Why Do I Have Trouble Breathing at Night?

Are you waking up suddenly in the middle of the night and feeling short of breath? or is your troubled breathing not letting get any sleep at all?

What Is Shortness of Breath?

Shortness of breath, also known as dyspnea or breathlessness—is a sensation that suggests something's off with our respiratory system.

An increased effort to breathe, chest tightness, and the feeling of not getting enough oxygen are some of the ways to describe this uncomfortable sensation.

You may feel this after performing strenuous exercise, being exposed to extreme temperatures, or high altitudes. However, when this feeling persists in the evening hours when lying down (orthopnea) or during the hours of sleep (paroxysmal nocturnal dyspnea), shortness of breath can signal more serious and even life-threatening illnesses that require medical attention.

Most of the conditions that trigger chronic shortness of breath are related to your lungs, heart, or mental health, like asthma, high blood pressure, heart disease, lung disease, irregular lung conditions or heart rate, chronic obstructive pulmonary disease (COPD), or obstructive sleep apnea, or even anxiety and panic attacks.

Since there are many variables that cause shortness of breath and it's important to identify the underlying cause, let's review the most common causes and related health conditions and explore why you're not getting enough air at night. 

So, why do you have shortness of breath at night?

These are some of the most common conditions that can help you identify the cause of your nighttime shortness of breath and find ways to treat it.

Sleep apnea

Obstructive sleep apnea is one of the most common reasons people experience shortness of breath while lying down. Obstructive sleep apnea (OSA) causes shallow breaths or pauses in breathing while asleep. The muscles in your throat relax and obstruct your airways, especially when lying on your back, leading to difficulty breathing. 

The symptoms of sleep apnea include:

• difficulty sleeping
• feeling fatigued during the day
• snoring 
• waking up with a dry mouth

Sleep apnea can be treated using continuous positive airway pressure (CPAP), a therapy treatment that helps keep airways open using a CPAP mask and CPAP machines with mild air and alleviate breathing problems during sleep.

Lifestyle factors are also important to consider to improve your sleep apnea condition, such as weight loss, quitting smoking, and exercise. 

Asthma

This is a respiratory condition marked by inflammation of the lungs, causing difficulty in breathing. It usually results from an allergic reaction or other forms of hypersensitivity. The chances of experiencing asthma symptoms such as wheezing, coughing, and trouble breathing are higher during sleep because:

• You might receive exposure to allergens
• Your sleeping position puts pressure on your diaphragm
• Your hormone secretions fluctuate at night

Asthma can usually be managed with rescue inhalers to treat symptoms and controller inhalers that prevent symptoms. Severe cases may require longer-acting inhalers that keep the airways open, as well as oral steroids and by losing weight.

Chronic obstructive pulmonary disease (COPD)

COPD causes blocked or narrowed airways that make breathing more difficult. You may also experience symptoms like wheezing, coughing, mucus production, and tightness in the chest. 

Pneumonia

An infection developed by a virus, bacteria, or fungi causing inflammation in the air sacs in your lungs and making it difficult to breathe.

Pulmonary embolism

A pulmonary embolism occurs from a blockage in one of the pulmonary arteries in your lungs caused by blood clots and may lead to chest pain, coughing, and swelling. 

Heart Disease

Heart failure, the inability to pump blood at a sustainable level, is a condition that can lead to high blood pressure (hypertension), a heart attack, fast palpitations, congestive heart failure, or other forms of heart-related disease. These are typically associated with symptoms of shortness of breath such as chest pain and tightness, sweating, nausea, and fatigue.

Risk factors include a poor diet, diabetes, certain medications, smoking, and obesity.

Allergies

Allergies sufferers know how their symptoms can worsen at night and lead to shortness of breath, mainly if the sleeping environment contains a buildup of allergens like dust, mold, and pet dander that trigger allergy symptoms.

What Should You Do Now?

If you have difficulty breathing when lying down, you should call your doctor. Please note that this article is only about common symptoms and although it explains some medical terms it is not meant to substitute the advice from your health care provider. 

By visiting your primary health care provider and performing a physical exam, you can get more detailed information about your health.

If you have breathing difficulty that seriously interferes with your quality of life, please seek medical advice or if it's a medical emergency, please visit your doctor or call 911.

Our bodies are smart and let us know when something is wrong. If you're experiencing any of the above-mentioned warning signs, please consult with your health care provider to identify your medical condition and evaluate your treatment options.