Orthopneais the sensation of breathlessness when lying down that goes away when sitting or standing up.
When you lie flat, gravity redistributes blood and fluid from your legs and abdomen to your lungs.
This fluid redistribution has little impact on healthy individuals.
SimonSkafar / Getty Images
SimonSkafar / Getty Images
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Eventually, as the heart muscle weakens, symptoms like orthopnea manifest.
Orthopnea results from blood backing up into the heart and lungs, which worsens when lying flat.
Blood backing up into the lungs is called pulmonary congestion.
When a person sits or stands up, the pulmonary congestion decreases due to gravity, and breathing improves.
Similar to heart failure, symptoms may be absent or mild in the early stage of COPD.
As the disease worsens, cardinal symptoms include cough with or without phlegm and breathlessness, especially with exertion.
Orthopnea candevelop in people with advanced COPD.
In individuals with obesity, fat accumulation within the chest and abdomen interferes with the mechanics of breathing.
Specifically, fat is deposited around the lungs and the diaphragm, restricting a person’s typical movements.
Obesity is a risk factor for lung-related conditions that can also cause orthopnea, including:
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As a result, the hallmark symptom of OSA is excessive daytime sleepiness.
Diaphragm Paralysis
Diaphragm paralysis is a rare cause of orthopnea, but when present, it can be severe.
The diaphragm is a dome-shaped muscle between the chest and abdomen whose primary function is to help you breathe.
The left and rightphrenic nervescontrol movement of the left and right side of the diaphragm, respectively.
During exhalation, decreased signaling from the phrenic nerve relaxes the diaphragm, pushing air out of the lungs.
What Is the Phrenic Nerve?
Other possible causes of diaphragmatic paralysis include:
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Pleural Effusion
Apleural effusionis an accumulation of fluid within the chest wall surrounding the lungs.
Breathlessness (dyspnea) is the hallmark symptom of pleural effusion.
Depending on the underlying cause, other possible symptoms of a pleural effusion include:
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This excess fluid and the already inflamed and fluid-filled air sacs within the lung make breathing even more challenging.
The cause behind breathing alterations in panic disorder remains unclear.
Further investigation is needed.
Orthopnea is often managed by propping one’s head and chest up in bed with multiple pillows.
Even more essential, though, is treating the underlying cause.
Speak with a healthcare provider if you are developing new-onset orthopnea or your orthopnea worsens.
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