of respiratory infections: an upper infection and a lower infection. An upper respiratory tract infection begins in the sinuses and ends in the vocal cords, while a lower respiratory tract infection begins in the vocal cords and ends in the lungs.

While symptoms vary depending on whether you have an upper or lower respiratory tract infection, you may experience a sore throat, runny nose, headaches, sneezing, and aches and pains.

Talk to your doctor about shortness of breath

It is good to contact your doctor as soon as you have unexpected breathing problems. If you find that you have other symptoms, such as chest pain, lips turning blue, or swelling in your ankles and feet, you should go to the hospital immediately. All of this could point to a larger medical problem.

To diagnose the problem, your doctor will likely perform a physical exam and ask about your medical history, along with other questions about the nature of your breathing difficulties.

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Some questions that may be asked include:

  • What seems to make your breathing worse or better?
  • Are there other times when you have trouble breathing?
  • How many pillows do you use to breathe comfortably? Alternatively, youuse a wedge pillowto breathe better?
  • Is there swelling in the ankles or feet?

If the physical exam doesn't clarify what the problem is, your doctor may order more tests, such as blood tests, a chest x-ray or CT scan, lung function tests, or an echocardiogram. They may even refer you to a specialist who works in respiratory medicine, such as an allergy and asthma clinic.

Beware of fiberglass in the bedroom

If you find yourself gasping, coughing, and gasping for breath when you weren't before, check the mattress cover for a hole or small shiny shards in and around the bed. If you notice these things, you mayfiberglass inside your mattressescaped and is causing respiratory irritation.

The purpose of the fiberglass inside a mattress is to serve as a barrier against flames. However, if the fiberglass escapes and is inhaled, it can cause shortness of breath and other symptoms such as stomach irritation. These potential problems are why many buyers are switching tofiberglass mattresses.

If you don't know if your mattress has fiberglass, take a look at the ingredients listed on the clothing label or do a quick web search to see if the model has any customer complaints about fiberglass. Even if your mattress is in good condition, escaping and ingested fiberglass can worsen pre-existing breathing difficulties. If you have fiberglass you cantime to change your mattress.

frequent questions

Can dehydration cause breathing problems?

Yes, without adequate fluids, the body cannot provide enough energy to the cells. The water moistens the bronchi, lungs and nasal passages of the body. It also thins mucus and prevents coughing spells. Drink at least 3.7 liters (125 oz) of water if you are a man and 2.7 liters (91 oz) of water if you are a woman every day to stay adequately hydrated.

When should I worry about my shortness of breath?

Signs of a medical emergency include:

  • Severe shortness of breath (inability to speak)
  • Allergic reaction
  • Chest pain, sharp pain in the arm, profuse sweating (heart attack)
  • weak pulse
  • Dizziness
  • Fever
  • Rapid breathing or heart rate
  • A blue tint on your lips

If you experience any of these symptoms, seek medical attention immediately.

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How should I sleep to avoid shortness of breath?

Consider sleeping on a slope - with a wedge pillow oradjustable bed frame– to improve circulation and prevent shortness of breath that occurs when lying down. You can also add a pillow under your knees to help relax your body and provide additional support for your back and spine.

Another position you can try is to lie on your side with apillow between knees. That way, your tongue won't settle in the back of your throat and block your airway.

You can also try using nasal strips and using a saline spray or nasal irrigation system to clear your sinuses before bed. For people with sleep apnea, the use of a continuous positive airway pressure (CPAP) machine can relieve symptoms.

Does lack of oxygen make you sleepy?

Yes, lack of oxygen causes lethargy because without oxygen your body cannot function normally. A low blood oxygen level is anything below 60 millimeters of mercury (mm Hg), while a normal blood oxygen level is between 75 and 100.

However, if your body experiences low oxygen levels while you sleep, the brain tends to wake you up so you can breathe easier. This is why sleep apnea, in which a sleeping person's breathing can stop while resting due to a blockage in the throat, can make a person feel overly tired during the day.

How to relieve my shortness of breath?

If your shortness of breath is not severe, you can practice controlled breathing techniques, such as pursed lips and diaphragmatic breathing, to improve your symptoms. You can also leave a fan running in your bedroom, as it can alleviate the feeling of lack of air, although this has its advantages and disadvantages.sleep with the fan on.

When you have obstructive sleep apnea, your doctor may recommend the use of aCPAP or BiPAP (bi-level positive airway pressure) machineto relieve shortness of breath during sleep. Lifestyle changes can also help you breathe easier, such as avoiding allergens or irritants and staying away from foods that can trigger acid reflux.


Orthopnea is very uncomfortable, can ruin sleep, and is not safe in certain situations. Even if your shortness of breath is not life-threatening, always contact your doctor if you experience unexplained shortness of breath when lying down. The causes and severity differ from case to case, so it is important to receive the proper diagnosis and treatment options.

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