January 25, 2021

Why Do I Have Shortness of Breath at Night?

Why Do I Have Shortness of Breath at Night?

We can all agree that waking up with shortness of breath and gasping for air in the middle of the night can be both uncomfortable and frightening.

Shortness of breath feels like you've just run an all-out sprint, and you're struggling to get enough air in, making it challenging to inhale and exhale. 

Common symptoms that you may experience with shortness of breath include:

  • chest pain or a tight sensation
  • the need to breathe more or more quickly
  • feeling unable to get enough oxygen quickly enough

If you are concerned about your shortness of breath, you should consult your doctor as it may sign a more serious and life-threatening condition.

Let's dive deeper into what shortness of breath is, the common causes, and what you can do about it.

You've got questions; we've got answers:

  • What are the different types of breathlessness?
  • What causes shortness of breath at night?
  • What treatments are available to alleviate shortness of breath at night?
  • What lifestyle changes should I make to relieve shortness of breath?

What are the different types of breathlessness?

The different types of breathlessness include:

  • Dyspnea
  • Orthopnea
  • Paroxysmal nocturnal dyspnea

Let's look at the difference between these types of breathing difficulties: 

Dyspnea is the medical term for the sensation of difficult or uncomfortable breathing and can generally occur after exertion, for example, intense running. However, if it happens at a level of usually well-tolerated activity, it's typically indicative of disease, such as heart failure. Dyspnea feels like you're short of breath or you have trouble catching your breath, no matter what activity you're doing or what position you're in.

Shortness of breath when you lie down is called orthopnea, and it's relieved by sitting or standing. Sleep apnea is one of the most common reasons people have shortness of breath while lying down.

When the symptom occurs after a few hours of sleep, it is called paroxysmal nocturnal dyspnea, and can awaken you and is usually relieved in the upright position. 

These types of breathlessness create breathing difficulty that may prevent you from sleeping properly, impairing your overall health, which is why it's important never to overlook this sign and seek medical attention if deemed necessary. 

What causes shortness of breath at night?

man in bed not able to sleep due to shortness of breath

Shortness of breath at night can occur if your body can't adequately pump oxygen into your blood, causing your lungs a hard time processing the intake of oxygen, or your heart may not pump blood effectively.

There are many common causes and health conditions behind experiencing difficulty breathing and shortness of breath. From post-nasal drip, high altitudes, and strenuous exercise to anxiety, snoring, respiratory infections, heart disease, obesity, lung disease, sleep apnea, or even Covid-19 are valid reasons behind having trouble breathing. 

Some causes may require medical attention and a long-term treatment plan; it's always best to get medical advice from a healthcare professional. 

Anxiety: Many people experience anxiety at some point in their lives; in fact, it's a normal response to stressful life events. However, an anxiety disorder can be debilitating and is typically associated with panic attacks that include rapid heartbeat, sweating, shaking, chest tightness, nausea, fear of dying or losing control, and yes, you guessed it: shortness of breath.

Sleep apnea: One of the most common reasons people have shortness of breath while lying down is sleep apnea. People with obstructive sleep apnea (OSA) experience brief pauses in breathing while sleeping due to obstruction of the airways. They are more prone to encounter trouble breathing or awaken with shortness of breath or have difficulty getting to sleep or staying asleep. Luckily, there are treatment plans to alleviate this feeling. Simple nasal decongestants may be enough to resolve sleep apnea, though some people's symptoms might respond better to continuous positive airway therapy (CPAP) using a CPAP machine.

Lying down too soon after eating:  regurgitating food up to your esophagus can cause difficulty breathing. Preventing eating meals so close to bedtime or sitting up for a few hours before lying down can help avoid this sensation. An upright position may also alleviate the stress on the stomach from pressing down on your diaphragm, which separates the stomach from the lungs. Wearing tight clothing may cause the same feeling.

Heart failure: All types of heart failure can cause shortness of breath. This may be an ongoing condition or may start suddenly and give the feeling of palpitations, suffocating, smothering, and hungering for air. See your healthcare provider if you think you might be experiencing signs or symptoms of heart failure.

Lung Conditions: Different lung conditions can cause shortness of breath, such as asthma, pulmonary embolism, chronic obstructive pulmonary disease (COPD), pneumonia, lung cancer, stroke, muscular dystrophy, and others. 

COVID: The Coronavirus (COVID-19) is an infectious disease that affects different people in different ways. In some individuals, COVID-19 causes more severe symptoms like high fever, severe cough, and shortness of breath, which are also warning-signs of contagion.

Allergies: Allergies usually escalate at night and lead to shortness of breath. Maintaining a clean sleeping environment using an air purifier can help you stay free of allergens like dust, mold, and pet dander that trigger your allergy symptoms.

Pregnancy: Feeling breathless while pregnant is completely normal. During pregnancy, especially the last trimester, the growing uterus presses down against the organs, particularly the diaphragm and lungs, decreasing lung capacity. Also, the body releases a hormone called progesterone, triggering the brain to take faster breaths. As pregnancy continues, the body needs to secure more blood flow to accommodate the growing fetus.

What treatments are available to alleviate shortness of breath at night?

Shortness of breath treatment depends on the underlying cause, current medical condition, risk factors, and duration of symptoms. Treatment options should be discussed with your doctor to develop a plan of care. 

However, if your shortness of breath is not severe and isn't caused by a medical emergency, you can try home treatments to mitigate your condition, including:

  • breathing techniques, such as deep breaths, pursed-lip or diaphragmatic breathing 
  • prevent eating closer to bedtime
  • sitting forward or in the upright position
  • sleeping with your head elevated by pillows
  • Lying on your side with a pillow between your legs
  • Using a fan with cool air blowing toward your face 

If suffering from obstructive sleep apnea, your doctor might recommend using a CPAP or BiPAP (Bilevel Positive Airway Pressure) machine to relieve shortness of breath while sleeping.

What lifestyle changes should I make to relieve shortness of breath?

Lifestyle changes you can make to prevent shortness of breath and improve your quality of life include:

  • quit smoking 
  • avoiding exposure to pollutants, allergens, and environmental toxins
  • weight loss
  • avoiding exertion at high elevations
  • eating a healthy balanced diet
  • getting enough sleep
  • following the recommended treatment plan for any underlying illness such as an inhaler for asthma or CPAP therapy for sleep apnea.

If you’re concerned about your shortness of breath contact your primary care provider.

Written by Karina Lima

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