Breathing difficulty, lying down

Alternative names:

difficulty breathing while lying down; orthopnea; paroxysmal nocturnal dyspnea; PND; waking at night short of breath

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?
  • Has it been developing slowly?
  • Is it slowly 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:

• ECG
• pulmonary function tests
• chest X-ray

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.