Home Heart Failure Symptoms The Causes, Treatment, and Symptoms of Orthopnea

The Causes, Treatment, and Symptoms of Orthopnea

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Orthopnea is a health condition that causes breathing difficulties when lying down. It’s mostly occurs at night, just a few minutes after going to sleep. People suffering from this usually experience shortness of breath and some unusual tightness in the chest. Oxygen deficiency in patients suffering from that is basically induced by the lying positions. Orthopnea itself is not a serious condition, but a pointer towards a more serious medical condition like heart failure. It is therefore very important that you seek for medical consultation if you experience frequent this condition.

What is Orthopnea?

It can be defined as the difficulty to breath or shortness of breath when lying down. The term orthopnea originates from the Greek words “ortho” which means vertical or straight and “pnea” meaning to breathe.

If you have orthopnea, you will have problems breathing when lying down. However, the difficulty in breathing goes away when you stand up or sit down. Experts say that, in fact, a symptom of a pending heart failure. When you lie down, lots of blood flow to your lungs, and when your heart is not in a position to push that blood to the rest of the body as required, its referred to as heart failure. It is this pressure buildup in the lungs that leads to breath shortness.

People often confuse orthopnea and dyspnea; the two are different. Dyspnea is difficulty in breathing experienced when one is involved in non-strenuous activities. those having dyspnea experience shortness in a breath without necessarily lying down, it happens whether standing or sitting or lying down.
Other variations on this symptom include:
a) Platypnea disorder leads to shortness of breath when standing.
b) Trepopnea disorder leads to shortness of breath when lying on your side.


Orthopnea itself is a symptom. You feel unable to breathe properly when lying down, but when you stand up or sit upright, your breath comes back to normal or improves. The doctor can know the severity of your orthopnea by asking for the number of pillows you use at night. For instance, your condition is severe if you use three or more pillows.


Orthopnea is known to be caused by an increase in the lungs blood vessels pressure. When lying down, the blood flows from the legs, to heart and to lungs. For the healthy people, when blood flows in this manner, there is no side effect, but it becomes a problem for those with heart failure or heart disease. The heart may not have enough strength to pump blood normally to the lungs and other parts of the body if you have these heart problems. Heart failure and related problems may lead to high pressure in the lung capillaries and veins, causing leakage of fluids in the lung. It is the extra fluids in the lungs that causes difficulty in breathing when you lie in different positions. There are cases where people suffering from pulmonary disease experience orthopnea. One becomes even more vulnerable if the lungs produce more mucus since the lungs do not effectively mucus when you lie down.

COPD is another cause of orthopnea. Chronic obstructive pulmonary disease (COPD) is a mix of lung illnesses that includes chronic bronchitis and emphysema. COPD also causes shortness of breath, chest tightness, and coughing. COPD orthopnea begins immediately you lie down, unlike the heart failure orthopnea.

Other possible causes include:
– Too many fluids in the lungs
– Obesity
– Severe pneumonia
– Diaphragm paralysis
– The buildup of fluids around the lungs
– The buildup of fluids in the abdomen

Orthopnea Treatment

It’s advisable that you prop up about one or two pillows while sleeping to relieve oneself from shortness of breath. Using pillows at night helps your breath with ease. You may also use oxygen as a supplementary either at home or in the hospital. The doctor has to diagnose your orthopnea to understand the cause and then diagnose a specific treatment. The recommended treatments for heart failure include medication, devices and surgery.

Here is the main medication for relieving orthopnea caused by heart failure:
– Diuretics are a medication that stops the buildup of fluids from building up in your body. Furosemide drugs prevent the buildup of fluids in your lungs.
– Angiotensin-converting enzyme (ACE) inhibitors drugs are suitable for those diagnosed with left-sided heart failures. These drugs enhance blood flow and prevent it from working too hard. ACE drugs include captopril, Lisinopril and enalapril.
– Beta-blockers are also recommended for people with heart failure.

If you suffer from COPD, then the doctor will recommend drugs that minimize lungs inflammation and relaxes the airways:
– Bronchodilators
– Inhaled steroids
– A mix of bronchodilators and inhaled steroids

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