You may find yourself short of breath at night for several reasons. The primary causes are conditions affecting the lungs or the heart. It can also happen from asthma, allergies, or anxiety.

Shortness of breath, also called dyspnea, can be a symptom of many conditions. In some cases, shortness of breath can also happen at night. To treat it, you need to understand the cause.

Sudden and severe shortness of breath at night can mean a serious condition. Seek prompt care if you:

  • can’t catch your breath when lying flat
  • experience worsening or prolonged shortness of breath that doesn’t go away or gets worse

You should also seek immediate medical attention if your shortness of breath occurs with:

  • blue lips or fingers
  • swelling near your feet
  • flu-like symptoms
  • wheezing
  • a high-pitched sound when breathing

Shortness of breath can occur if your body can’t adequately pump oxygen into your blood. Your lungs may be unable to process the intake of oxygen, or your heart may not be able to pump blood effectively.

Chronic shortness of breath occurs when you experience the symptom for more than a month. About 85% of conditions triggering chronic shortness of breath are related to your lungs, heart, or mental health.

Shortness of breath when you lie down is called orthopnea. When it occurs after a few hours of sleep, it is called paroxysmal nocturnal dyspnea.

Read on to learn about common causes of nighttime shortness of breath.

Different lung conditions can cause shortness of breath. Some are chronic or life threatening, while others can be treated.


Asthma occurs because of inflammation in your lungs. This leads to breathing difficulties. You may experience nighttime shortness of breath related to your asthma because:

  • your sleeping position puts pressure on your diaphragm
  • mucus builds up in your throat, causing you to cough and have difficulty breathing
  • your hormones change at night
  • your sleeping environment triggers your asthma

Asthma can also be triggered by conditions like gastroesophageal reflux disease (GERD).

Allergies can cause allergic rhinitis, which can cause postnasal drip. This can irritate your throat and cause congestion, leading to coughing and difficulty getting a full breath.

Asthma is also closely related to allergies. Exposure to allergic triggers in your sleeping environment — like dust, mold, and pet dander — may also trigger your allergy symptoms, which may, in turn, exacerbate asthma symptoms.

Open windows may cause allergens like pollen to enter your room as well.

Pulmonary embolism

A pulmonary embolism occurs if a blood clot forms in your lungs. You may also experience chest pain, coughing, and swelling. You may develop this condition if you have been confined to bed for a period of time. This can restrict your blood flow.

If you think you have a pulmonary embolism, seek emergency medical care.

Chronic obstructive pulmonary disease (COPD)

COPD causes blocked or narrowed airways that make breathing more difficult.

You may also have symptoms like wheezing, coughing, mucus production, and tightness in the chest. Smoking or exposure to harmful chemicals can cause COPD.


Pneumonia can develop because of a virus, bacteria, or fungi. The condition inflames your lungs. You may also experience flu-like symptoms, chest pain, coughing, and tiredness.

You should seek medical treatment for pneumonia if you have a high fever, shortness of breath, and coughing.

Conditions that affect your heart can interfere with its ability to pump blood. This may lead to shortness of breath when you lie down or after sleeping for a few hours.

Heart failure and related conditions

Shortness of breath is the most commonly reported symptom of congestive heart failure.

It happens because your heart can’t pump blood at a sustainable level. You may develop heart failure for many reasons. Risk factors include an unhealthy diet, diabetes, certain medications, smoking, and obesity.

A condition that can lead to a heart attack is coronary artery disease. You may experience shortness of breath from a heart attack, chest pain and tightness, sweating, nausea, and fatigue. You should seek medical care immediately if you suspect you’re having a heart attack.

Other conditions associated with heart failure include high blood pressure, trauma to the heart, inflammation, or irregular heart rate.

Sleep apnea is a condition that occurs during sleep and causes narrowing airways and a low oxygen level. You awaken throughout the night to take deeper breaths, preventing you from getting adequate sleep.

You may feel like you’re gasping for air during the night or wake up in the morning feeling tired. You may also have headaches or feel irritable.

Anxiety or stress can correlate with nighttime shortness of breath.

Feeling anxious can trigger a fight-or-flight response in your body and cause a panic attack. You may struggle to take breaths, feel faint, and become nauseous during a panic attack.

Learn more about how anxiety can cause shortness of breath.

Several other conditions may cause nighttime shortness of breath. These include:

Your doctor will perform a physical exam and ask you about your health and family history when determining the cause of your shortness of breath. Often, your doctor will be able to diagnose the condition just based on this initial exam. Doctors can diagnose 66% of cases of shortness of breath just on clinical presentation.

You may need to undergo more testing to diagnose the cause. Your doctor may order the following tests:

  • pulse oximetry
  • chest radiography
  • electrocardiography
  • spirometry
  • stress testing
  • sleep study

Treatment for shortness of breath at night will vary depending on the condition causing it. Here are common causes and treatments:

  • asthma: Adhere to a treatment plan, avoid triggers, and sleep propped up by pillows to keep the airways more open.
  • COPD: Quit smoking and avoid exposure to other harmful chemicals. Treatment plans may include an inhaler, other medications, and oxygen therapy.
  • pneumonia: Treat with antibiotics, cough medicines, pain relievers, fever reducers, and rest.
  • heart failure: Follow your doctor’s treatment plan, which can vary based on your condition. Your doctor may recommend certain medications, lifestyle adjustments, devices, and other equipment to keep your heart working properly.
  • sleep apnea: Modifying your lifestyle by losing weight and quitting smoking may help. You may need an assistive device when sleeping to ensure your airways stay open.
  • allergies: Keep your bedroom free of allergens and clean regularly. Carpeting, window treatments, bedding, and ceiling fans can collect dust and trigger allergy symptoms. You may want to try hypoallergenic bedding or an air purifier in your bedroom.
  • anxiety and panic attacks: Breathing exercises, avoiding triggers, and talking to a mental health professional may help you relieve feelings of anxiety and avoid panic attacks.

Experiencing shortness of breath at night can occur for several reasons. You should talk to your doctor about the symptom to diagnose the underlying cause.

Get quick emergency medical treatment if you suspect the shortness of breath signals a life threatening condition.