Orthopnea is shortness of breath or difficulty breathing when you’re lying down. If you have this symptom, your breathing will be labored when you lie down. It should improve once you sit up or stand. In most cases, orthopnea is a sign of heart failure. It is slightly different from dyspnea, which is difficulty breathing during non-strenuous activities. If you have dyspnea, you feel like you’re short of breath or you have trouble catching your breath, no matter what activity you’re doing or what position you’re in.
What causes orthopnea?
Orthopnea is caused by the accumulation of too much fluid in the lungs when a person lies down. In a prone position, blood volume from the feet and legs redistributes to the lungs, which doesn't cause a problem for people whose hearts are pumping normally. However, in people with heart failure, excess blood in the lungs can cause breathing problems or shortness of breath.
Apart from the tightness in the chest, the extra effort needed to breathe, and the discomfort one feels due to the lack of oxygen when lying down, there are a few other indicators that a person must look out for:
- Swollen feet or ankles.
- Intermittent chest pain
- Coughing more often
Another condition associated with orthopnea is known as Paroxysmal Nocturnal Dyspnea. This condition is recognized by a person feeling such a severe shortness of breath that they get woken up from sleep very suddenly. When this person sits or stands up, the discomfort quickly dissipates.
To relieve shortness of breath, prop yourself up against one or more pillows because this should help you breathe more easily. You may also need supplemental oxygen, either at home or in a hospital. Once your doctor diagnoses the cause of your orthopnea, you’ll get treated. Medications that relieve orthopnea in people with heart failure include:
Diuretics. These medications prevent fluid from building up in your body - drugs like furosemide (Lasix) stop fluid from building up in your lungs.
Angiotensin-converting enzyme (ACE) inhibitors. These drugs are recommended for people with left-sided heart failure. They improve blood flow and prevent the heart from having to work as hard.
Beta-blockers are also recommended for people with heart failure. Depending upon how severe your heart failure is, there are other medications that your doctor may prescribe as well.
Doctors may also prescribe inotropic drugs, which increase the strength of heart muscles and boost the amount of blood pumped with each contraction. They may also prescribe vasodilators, which are medicines that increase the diameter of veins, thereby increasing blood flow and preventing high blood pressure in the pulmonary veins. If medications don’t work, doctors may perform a procedure known as ultrafiltration. People with obesity in the abdominal area are more prone to Orthopnea and must be careful if they experience any of the stated symptoms. Pregnant women are also seen to suffer from Orthopnea quite often and must get checked by a physician if they think they suffer from this condition.
Orthopnea is a symptom associated with many illnesses. It could be indicative of heart failure, so if you think that you may be suffering from this affliction, it is best to get it checked by a physician to rule out any other issues.