What Does Orthopnea Mean?

Reviewed on 4/1/2021
Orthopnea is different from sleep apnea.
Orthopnea is different from sleep apnea.

When you find it difficult to breathe while lying down because of the accumulation of fluids in your lungs, it is known as orthopnea. Usually, it takes time to have a sudden onset. You may wake up from sleep because of lack of oxygen.

Orthopnea is different from sleep apnea. Sleep apnea occurs when your throat muscles relax while you are sleeping and obstruct the airway passage. However, orthopnea is mostly noticed when you are awake but in a lying position.

If you have orthopnea, you may:

  • Wheeze when you lie down.
  • Have dry or frothy cough.
  • Have cough and wheezing that ameliorate when you sit or stand.
  • Have difficulty breathing while exercising or during any daily activities.
  • Feel breathless on waking up.
  • Feel more tired than usual.
  • Have swelling on the feet and ankles.
  • Gain excessive weight suddenly.

Why do you get orthopnea?

The reason behind orthopnea may be your weak heart. Heart failure is when your heart is not strong enough to pump out all the blood sent by your lungs. This may occur because of

Heart failure may cause the accumulation of fluids in the lower lung spaces that eventually seep into the air sacs. When you lie down, the fluid moves to the upper airways making you breathless.

When you lie down, the blood moves from your legs to your chest and belly. As your weak heart cannot pump out the extra blood required, your lungs absorb even more fluid than when you were standing. Some nonheart-related causes that cause the accumulation of fluids in the lungs:


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How will your doctor diagnose orthopnea?

Your doctor will evaluate you clinically. They will ask questions pertaining to coughing and wheezing while lying down, getting better by standing, worsening of symptoms over time, and the total number of pillows you require while sleeping and thus estimate the severity of your condition. If your doctor suspects any heart-related condition during clinical examination, then they will order several tests to determine the exact reason:

Higher B-type natriuretic peptide (BNP) may suggest a heart condition that is causing the accumulation of fluids in the lungs.

What are the treatment options for orthopnea?

For a short time, you can ameliorate your symptoms by standing and sitting upright or raising your upper body with pillows.

Your doctors may

  • Put intranasal tubes (tubes into your nose) through which you will be provided oxygen.
  • Prescribe some diuretics (water pills) to get rid of extra fluid in your body.

For long-term cure, you should consult a cardiologist about your heart health, the condition that might be causing your orthopnea, and treatment options.

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