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What causes difficulty breathing when lying down? 20 possible conditions

Difficulty Breathing When Lying Down Overview

It is not uncommon to become short of breath after physical activities or during moments of extreme stress. However, if you have difficulty breathing after lying down, this may be a sign or side effect of a serious medical condition. Certain diseases, anxiety disorders, and lifestyle factors may cause breathing difficulty, and this condition is not always a medical emergency. However, any difficulty breathing when lying down should be reported to your doctor right away.

What Causes Difficulty Breathing When Lying Down?

Common causes for difficulty breathing when lying down are:

  • panic disorder
  • snoring
  • respiratory infections
  • sleep apnea
  • chronic obstructive pulmonary disease (COPD)

Sleep apnea is a condition that causes a person to have shallow or brief pauses in breathing while sleeping. This condition is usually caused by an obstruction in the airways.

Lying down too soon after eating may cause difficulty breathing. This may be due food regurgitating up your esophagus or due to the pressure of the food in your stomach pressing down on your diaphragm. Your diaphragm separates your stomach from your lungs. This uncomfortable feeling is generally relieved by sitting up for a few hours until the food digests.

People who are obese or extremely overweight may experience difficulty breathing when lying down. This is because excess weight puts pressure on the lungs and diaphragm. Wearing tight clothing may cause the same feeling.

In some cases, breathing difficulty can be a sign of a medical emergency. Severe causes for difficulty breathing when lying down include heart failure.

What to Look for

Initial symptoms may include a feeling of being breathless upon lying flat on your back. You may feel like you have difficulty taking deep breaths or breathing out. If this symptom was caused by a medical condition such as sleep apnea or COPD (a lung disease that blocks airflow), other symptoms may be present.

Symptoms of sleep apnea include:

  • difficulty staying asleep
  • feeling fatigued during the day
  • snoring while sleeping
  • waking up with headaches
  • waking up with a sore throat

Symptoms of COPD include:

  • chronic coughing
  • difficulty breathing with activity
  • wheezing
  • frequent chest infections like bronchitis

If you experience any of the following symptoms along with difficulty breathing, seek medical attention immediately:

  • pain in the chest
  • pains in the arms and neck or shoulders (often described as shooting pain)
  • fever
  • rapid breathing
  • rapid heart rate
  • weak pulse
  • dizziness upon standing or sitting

When to Seek Help

While breathing difficulty may not always be a sign of a serious medical condition, you should talk to your doctor about any breathing issues right away. To diagnose the underlying cause of your breathing difficulty, your doctor will perform a physical examination, review your symptoms, and ask you about your medical history. You should also notify your doctor if you begin having difficulty breathing after taking a prescription or over-the-counter medication. Certain drugs used to treat pain, muscle stiffness, or anxiety can cause breathing issues. (ALSA)

A physical exam will pay close attention to your heart and lungs. Additional tests may be needed, such as:

  • chest X-rays to view the heart and lungs
  • echocardiogram to better view and diagnose potential problems with heart function
  • electrocardiogram (ECG) to test the electrical activity in the heart

How Are Breathing Issues Treated?

Treatment will depend on the underlying cause of your breathing difficulty.

If you have a respiratory infection that causes breathing difficulty when lying down, your doctor may prescribe antibiotics or antiviral medications to help clear up an infection. However, in most cases minor chest infections may clear up without the use of any medications.

Difficulty breathing caused by obesity may be relieved temporarily by sleeping on your side instead of your back. Lying on your side decreases the pressure being put on your lungs by the excess weight. Talk to your doctor about successful weight loss or dieting plans to shed excess pounds and prevent future health concerns associated with obesity.

While there is no cure for COPD, breathing difficulties may be relieved after using fast-acting inhalers (such as Albuterol) or other medications used to clear up any infections of the lungs, such as bronchitis.

Difficulty breathing when lying down caused by sleep apnea may be helped with the use of assistive devices such as mouth guards or a continuous positive airway pressure (CPAP) device.

If an anxiety disorder is causing your breathing issues, various treatments can help ease symptoms. Group or one-on-one therapy may be help you cope with anxiety. Therapy is usually combined with antidepressant or antianxiety medications. These medications are available by prescription only.

