Health Encyclopedia

Breathing difficulty - lying down

Definition

Breathing difficulty while lying down is an abnormal condition. A person with this condition must keep the head elevated (by sitting or standing) to be able to breathe deeply or comfortably. The condition may also cause a person to wake up suddenly during the night, feeling short of breath (paroxysmal nocturnal dyspnea).

Alternative Names

Waking at night short of breath; Paroxysmal nocturnal dyspnea; PND; Difficulty breathing while lying down; Orthopnea

Considerations

For people with some types of heart or lung problems, this is a common complaint. Sometimes the problem is subtle and is only noticed when the person realizes that sleep is more comfortable with lots of pillows under the head, or in a propped-up position.

Common Causes

Chronic obstructive pulmonary disease (COPD)
Cor pulmonale
Heart failure
Hypertensive heart disease
Obesity (does not directly cause difficulty breathing while lying down but often aggravates other conditions)
Panic disorder
Sleep apnea
Snoring

Home Care

Your health care provider may prescribe treatment to treat breathing difficulty while lying down. The treatment will depend on the specific illness causing the problem.

Weight reduction is generally recommended in cases of obesity.

Call your health care provider if

If you have any unexplained difficulty in breathing while lying down, call for an appointment with your health care provider.

What to expect at your health care provider's office

The health care provider will perform a physical examination and will obtain your medical history.

Medical history questions documenting nocturnal dyspnea include the following:

Did this problem develop suddenly or slowly?
Is it getting worse (progressive)?
How bad is it?
How many pillows do you need to help you breathe comfortably?
Is there any ankle, feet, and leg swelling?
Do you have difficulty breathing at other times?
How tall are you? How much do you weigh?
What other symptoms are also present?

The physical examination will include special attention to the heart and lungs (cardiovascular and respiratory systems).

Diagnostic tests that may be performed include the following:

Supplemental oxygen may be given.

Review Date:1/18/2007
Reviewed By:Benjamin W. Van Voorhees, MD, MPH, Assistant Professor of Medicine and Pediatrics, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.

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