Paroxysmal nocturnal dyspnea is a serious symptom of various conditions, often caused by left heart failure. It causes shortness of breath and coughing while lying down, which can be relieved by sitting up. Treatment may include medication or surgery, and close monitoring by a cardiologist is recommended.
Paroxysmal nocturnal dyspnea can cause great concern and alarm and is a serious symptom of a variety of conditions. When this occurs, people tend to wake up several hours after going to sleep and feel short of breath or not being able to breathe (dyspnea). This usually causes people to shift positions and very often sit up for a few minutes, resulting in a cessation of symptoms. The person can then go back to sleep and may experience another episode during the night or sleep through the night. This symptom can occur every night and is one that requires a doctor’s attention.
There are several things that can cause paroxysmal nocturnal dyspnea and most of them involve the heart system. Failure of different parts of the left ventricle to function properly is often the cause, and people with this condition may have damaged mitral or aortic valves. In general, the symptom is attributed to left heart failure.
More specifically, larger amounts of blood in the heart are not being adequately pumped around the body. Fluid can begin to back up into the lungs, particularly when a person has been lying down for several hours. This can create a feeling of drowning or not being able to breathe, which tends to be relieved by moving the body to an upright position. Not only can the sensation of breathing be affected, but people can also develop congestion or a cough when lying down. Some people have mucus production that may appear to contain blood.
Another indication of paroxysmal nocturnal dyspnea is edema or swelling and swelling in the ankles and feet. This also suggests heart failure. When swollen ankles and scary breathing episodes at night are combined, it tends to confirm the diagnosis of this disorder and suggest that some form of heart failure is occurring.
Because different types of heart failure can be involved, treatment of paroxysmal nocturnal dyspnea may need to be tailored to the individual. Heart failure, though the term sounds so bad, is a long, progressive process that can often be addressed early with medication. Some medications that may be indicated include those that dilate blood vessels called vasodilators. Diuretics may be given to reduce fluid volume. Other common heart medications may be suggested as needed.
People who have heart failure and symptoms such as paroxysmal nocturnal dyspnea may require closer monitoring with a cardiologist. If medications fail to adequately address the underlying heart problems, surgery may be considered. The type of surgery, again, depends on the problem troubling you: An aortic valve might need to be opened, replaced, or repaired, or a mitral valve might need replacement. Patients should be especially alert to report continuing problems with this condition after initiating treatments. Those experiencing this symptom for the first time should plan to get in touch with doctors right away to report it.
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