Trouble breathing lying down before sleep

by Teri

Prior to my diagnoses of OSA I struggled to breathe lying in bed or on the lounge after some time started to have panic attacks.

This went on daily for 2 yrs prior to diagnosis of severe range of OSA.

Once I had CPAP machine I never had another panic attack. Still sometimes have trouble breathing wen I lay down without machine so always sit upright until I'm ready for sleep.

Drs have refused to accept the link, can this be caused by sleep apnea?

Il note that I had never suffered anxiety until this happened & was only mildly overweight prior to panic attacks & am now obese.

Would be forever grateful for your advice. Thanks.


Your description about breathing difficulties when lying in bed reminds me of something very familiar to me. I think I can give you some helpful information.

Breathing difficulty while lying down is an abnormal condition in which a person must keep the head elevated (such as by sitting or standing) to be able to breathe deeply or comfortably. The name of this condition is orthopnea.

There is a similar condition when the person awakens suddenly during the night feeling short of breath - paroxysmal nocturnal dyspnea.

As you said, a patient with orthopnea is usually relieved by two or three pillows under the head and back, or standing.

In an episode of paroxysmal nocturnal dyspnea, the patient is aroused from sleep gasping for air and must sit up or stand to catch his or her breath; sweating may be profuse.

Sometimes the patient throws a window open wide in an attempt to relieve the oppressive sensation of suffocation.

The chest tends to become fixed in the position of forced inspiration. Both inspiratory and expiratory wheezes, often simulating typical asthma, are heard.

However, you say you have panic attacks... If your doctor told you that you have anxiety while lying down trying to sleep, he may be right.

But I want to tell you that orthopnea and paroxysmal nocturnal dyspnea are common symptoms in patients with:

  • impaired cardiac function that results in lung congestion

  • heart failure in whom the ventricular dysfunction causes an increase in the pulmonary venous pressure, thereby allowing fluid to pass from the blood vessels into the alveoli of the lung, impairing respiratory gas exchange.

  • cardiovascular disorders including those that affect cardiac rhythm and cardiac output.

  • congestive heart failure

  • obstructive sleep apnea

  • disordered diaphragmatic dysfunction

  • Amyotrophic lateral sclerosis (ALS)
Your breathing problems can be affected by obstructive sleep apnea indirectly. An untreated sleep apnea can produce pulmonary hypertension and result in right-sided heart failure, with the development of liver congestion and ankle edema.

Patients with impaired cardiac function that results in lung congestion have symptoms of orthopnea or paroxysmal nocturnal dyspnea.

Treatment of obstructive sleep apnea syndrome - CPAP - usually results in improved cardiac function, with correction of the congestion and edema.

And you said when you use CPAP your breathing problems and anxiety disappear... Is this only a coincidence, or you really have orthopnea?

Hmmm... I would visit as soon as possible a cardiologist (to see if you have problems with your heart), and I would also visit a sleep doctor. A sleep test is essential to monitor your sleep apnea.

Teri, I gave you only a hint of what you might have... Remember to check your heart.

I hope it helps. Don't be afraid to comment back.

Remy Thierry
Founder of Sleep Apnea Guide

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