Shortness Of Breath When Lying Down At Night – Decoding The Mystery

After a bustling day, all you need is a good snooze to gear up for the next. However, if it has become difficult for you to have a peaceful retreat due to shortness of breath at night, it is a cause of concern. Medically, we categorize this condition as orthopnea. It has various underlying causes that contribute to this nightmare. Here’s a brief breakdown of 9 possible causes for this issue.

1. Sleep Apnea

The main cause of this issue, sitting on the throne, is sleep apnea. Contrary to common belief, it is not just about snoring. Sleep apnea is a disorder in which your breathing repeatedly stops and starts in a single night. This occurs when throat muscles relax when they are not supposed to and obstruct the airways, particularly when lying on your back. This condition presents itself with signs like snoring, waking up, gasping for air during sleep, and dry mouth. If you have any of these symptoms that are decreasing your quality of life, treatments such as nasal decongestants or a continuous positive airway pressure (CPAP) machine are fruitful.

1. Congestive Heart Failure

CHF is another leading reason for shortness of breath at night while lying down. When your heart fails to pump blood throughout your body, it can impact lung function. One of the contributing factors for this is narrowed arteries or high blood pressure, making it harder for the lungs to operate at full capacity.

1. Asthma or Allergies

If your sleeping area has excessive dust, mold, or pet dander, expect your nocturnal snooze to hamper if you have asthma or allergies. Factors such as sleeping positions, mucus buildup, and hormonal changes at night exacerbate asthma symptoms. However, if you manage these symptoms effectively by getting rid of the stimuli, it is possible to enjoy a good sleep.


Chronic obstructive pulmonary disease (COPD) is a condition in which the airways narrow, making breathing difficult.

5. Obesity

As excessive levels of fat accumulate, it changes the shape and function of the respiratory system, adding pressure to the chest and affecting diaphragm movement. Lifestyle changes, a healthy diet, and exercise can alleviate orthopnea.

6. Pleural Effusion

When the surroundings of your lungs collect fluid, you may feel suffocated and find yourself struggling to catch a breath at night. Identifying underlying conditions such as infections, cancer, or pulmonary embolism is crucial for effective treatment.

7. Pneumonia

It is a lung infection that is characterized by shortness of breath, cough with colored phlegm, and fever. Seeking medical advice as soon as possible is essential as the illness is much worse than just making breathing difficult at night. If you leave it untreated, the situation can turn fatal.

8. Ascites

Similar to the lungs, your liver may be burdened with excessive fluid that can cause shortness of breath. Identifying causes like obesity, alcohol consumption, or pancreatic issues is vital to manage this condition.

9. Anxiety or Panic Disorder

Panic, anxiety, and fear may cause orthopnea, but that is a rare case scenario. Mostly, these conditions impact sleep. Treatment options, including medications and therapy, offer relief for those experiencing nighttime anxiety.

10. Snoring

More than 25% of the population snores. Factors like nose anatomy, frequency of alcohol consumption, obesity, or colds/allergies can contribute to it.

11. Respiratory Infections

Upper respiratory infections (URIs), resulting from viruses or bacteria, lead to sleeping issues at night. Recognizing symptoms ensures proper management of respiratory infections.

Closing Note

If you find yourself battling with breathlessness at night, consult our expert, Dr. Fakhri Kalolwala, a Board Certified Internal Medicine Physician at Aqeeq Internal Medicine, for accurate diagnosis and management of your condition. Do not hesitate to set up an appointment with us by dialing (832) 786-8195. You can also drop by our office in Houston, Texas.



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