What is Orthopnea?

In today’s article we take a close look at orthopnea. We look at the causes, the effects, and also the treatments of this peculiar problem.

doctor's checklist

Orthopnea is a worrying problem that is often the sign of serious underlying health conditions.

As ever, we’ll explain all in our article. Start with the quick answer, but be sure to read on to get all the details.

So, what is orthopnea?

The Quick Answer

Othopnea definition: Orthopnea describes a shortness of breath and difficulty of breathing when a person is lying flat on their back.

The Detailed Answer

The word itself is derived from Greek, where ortho means regular or straight, and pnoia means breath.

This refers to the upright position a sufferer must take in order to breath properly.

The shortness of breath that orthopnea describes is known as dyspnea. It is usually caused by a serious medical condition.

Medical conditions linked to orthopnea include heart failure, pulmonary disease, and abdominal obesity. Since orthopnea is an indicator of the presence of such serious medical conditions, it should never be ignored.

If the condition worsens it could indicate that the health of the heart is becoming critical.

lungs breathing

It is usually relieved by sitting or standing, and a person may need to sleep propped up by many pillows.

In fact, the condition’s severity is sometimes informally described by the number of pillows the patient requires to sleep properly.

Orthopnea is the opposite of platypnea. Platypnea is an intense shortness of breath that is caused by sitting or standing up.

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Orthopnea Causes

The condition is caused by an increased blood flow to the pulmonary (lungs) area of the body.

When a person lies down, blood flows toward the lungs and heart. This isn’t a problem in a healthy person, but if your heart is weak then it may struggle to redistribute this extra blood in the area around the lungs.

This extra blood flow causes the pressure in the blood vessels (veins & capillaries) of the lungs to increase. The increased pressure in the blood vessels causes fluid to leak into the lungs. This fluid makes it difficult to breath as the lungs are being reduced in capacity.


Orthopnea can be a symptom of numerous diseases that concern the heart and lungs. We mentioned that a weakness of the heart means that the lungs are affected by fluid.

However, lung diseases that produce mucus are also a cause. This is due to the difficulty in clearing the mucus when in a recumbent position (lying down).

Illnesses that can cause orthopnea:

  • Left ventricular heart failure
  • Pulmonary edema (difficulty in breathing caused by excess fluid in the lungs)
  • Chronic bronchitis
  • Severe asthma
  • Severe pneumonia
  • Obesity
  • Paralysis of the diaphragm
  • Pleural effusion (fluid in the lungs)
  • Ascites (fluid in the abdominal cavity)

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Orthopnea Treatments

Treating the condition is best achieved by curing the underlying health problem. However, steps can be taken to lessen the difficulty experienced by the patient.

The best way of making sleeping more bearable is to have the patient sleep in a more upright position. This is usually done by using extra pillows to prop a person up, or even with a specially designed bed.

Lying propped up in this way is often called the orthopneic position. However, this does nothing to improve the patient’s actual health, and there are more serious issues that need to be addressed too.

As we discussed earlier, too much fluid in the body is a problem that causes orthopnea. Doctors usually treat this in two ways. The first is by prescribing diuretics.

These are pills that increase the production of urine by the body. By going to the bathroom more, less fluid will be stored inside the body.

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The second way of decreasing the amount of fluid stored on the body is by reducing the amount of sodium in a patient’s diet. A diet containing high levels of sodium is thought to cause fluid to build-up

A weak heart is another cause of orthopnea. Physicians can prescribe medication to help the heart muscles pump more blood. The problem is specifically with the left ventricle.

There’s a great article on that explains all the kinds of drugs that are used to strengthen the heart and improve the way it pumps blood around the body.

One such drug type is inotropics, or to be completely accurate positive inotropics. These are drugs that help the heart pump more blood by strengthening its contractions (or weakening the heart’s contractions in the case of negative inotropics).

Another way of increasing blood flow around the lungs is by using vasodilators. Vasodilators are drugs that help the circulation of blood by dilating the blood vessels.

Vasodilators can be used specifically to target the high blood pressure in the arteries of the lungs that causes orthopnea. There are various types of vasodilator and a physician would prescribe the right one.

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Paroxysmal Nocturnal Dyspnea

Paroxysmal nocturnal dyspnea (PND) is a condition that is caused by some similar health conditions to orthopnea.

It too is a shortness of breath experienced while lying down. However, PND relates to a problem while sleeping. It causes a person to wake up after a short period of sleep due to the shortness of breath.

PND can be caused by an increased blood pressure in the area of the lungs just like orthopnea. It has also been linked to problems with the respiratory center of the brain and the tissue of the heart.

Well hopefully now when asked to define orthopnea you’ll be well prepared! If you think we’ve missed something important then please let us know in the comments below. We always want our articles to be as informative and interesting as possible.

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For more interesting articles about health why not check out our post on sonography?

Until next time!

Disclaimer: We’re not physicians and we don’t pretend to be. If you have a medical condition then you should seek the professional advise of a doctor. Our articles at Know More Stuff are intended for lighthearted reading only, and should never be used for the purposes of diagnosis or treatment of illness.

Extra sources:

By Patrick J. Lynch, medical illustrator – Patrick J. Lynch, medical illustrator, CC BY 2.5,

By Tvanbr (Own work) [CC BY-SA 3.0 (], via Wikimedia Commons

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