Many things can cause difficulty breathing when lying down, including diseases, anxiety disorders, and lifestyle factors. It isn’t always a medical emergency, but it’s important to make an appointment with a doctor.

Becoming short of breath after physical activities or during moments of extreme stress isn’t uncommon.

However, difficulty breathing when you are lying down, called orthopnea, may be a symptom of a serious medical condition.

Common causes of difficulty breathing when lying down are:

Congestive heart failure

In some cases, breathing difficulty can be a medical emergency.

Heart failure can be a severe cause of difficulty breathing when lying down. It occurs over time and results when the heart can no longer pump blood efficiently.

All types of heart failure can cause shortness of breath. It is usually pulmonary edema, or fluid retention in the lungs, that causes shortness of breath when lying down.

Other symptoms may include fatigue and fluid retention (edema) in the legs.

Treatment for congestive heart failure may include medications and lifestyle changes.

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) refers to a group of diseases that cause breathing problems. It includes chronic bronchitis and emphysema. According to the Centers for Disease Control and Prevention (CDC), about 16 million people in the United States have COPD.

The symptoms of COPD include:

No cure for COPD is available yet, but you can relieve breathing difficulties with fast-acting inhalers or other medications people use to clear lung infections.

Obstructive sleep apnea

Sleep apnea causes shallow or brief pauses in breathing while sleeping. The two types of sleep apnea are obstructive sleep apnea and central sleep apnea. Central sleep apnea results from your brain not sending the proper signals needed to breathe.

The most common sleep apnea occurs due to obstruction of the airways. The symptoms of sleep apnea may include:

If sleep apnea makes breathing difficult while lying down, you may find using a continuous positive airway pressure machine helpful.


Snoring can be a cause of your difficulty breathing when lying down flat. According to the American Academy of Otolaryngology, more than 25% of the population snores regularly.

Snoring occurs when your tongue, throat, and the roof of your mouth (soft palate) relax during sleep, obstructing your airway. This can happen because of your anatomy, alcohol consumption, obesity, or a cold or allergies.

Complications of snoring may include daytime sleepiness and difficulty concentrating.

It may be helpful to sleep on your side. You may also find that using a mouthguard helps with your snoring. More serious forms of snoring may require surgery.

Respiratory infections

An upper respiratory infection (URI) occurs from a contagious virus or bacteria. The most typical URI is known as the common cold. It is an infectious process whose symptoms are not associated with a history of other disorders, such as COPD.

Symptoms of a URI may include:

If you have a respiratory infection that causes breathing difficulty when you are lying down, your doctor may prescribe antibiotics or antiviral medications to help clear up the infection.

In most cases, however, minor chest infections may clear up without taking any medications.


If you have obesity or overweight, you may experience difficulty breathing when lying down. This is because having more weight may put pressure on the lungs and diaphragm.

You may experience difficulty breathing with obesity because of a hypoventilation syndrome called Pickwickian syndrome.

You can temporarily relieve difficulty breathing due to obesity by sleeping on your side instead of your back. Lying on your side can decrease the pressure on your lungs.

Talk with your doctor about sustainable weight loss and ask about diet plans. Losing weight in a safe, sustainable way can help prevent future health concerns associated with obesity.

Gastroesophageal reflux disease

Lying down too soon after eating may also cause difficulty breathing. This may be due to regurgitating food up your esophagus and is a condition known as gastroesophageal reflux disease or GERD.

It may also be the pressure of the food in your stomach pressing down on your diaphragm. Your diaphragm separates your stomach from your lungs.

Sitting up for a few hours until you digest the food can relieve this discomfort. You may be able to manage this condition with lifestyle changes.


It is a typical part of life to have occasional stress. Things such as difficulties with money, health, or family can cause stress. However, if your chronic stress interferes with daily activities, it may be anxiety.

Symptoms of anxiety or panic disorder may include:

If an anxiety disorder causes your breathing issues, various treatments can help ease symptoms. Psychotherapy may help you cope with anxiety. Mindfulness practices, such as meditation and deep breathing, may also be beneficial.

For severe anxiety, treatment usually involves therapy combined with antidepressant or anti-anxiety medications. These medications are available by prescription only.

Initial symptoms may include feeling breathless upon lying flat on your back. You may feel like you have difficulty taking deep breaths or breathing out.

Other symptoms may be present if this symptom occurs due to a medical condition, such as heart failure, sleep apnea, or COPD.

Other important symptoms

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

Breathing difficulty isn’t always due to a serious medical condition, but it’s important to talk with your doctor about any breathing issues.

Your doctor will perform a physical exam to help them diagnose the underlying cause of your breathing difficulties. They’ll ask you about your symptoms and medical history.

Tell your doctor about every over-the-counter or prescription medication you take. Certain drugs people take for treating pain, muscle stiffness, or anxiety can cause breathing issues.

Your doctor will pay close attention to your heart and lungs during the physical exam. Additional tests may be necessary, such as:

What is it called when you have difficulty breathing?

Difficulty breathing when lying down is called orthopnea.

What is the best sleeping position for breathing problems?

Lying on your side with your head somewhat elevated is the best sleeping position for breathing problems.

What is the cause of difficulty breathing when lying on the left side?

Difficulty breathing when lying on your left side could result from heart failure or a disease of one lung.

If you ever experience difficulty breathing when lying down, you may want to seriously consider speaking with your doctor about it. It may be a minor medical condition, but it could also signify a serious medical condition.