Breathing difficulty

Breathing difficulty - lying down

Definition:

An abnormal condition in which a person must keep the head elevated (sit or stand) to breathe deeply or comfortably (orthopnea) or wakes up suddenly in the middle of the night 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:

heart failure
chronic obstructive pulmonary disease (COPD)
panic disorder
hypertensive heart disease
obesity (does not directly cause difficult breathing while lying down, but it often aggravates other conditions)
sleep apnea
snoring
cor pulmonale

Home Care:

Follow the doctor's prescribed therapy. Some temporary relief may be provided by leaning over a table with the chest forward. Weight reduction, in cases of obesity, is recommended.

Call your health care provider if:

there is any unexplained difficulty in breathing while lying down.

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination will be performed.

Medical history questions documenting nocturnal dyspnea include:

time pattern
- Did this develop suddenly or slowly?
- Is it getting worse (progressive)?
quality
- How bad is it?
- How many pillows are required to breathe comfortably?
aggravating factors
- Is there any ankle, feet, and leg swelling?
- Does the person have difficulty breathing at other times?
- How tall is the person? How much do they weigh?
other
- 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:

Supplemental oxygen may be administered.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to breathing difficulty when lying down, you may want to note that diagnosis in your personal medical record.

Review Date: 11/30/2001
Reviewed By: Steven Angelo, M.D. Department of Internal Medicine, Yale School of Medicine, Hospital of Saint Raphael, New Haven, CT. Review provided by VeriMed Healthcare Network.

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