Shortness of Breath During Sleep: Causes and Solutions

The symptom of sudden breathlessness during sleep often catches many people off guard, leaving them bewildered about its cause. In reality, this phenomenon can be caused by various underlying medical conditions, some of which are potentially dangerous and require prompt treatment. The following article will delve into this condition in detail.

Causes of Breathlessness and Shortness of Breath During Sleep

Breathing is the coordinated effort of organs within the respiratory system, including the lungs, mouth, and nose. Air is drawn in through the mouth and nose before reaching the lungs. From there, it proceeds to the alveoli. When you have to exert more effort than usual to breathe during sleep, it is considered a phenomenon of difficulty breathing or breathlessness. This can occur due to a decrease in oxygen levels in the blood, insufficient airflow during sleep, or issues within your respiratory tract caused by an underlying medical condition.

Shortness of breath during sleep indicates an issue with your airway.

Shortness of breath during sleep indicates an issue with your airway.

The causes of breathlessness and shortness of breath during sleep can include:

  • Heart failure: Patients with heart failure not only experience difficulty breathing during sleep but also exhibit symptoms such as swollen ankles, reduced exercise tolerance, etc.
  • Fatigue and stress: Prolonged periods of fatigue and stress can suddenly lead to breathlessness during sleep. Some individuals may even have nightmares, experience sleep paralysis, or feel short of breath.
  • Sleep apnea: Sleep apnea is a common factor leading to breathlessness in many people. This condition occurs when a person’s airway becomes abruptly obstructed during sleep.
  • Asthma: During asthma attacks, increased mucus production in the respiratory tract reduces oxygen flow to the brain, causing breathlessness, wheezing, chest pain, and more.
  • Pulmonary edema: Pulmonary edema results in the accumulation of excess fluid in the air sacs, causing compression and breathlessness when lying down. Those affected often feel breathless during sleep.
  • Sinusitis and allergic rhinitis: Patients with these conditions may experience symptoms like a runny nose and nighttime breathing difficulties. This is due to mucus dripping down the throat when lying on the back, obstructing the airway and limiting oxygen supply to the lungs and nervous system.
  • Chronic obstructive pulmonary disease (COPD): COPD is a lung disease that limits airflow and causes persistent breathlessness. Breathlessness can occur at any time, accompanied by symptoms such as coughing, phlegm production, and more.
  • Pneumonia: Pneumonia caused by viruses or bacteria can lead to inflammation in the respiratory tract, swelling the airways and causing breathlessness and fatigue. Other symptoms include fever, headache, cough, chills, loss of appetite, nausea, and more.
  • Pulmonary embolism: Pulmonary embolism occurs when a blood clot from another part of the body travels to the lungs. This condition can cause sudden breathlessness, chest pain, and coughing up blood. It can be life-threatening and requires immediate treatment.
  • Carbon monoxide poisoning (CO gas): Carbon monoxide (CO) is a colorless, odorless, tasteless gas that can accumulate in confined spaces and enter the body through inhalation. Inhaling CO displaces oxygen in red blood cells, causing damage to the brain and, in severe cases, death.
There are numerous factors that can cause individuals to experience shortness of breath during sleep.

There are numerous factors that can cause individuals to experience shortness of breath during sleep.

Is it dangerous to experience breathlessness while sleeping? When should you see a doctor?

According to specialists, experiencing breathlessness while sleeping can be associated with conditions such as heart disease, blood clots in the lungs, and issues with the main arteries. Along with these, there are various other dangerous complications such as brain damage, brain necrosis, stroke, and more. What’s crucial is to investigate the underlying cause of sleep-related breathlessness. Failure to identify the cause and receive proper treatment can have life-threatening consequences.

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Specifically, patients should seek medical attention if they experience the following symptoms:

  • Frequent episodes of breathlessness during sleep affecting their health and quality of life.
  • Persistent cough with prolonged phlegm production.
  • Shortness of breath that persists even after 30 minutes of rest.
  • Swelling in the feet and ankles.
  • Worsening nocturnal breathlessness.
  • Elevated body temperature and feeling chills.
  • Wheezing or whistling sounds while breathing in and out.
  • Audible breathing sounds.
  • Bluish fingertips or lips.
  • Fever and chills.
  • Chest pain or pressure.
  • Nausea.
  • Fainting.
  • Inability to perform activities due to breathing difficulties.
Patients should consult a doctor for timely examination and treatment.

Patients should consult a doctor for timely examination and treatment.

Treatment Options for Sleep-Related Breathlessness

Below are some treatment options for individuals experiencing sleep-related breathlessness:

Timing of Medical Consultation

Not all cases of breathlessness during sleep are necessarily dangerous. However, this phenomenon is often caused by underlying medical conditions. Therefore, it is advisable to consult a doctor for timely examination and treatment if the condition persists without showing signs of improvement.

Treatment Approaches

The treatment of sleep-related breathlessness should be tailored to the underlying cause, such as:

Psychological Causes: For breathlessness due to psychological factors, patients can make lifestyle adjustments, including dietary changes, improved rest, and moderate exercise.

Respiratory Issues:

  • Reduce inflammation and open airways using bronchodilator medications.
  • Pay attention to nutrition and engage in exercises to restore lung function.
  • Utilize oxygen therapy when necessary.

