All About Orthopnea – How It Affects Sleep

All About Orthopnea - How It Affects Sleep

Orthopnea is a condition that causes shortness of breath while sleeping. This condition is usually caused by a narrowing or collapse of the airways. The result is that you have to breathe harder in order to get enough oxygen, which in turn causes you to wake up feeling tired and out of breath. This is a very common condition that affects people of all ages, but most commonly occurs in older adults. It is important to understand that it is not the same as sleep apnea, and there are other conditions that can cause similar symptoms. So, here’s the article explaining all about orthopnea.

What is Orthopnea?

The term orthopnea is used to describe a condition in which you have trouble breathing while lying down. Depending on the underlying cause, It can happen over time or spontaneously. People may say that they need to use multiple pillows to sleep. A more severe form of orthopnea may be associated with an increased number of pillows required to sleep. The severity of three-pillow orthopnea may be more severe than two-pillow orthopnea.

It’s different from other breathing conditions:

  • Dyspnea is a feeling of difficulty breathing regardless of position.


  • Difficulty breathing when standing is described as platypnea.


  • Difficult breathing when lying on the side is described as trepopnea.

Symptoms of Orthopnea

Dyspnea usually occurs within a minute or two of lying down when a person is experiencing orthopnea. If the person sits up or raises his or her head, the shortness of breath usually resolves quickly. There is little doubt that this symptom is related to a change in position for a person with this symptom.

While lying down may bring about shortness of breath and dyspnea, it can also cause more serious respiratory symptoms like coughing or wheezing. People with orthopnea tend to end up propped up in order to sleep. Sometimes an extra pillow or two is all it takes to get rid of the symptom, and other people may have to sleep in a chair.

When assessing the severity of orthopnea, healthcare providers ask their patient how many pillows he/she needs to fall asleep. The answer can be recorded in the patient’s medical record as “two-pillow orthopnea” or “three-pillow orthopnea.” Healthcare providers track this data because an increasing number of patients develop worsening orthopnea. This is a sign that an underlying cause of heart failure may also be worsening.

Causes Of Orthopnea

The increased pressure in the blood vessels of your lungs causes orthopnea. Blood flows from your legs to your lungs when you are lying down. This redistribution of blood does not cause problems in healthy people.

Heart disease or heart failure can weaken your heart so it isn’t strong enough to pump the extra blood back out of the heart. Increased pressure in the veins and capillaries inside your lungs can cause fluid to leak into the lungs. The extra fluid in your lungs is what makes it hard to breathe.

Pulmonary disease often causes shortness of breath and coughing up of excess mucus, and can worsen over time. It can be hard for your lungs to clear mucus when you are lying down.

There are other possible causes for orthopnea:

  • obesity
  • fluid buildup in the abdomen (ascites)
  • diaphragm paralysis
  • severe pneumonia
  • excess fluid in the lungs (pulmonary edema)
  • fluid buildup around the lung (pleural effusion)

Diagnosis Of Orthopnea

You should expect to have a lot of questions asked about your breathing, which may include the following:

  • Are you coughing or wheezing when you lie down?
  • Does it get better when you are upright?
  • Do you think your symptoms are getting worse with time?
  • What number of pillows do you need to sleep with?

If you need more pillows, the problem will get worse. When you have symptoms, the more upright you are, the less fluid you have in your lungs.

 Your doctor will perform a number of tests on you to find out why you have fluid in your lungs. The first ones they’ll do can include:

  •  X-rays. To see if you have fluid in your lungs.
  • Blood tests. It’s good to get your doctor to test your blood for how much oxygen and carbon dioxide it has. They may even test your blood pressure and heart rate. This substance points to whether a heart condition is causing extra fluids.  
  • Echocardiogram. The doctor will use a handheld wand to take pictures of the beat of your heart and the flow of blood through the valves.

It’s possible that you may have orthopnea that’s related to a heart-related condition. Then doctors will diagnose the problem and try to treat it.

Treatment Of Orthopnea

If you are having trouble breathing, prop yourself up against one or more pillows. This will make it easier for you to breathe. It is possible that you need supplemental oxygen at home or in a hospital. After your doctor diagnoses the cause of your orthopnea, you will get treated. Medicine, surgery, and devices are used by doctors to treat heart failure.


Orthopnea is a condition where you feel like you’re not getting enough air while sleeping.

Orthopnea can be dangerous because it can lead to other health problems. For example, if you have orthopnea, you may not be able to get enough air while sleeping. This could lead to sleep apnea.

Orthopnea can be caused by several things, including obesity, smoking, and heart disease.

There are ways to prevent orthopnea. For example, you can lose weight and quit smoking.

 If you’re having trouble sleeping, try using a pillow that’s too soft. You can also try sleeping on your side instead of your back.

If you have orthopnea, you can try using a neck pillow. Also, you can use a machine that blows air into your nose or mouth.


It is a condition that causes shortness of breath while sleeping. It is the result of a decreased ability to breathe through the upper airways, which causes the lungs to collapse. The most common cause of orthopnea is obesity. It is also caused by other medical conditions such as sleep apnea. Patients with orthopnea are at risk of developing long-term consequences like heart failure, high blood pressure, and other cardiovascular diseases. Hence it is important to get this diagnosed by a physician. 

If you want to know more about different sleep-related disorders check out here.

If you are looking to buy a mattress check out here, also here.

To see the comparison of different types of mattresses click here.