Waking up from shortness of breath

Breathlessness during sleep may follow asthma, COPD, or an airway infection such as Acute Bronchitis. It can also occur when lying flat changes pressure in the chest or when the heart is not coping well with demand. Angina may cause chest discomfort with breathlessness, while Atrial Fibrillation can produce an irregular heartbeat and reduced exercise tolerance. Anaemia can leave you short of breath because the blood carries less oxygen. Bronchiectasis may bring breathlessness with a long-term cough and phlegm. A sudden reaction with swelling or breathing difficulty can indicate Anaphylaxis.

Sit upright, loosen restrictive clothing, and use a prescribed reliever inhaler exactly as your action plan says. Note whether the episode followed lying flat, wheezing, fever, chest pain, palpitations, or exposure to an irritant. Arrange medical review if episodes recur, wake you repeatedly, or are worsening. Bring your medicines and describe how quickly the symptoms began and settled. Do not borrow another person’s inhaler or delay assessment because the episode improved.

Call emergency services for severe or rapidly worsening breathlessness, inability to speak comfortably, blue or grey lips, fainting, confusion, severe chest pain, or swelling of the lips, tongue, or throat. Sudden breathlessness with a very fast or irregular heartbeat also needs urgent assessment.

Could my symptoms relate to asthma, heart rhythm, anaemia, or an infection? Do I need breathing tests, heart checks, or a written action plan? What should I do if it wakes me again?