Orthopnea

Orthopnea is dyspnea in the supine position, or shortness of breath when lying down. It is a disorder in which the person has to keep their head elevated (such as when sitting or standing) in order to breathe deeply and comfortably (orthopnea), or the person wakes up suddenly during the night experiencing difficulty breathing (paroxysmal nocturnal dyspnea).

General considerations

Orthopnea is a common symptom in people with heart or lung disease. Sometimes the problem is subtle and only becomes apparent when the person realizes that they need to sleep with several pillows under their heads or in an upright position. In heart failure, this is due to the fact that during the horizontal position the return of blood to the heart increases and the heart is not capable of pumping the excess blood, which manifests itself with excessive thirst for air, this can cause an accumulation of liquid that can go out into the lung and therefore cause the disorder and respiratory distress; Another pathology that can cause orthopnea is pericardial effusion, since the heart is in the middle of fluid that does not allow it to expand or contract well, which, due to the increase in cardiac work due to venous return, manifests as thirst for air in the heart. supine position (orthopnea).

Common causes

• Heart failure
• Chronic obstructive pulmonary disease (COPD)
• Asma
• Hypertensive heart disease
• Chagas disease
• Obesity (it is not a direct cause of respiratory difficulty while lying down, but usually aggravate other conditions)
• Sleep Apnea
• Cor pulmonale

Treatment

Your doctor may prescribe therapy to treat this breathing difficulty while you lie down. In cases of obesity, weight reduction is generally recommended. A doctor should be seen if unexplained shortness of breath occurs while lying down.