Shortness of breath when lying down: 8 Causes Explained

Written by Dreamcloud Editorial Team

Last Updated on Jul 21, 2022

In this article:

    Experiencing shortness of breath when playing, exercising, or doing household chores is quite common. But have you ever experienced shortness of breath when lying down? This can be orthopnea and a health risk factor. 

    Orthopnea is technically a Greek word - ortho (upright or straight) and pnea (breath). The matter of concern for someone experiencing shortness of breath when lying down is that it’s often a sign of heart failure. There can be additional factors like lung diseases, other heart diseases, and obesity. In addition, people might feel hard to breathe when lying down on their back, undergo tightness in the chest, and breathe uncomfortably. Read ahead to know the reasons explained for shortness of breath while lying down.

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    Sleep Apnea

    Sleep Apnea is the most typical health issue that causes trouble when lying down. Most people confuse sleep apnea with the trivial act of snoring, but in reality, obstructive sleep apnea results in shallow breaks in breathing while sleeping. This happens when the muscles in your throat relax and obstruct the airways, eventually leading to breathlessness. 

    People undergoing sleep apnea often suffer from immense daytime drowsiness. This happens because sleep apnea leads to absolute or maximum blockage in the airflow, resulting in a sudden drop in blood oxygen saturation. This is preceded by sudden sleep arousal to normalize the breathing process. 

    Heart Failure

    Another big reason behind shortness of breath when lying down is heart failure. In this condition, the heart ceases to pump enough blood efficiently and unwind like normal. Heart failure can result from other underlying diseases like high blood pressure, heart attack, and other heart defects. 

    Heart failure can be traumatizing. It leads to additional severe health issues like swelling of the feet, abdomen, and legs, fatigue, cough, and also loss of appetite. In this situation, walking and climbing stairs become difficult. 

    Obesity

    Obesity is one of the reasons behind shortness of breath when lying down. While lying down, your abdomen and chest gets compressed and fails to expand completely. Obesity might result from specific health issues, lifestyle choices, medications, and socioeconomic and class issues. Obesity is mainly correlated with diabetes, hypertension, and also some kinds of cancers. One of the best solutions in handling obesity is regular exercise and following a nutrient-rich diet prescribed by the doctor. 

    You can make simple changes to your diet by including:

    • Multiple servings of fruits and veggies in a day
    • Whole-grain cereals and bread
    • Healthy fats are found in nuts, seeds, olive oil, etc
    • Lean protein is found in poultry, fish, and beans
    • Restricted amounts of red meat

    Panic Disorder

    Panic attacks and anxiety attacks are traumatizing health issues that leave the person exhausted and also lead to shortness of breath while lying down. During panic attacks, the person feels an intense loss of authority, dread, and separation. Panic attacks continue for quite some minutes, and during that time, the person might gasp for breath - leading to breathlessness. Apart from the psychological symptoms, the person might feel physical symptoms like choking, sweating, lump in the throat, trembling, lightheadedness, tingling, and more. Psychotherapy, counseling, or cognitive behavioral therapy is the solution to look forward to.

    Chronic Obstructive Pulmonary Disease (COPD)

    COPD is a group of lung diseases that includes emphysema or chronic bronchitis, making it harder to breathe when lying down. One of the significant reasons behind COPD is poor air quality. One of the biggest reasons people ask ‘why can’t I breathe when I lay down’ may be because they are suffering from COPD. It becomes problematic because your lung’s air sacs are damaged, which makes the breathing tubes tightened- altogether making breathing difficult. 

    COPD cannot be completely cured - the damage cannot be reversed, but leaving it without treatment will even worsen it. However, it may be taken under control with the help of medications, surgery, inhalers, or rehabilitation.

    Pregnancy

    When pregnant, the maturing uterus tends to compress the organs, especially the diaphragm and lungs, reducing lung capacity. To add to that, the brain releases a hormone called progesterone that pushes the brain to breathe faster. As the days pass by, the body must pump more blood for the fetus to grow healthily. So, if you are pregnant and feel that you can’t breathe at night when lying down, then it’s normal to feel like that. Moreover, pregnant women tend to feel fatigued and undergo chest pain and heart palpitations as well.

    Pregnancy

    When pregnant, the maturing uterus tends to compress the organs, especially the diaphragm and lungs, reducing lung capacity. To add to that, the brain releases a hormone called progesterone that pushes the brain to breathe faster. As the days pass by, the body must pump more blood for the fetus to grow healthily. So, if you are pregnant and feel that you can’t breathe at night when lying down, then it’s normal to feel like that. Moreover, pregnant women tend to feel fatigued and undergo chest pain and heart palpitations as well.

    Respiratory Infections

    A typical reason behind shortness of breath when lying down can be the common cold, flu, cough, or sinus infections. The average duration of their continuation can be between 3 to 14 days, and gradually the difficulty with breathing pauses. There are two types of respiratory infections: 

    1. Upper Infection: This begins at the sinus and finalizes at the vocal cords.

    2. Lower Infection: This begins at the vocal cords and finalizes at the lungs. 

    Shortness of breath, sore throat, runny nose, sneezing, and achiness, are common symptoms of common cold or flu. 

    Iron Deficiency Anemia

    If you are experiencing shortness of breath when lying down, the reason might be iron deficiency anemia. This is quite a typical form of anemia where the blood lacks enough healthy red blood cells. And, red blood cells bring oxygen to the body’s tissues. As can be understood from the term, this condition results from insufficient iron that is responsible for producing enough substance in red blood cells enabling them to deliver oxygen (hemoglobin). Now, if there is an iron reduction, it might make you feel hard to breathe when lying down on your back.

    How To Sleep To Avoid Shortness Of Breath

    After learning quite a bit about shortness of breath when lying down, the person undergoing it might be interested in knowing how to avoid shortness of breath. Here are a few pointers for the same- 

    • Sleep in an inclined position by placing a wedge pillow.

    • Try and have an adjustable bed frame for yourself as it amps up circulation and averts breathlessness.

    • Consider placing a pillow underneath your knees to maximize comfort and relaxation and cushion your spine and back. 

    • Try side sleeping along with a pillow between your knees. This will prevent your tongue from resting and blocking your throat and airways. 

    • Nasal strips and saline spray are other measures to handle your shortness of breath when lying down.

    When To See A Doctor

    You need to see a doctor when you experience shortness of breath when lying down. If the shortness of breath is not a result of rigorous exercise or exposure to extreme temperatures, poor air quality, obesity, or high altitude - it’s time to consult a doctor. Not only that, it might be a sign of a severe medical condition if you find it hard to breathe and simultaneously undergo chest pain, pressure, fainting, or nausea. 

    Shortness of breath when lying down is normal for pregnant women and people undergoing common cold or flu, COPD, respiratory issues, panic disorder, and so on. However, if it persists, it is time to consult a doctor (though not for pregnant women or people with cold/flu). It’s not a trivial matter to ignore and should be looked upon.

    This article is for informational purposes and should not replace advice from your doctor or other medical professional.
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