Shortness of breath when lying down
Overview
Shortness of breath when lying down, also known as orthopnea, is difficulty breathing that occurs when a person is in a horizontal position. This symptom typically improves when the individual sits up or elevates their head with pillows.
Common Causes
This symptom often occurs due to heart conditions where the heart struggles to pump blood effectively when lying flat, causing fluid to back up in the lungs. Sleep apnea and other breathing disorders can also make it difficult to breathe properly while lying down. Pregnancy, obesity, and acid reflux are common lifestyle factors that can put pressure on the diaphragm and lungs when in a horizontal position. Lung conditions like asthma or chronic obstructive pulmonary disease may worsen when lying flat due to changes in airway positioning and mucus drainage.
Severity Levels
Mild: You notice slight breathing difficulty only when completely flat, but it resolves quickly when you prop yourself up with one pillow or sit upright.
Moderate: You consistently need two or more pillows to sleep comfortably and experience noticeable breathing difficulty when lying flat, though sitting up provides relief within a few minutes.
Severe: You cannot lie flat at all without significant breathing distress, require sleeping in a chair or completely upright position, and may wake up gasping for air even when propped up.
Medical Attention
Seek immediate medical attention if you experience sudden or severe difficulty breathing when lying down, especially if accompanied by chest pain, rapid heartbeat, or swelling in your legs. Contact your doctor promptly if this symptom is new, worsening, or interfering with your sleep. If you have a history of heart or lung conditions and notice changes in your breathing patterns, schedule an appointment with your healthcare provider soon.
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