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See a list of possible causes in order from the most common to the least.


Congestive Heart Failure (CHF)

Congestive heart failure (CHF) is a chronic condition that affects the chambers of your heart. CHF refers to fluid buildup around your heart.

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Heart Failure

Right-side heart failure occurs when the right ventricle can't properly pump blood to your lungs to collect oxygen. Excessive fatigue, shortness of breath and abdominal bloating are signs.

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Peripartum Cardiomyopathy

Peripartum cardiomyopathy is a rare type of heart failure that occurs during pregnancy or immediately after delivery. The damage weakens the heart muscle and causes the heart to become enlarged. As a result, the hear...

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Pulmonary Edema

This condition is considered a medical emergency. Urgent care may be required.

Pulmonary edema is a condition in which the lungs fill with fluid. When this occurs, the body struggles to get enough oxygen, often resulting in breathlessness, coughing, excessive sweating, and bluish skin or lips.

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Atrial Fibrillation and Flutter

Atrial fibrillation and atrial flutter are irregular heart rhythms that occur when the upper chambers of your heart (the atria) beat too fast.Atrial fibrillation can be sustained or can occur in bursts. It creates a...

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Ischemic Cardiomyopathy

Ischemic cardiomyopathy is a condition that occurs when the heart muscle is weakened due to insufficient blood flow to the heart's muscle. This inhibits the heart's ability to pump blood and can lead to heart failure.

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Chronic Bronchitis

People often develop acute bronchitis after a viral chest infection. Blue-colored lips ankle or foot swelling can result.

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High Blood Pressure Overview

High blood pressure (hypertension) increases your risk for heart attack, stroke, coronary heart disease, and other serious health problems. Left untreated, high blood pressure can damage blood vessels and vital organs.

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Hypertensive Heart Disease

Hypertensive heart disease refers to heart conditions caused by high blood pressure. Possible signs of acute hypertension include sweating and chills.

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Diabetic Ketoacidosis

This condition is considered a medical emergency. Urgent care may be required.

Diabetic ketoacidosis (DKA) is a serious complication that stems from diabetes. If you don't have enough insulin to help your body process sugars (glucose), your body will start burning fat to fuel itself. As a result...

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Dissection of the Aorta

This condition is considered a medical emergency. Urgent care may be required.

The aorta is a large artery that carries blood out of your heart. If you experience a dissection of the aorta, it means that blood has entered the wall of the artery, between the inner and middle layers. This can happe...

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Mitral Valve Prolapse

Your mitral valve is located on the left side of your heart, between two chambers, the atrium and the ventricle. Blood is pumped from the left atrium through the mitral valve and into the left ventricle on its way t...

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Multifocal Atrial Tachycardia and Your Heart

In multifocal atrial tachycardia (MAT), the upper heart chambers send electrical signals through too many pathways to the lower chambers, causing the heart beats much faster than normal. This can lead to rapid pulse an...

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Polycythemia Vera

Polycythemia vera is a disorder in which the body produces an excessive amount of red blood cells. This can lead to clots, which block blood from reaching the heart or brain, causing serious damage.

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The Deadly Potential of Digitalis: Digitalis Toxicity

This condition is considered a medical emergency. Urgent care may be required.

Digitalis toxicity happens when you take too much digitalis, a medication for heart conditions. This results in nausea, vomiting, chills and sweating.

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Mitral Valve Stenosis

Mitral valve stenosis, also known as mitral stenosis, is when the mitral valve opening is narrowed. This means that not enough blood can flow through it.

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Alcoholic Cardiomyopathy

Alcoholic cardiomyopathy is a form of heart disease caused by alcohol abuse. Long-term alcohol abuse weakens and thins the heart muscle. The damaged muscle cannot pump blood as it should, which deprives the bod...

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Cardiomyopathy is a progressive disease of the heart muscle. Learn about the types, symptoms, treatment, and prognosis of this disease.

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Tricuspid Regurgitation (Tricuspid Valve Insufficiency)

In order to understand tricuspid regurgitation (TR), it helps to understand a little about the anatomy of your heart. Your heart is divided into four sections, called “chambers.” The upper chambers are th...

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.