Respiratory Tract Disorders:

  • Use antibiotics to prevent infections.
  • Clear nasal passages with saline nasal irrigation to improve airflow, combined with anti-inflammatory medications to reduce swelling.

Heart Failure or Lung Cancer:

  • Manage the condition with medication and supportive measures to ease the workload on the heart and improve oxygen transport.
  • Eliminate tumors through immune therapy, chemotherapy, radiation therapy, or surgery.
Individuals with heart failure or lung cancer should be treated according to their doctor's protocol.

Individuals with heart failure or lung cancer should be treated according to their doctor’s protocol.

Home Care

In addition to following the doctor’s prescribed treatment plan, individuals experiencing sleep-related breathlessness can also apply certain measures to improve their condition, as follows:

Balanced Diet

Frequent episodes of breathlessness and sleep-related issues can lead to fatigue, loss of appetite, and overall weakness. Therefore, establishing a well-balanced and nutritious diet is crucial. To achieve this, it’s essential to ensure an adequate intake of vitamins and minerals, especially plant-based fats to provide energy to the body, helping to reduce elevated CO2 levels in the blood and minimize free radicals. Additionally, it’s advisable to limit the consumption of stimulants, as they can exacerbate sleep difficulties.

Engaging in regular daily physical exercise helps improve respiratory issues.

Engaging in regular daily physical exercise helps improve respiratory issues.

Regular Physical Exercise

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Engaging in daily, moderate-intensity physical exercises can help improve respiratory function, particularly breathlessness, and promote deeper sleep. When walking, patients should focus on proper breathing techniques and avoid sudden stops, instead opting for gradual pauses. This practice can also help reduce instances of breathlessness when climbing stairs.

Stress Management

Stress and fatigue are primary factors contributing to breathlessness and sleep-related difficulties, hindering the attainment of restful and deep sleep. Therefore, it’s essential to strive for mental comfort and relaxation to improve sleep quality.

Comfortable Sleeping Positions

Breathlessness during sleep can lead to frequent awakenings, resulting in overall fatigue. Therefore, finding a comfortable sleeping position is crucial, especially for cases attributed to anxiety or excessive exertion.

The following positions are considered effective in relieving pressure on the airways:

  • Leaning forward on a chair or resting your head on a table.
  • When standing, placing both hands on a table to reduce leg pressure.
  • Leaning against a wall with an upright posture.
  • Sleeping on your side with a pillow positioned between your legs, maintaining a straight back, and using multiple pillows to elevate your head.
  • Lying on your back with a straight back, elevating your knees with a pillow, and placing an additional pillow between your knees.

Breathlessness during sleep varies in severity and root causes among individuals. Therefore, self-diagnosis and home treatment are not recommended. Instead, it’s advisable to consult a specialist to undergo a thorough examination and identify the underlying factors contributing to this condition.

Types of Medications to Assist in Treating Shortness of Breath During Sleep

Shortness of breath during sleep can be a distressing and potentially serious condition that may require medical intervention. Various medications can be used to help manage and alleviate this symptom, depending on the underlying cause. Here are three types of medications commonly employed to support the treatment of shortness of breath during sleep:


  • Description: Bronchodilators are medications that help relax and widen the airways in the lungs, making it easier to breathe. They are commonly used to treat conditions like asthma and chronic obstructive pulmonary disease (COPD) that can lead to breathlessness during sleep.
  • How They Work: Bronchodilators work by relaxing the smooth muscles in the airways, reducing airway resistance, and allowing for improved airflow.
  • Types: There are short-acting and long-acting bronchodilators available, and they can be administered through inhalers, nebulizers, or oral tablets.
  • Common Examples: Albuterol (short-acting), Salmeterol (long-acting).


  • Description: Diuretics, also known as water pills, are medications used to reduce excess fluid buildup in the body, particularly in conditions like congestive heart failure, which can lead to fluid accumulation in the lungs and cause breathlessness during sleep.
  • How They Work: Diuretics increase urine production, helping to eliminate excess fluid and reduce the volume of blood that the heart must pump, which can ease the strain on the heart and improve breathing.
  • Types: Diuretics are available in various forms, including loop diuretics, thiazide diuretics, and potassium-sparing diuretics.
  • Common Examples: Furosemide (loop diuretic), Hydrochlorothiazide (thiazide diuretic).
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Continuous Positive Airway Pressure (CPAP) Therapy:

  • Description: CPAP therapy is a non-pharmacological approach used to treat sleep apnea, a condition characterized by repeated interruptions in breathing during sleep, leading to brief awakenings and shortness of breath.
  • How It Works: CPAP therapy involves the use of a machine that delivers a constant stream of air through a mask to keep the airway open. This continuous airflow prevents airway collapse and promotes uninterrupted breathing during sleep.
  • Types: Various CPAP devices and masks are available to suit individual preferences and needs.
  • Effectiveness: CPAP therapy is highly effective in treating sleep apnea-related shortness of breath, and its use can significantly improve sleep quality and reduce daytime fatigue.

It’s essential to note that the choice of medication or treatment approach should be based on a thorough evaluation by a healthcare provider, as the underlying cause of shortness of breath during sleep can vary from person to person. Additionally, lifestyle modifications and addressing any contributing factors, such as obesity or smoking, may also be crucial components of treatment.

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