Difficulty breathing while sleeping

Some people wake suddenly gasping, snore loudly, or notice pauses in breathing reported by a partner. Obstructive sleep apnoea can narrow the upper airway during sleep. Nasal congestion, asthma, heart or lung conditions, and acid reflux may also disturb nighttime breathing. Breathlessness that improves when sitting upright is useful information, but it does not identify the cause by itself.

Record whether episodes occur when falling asleep or after several hours, how often they happen, and whether you have snoring, wheezing, chest discomfort, ankle swelling, morning headache or marked daytime sleepiness.

Sleep on your side if that is comfortable, keep the room free from smoke, and manage nasal congestion with measures suitable for you. Follow prescribed asthma or heart medicines as directed and do not change doses independently. Avoid alcohol or unapproved sedatives before bed because they can worsen breathing problems. Arrange a medical assessment for recurrent episodes; testing may include an examination or a sleep study depending on the pattern.

Call emergency services for severe breathlessness, blue or grey lips, fainting, confusion, severe chest pain, or symptoms that do not settle after sitting upright. Seek prompt medical care for repeated awakenings gasping, new swelling, worsening wheeze, or breathlessness that is also present while awake.

Could this be sleep apnoea, asthma, reflux or a heart or lung problem? Would someone observing my sleep or a sleep study help? Which treatments are safe with my current medicines?