Why Do I Have Shortness of Breath at Night?
Medically reviewed by Gerhard Whitworth,
Lung conditions
Heart conditions
Allergies
Sleep apnea
Anxiety
Diagnosis
Treatment
Takeaway
There are several reasons why you may find yourself short of breath at night. Shortness of breath, called dyspnea, can be a symptom of many conditions. Some affect your heart and lungs, but not all.

You may also have conditions like sleep apnea, allergies, or anxiety. You need to understand the cause of your nighttime shortness of breath to treat it.

When to seek immediate medical care
Sudden and severe shortness of breath at night can be a sign of a serious condition. Seek prompt care if you:

can’t catch your breath when lying flat
experience worsening or prolonged shortness of breath that doesn’t go away or gets worse
You should also seek immediate medical attention if your shortness of breath occurs with:

blue lips or fingers
swelling near your feet
flu-like symptoms
wheezing
a high-pitched sound when breathing
What causes shortness of breath?
Many conditions cause shortness of breath at night. Chronic shortness of breath occurs when you experience the symptom for more than a month. According to an article in American Family Physician, 85 percent of conditions that trigger chronic shortness of breath relate to your lungs, heart, or mental health.

Shortness of breath can occur if your body can’t adequately pump oxygen into your blood. Your lungs may be unable to process the intake of oxygen or your heart may not able to pump blood effectively.

Shortness of breath when you lie down is called orthopnea. When the symptom occurs after a few hours of sleep, it is called paroxysmal nocturnal dyspnea.

Lung conditions
Different lung conditions can cause shortness of breath. Some are chronic or life-threatening and others can be treated.

Asthma
Asthma occurs because of inflammation in your lungs. This leads to breathing difficulties. You may experience nighttime shortness of breath related to your asthma because:

your sleeping position puts pressure on your diaphragm
mucus builds up in your throat causing you to cough and struggle for breath
your hormones change at night
your sleeping environment triggers your asthma
Asthma can also be triggered by conditions like gastroesophageal reflux disease (GERD).

Pulmonary embolism
A pulmonary embolism occurs if a blood clot forms in your lungs. You may also experience chest pain, coughing, and swelling. You may develop this condition if you have been confined to bed for a period of time. This can restrict your blood flow.

If you think you have a pulmonary embolism, seek emergency medical care.

Chronic obstructive pulmonary disease (COPD)
COPD causes blocked or narrowed airways that make breathing more difficult. You may also have symptoms like wheezing, coughing, mucus production, and tightness in the chest. Smoking or exposure to harmful chemicals can cause COPD.

Pneumonia
Pneumonia can develop because of a virus, bacteria, or fungi. The condition inflames your lungs. You may also experience flu-like symptoms, chest pain, coughing, and tiredness.

You should seek medical treatment for pneumonia if you have a high fever along with shortness of breath and coughing.

Heart conditions
Conditions that affect your heart can interfere with its ability to pump blood. This may lead to shortness of breath when you lie down or after sleeping for a few hours.

Heart failure and related conditions
You may experience shortness of breath because your heart can’t pump blood at a sustainable level. This is known as heart failure. You may develop this condition for many reasons. Risk factors include poor diet, diabetes, certain medications, smoking, and obesity.

One condition that can lead to a heart attack is coronary artery disease. You may experience shortness of breath from a heart attack as well as chest pain and tightness, sweating, nausea, and fatigue. You should seek medical care right away if you suspect you’re having a heart attack.

Other conditions associated with heart failure include high blood pressure or if your heart experiences trauma, inflammation, or irregular heart rate.