Causes of shortness of breath at night

Waking with wheezing, coughing or chest tightness can occur with Asthma, while a chesty cough and fever may point towards Acute Bronchitis. Breathlessness that is worse when lying flat, or that wakes you needing extra pillows, needs assessment for a heart or lung cause. Long-term cough and mucus can occur with COPD or Bronchiectasis. Palpitations alongside breathlessness may occur with Atrial Fibrillation, and tiredness or pale skin can accompany Anaemia. Sudden symptoms with swelling of the lips, tongue or throat may signal Anaphylaxis.

Sit upright, loosen tight clothing and use a prescribed reliever inhaler exactly as directed. Note whether symptoms follow dust, pets, exercise, a respiratory illness or lying down. Avoid smoke and strong fragrances, and arrange a medical review if episodes recur, disturb sleep or are gradually worsening. Do not start another person’s inhaler or medicine.

Call emergency services if breathing is severely difficult, you cannot speak in full sentences, your lips look blue or grey, you have faintness or crushing chest pain, or your face, mouth or throat swells. Urgent assessment is also needed for new breathlessness with coughing blood, confusion or rapidly worsening symptoms.

Ask what may be triggering the episodes, whether you need breathing tests or heart checks, and which warning signs should prompt immediate help. Bring a list of medicines and describe whether sitting up changes the symptom.