Waking up short of breath at night: what to know

Breathlessness can happen when the airways narrow, when infection irritates the lungs, or when lying down changes how the body handles fluid. Asthma may cause wheeze, cough, or chest tightness. COPD, bronchiectasis, and acute bronchitis can also cause cough and disturbed breathing.

Anaemia may cause breathlessness with tiredness or a fast heartbeat. Angina can cause chest pressure with exertion, while atrial fibrillation may bring an irregular heartbeat or awareness of palpitations. These are different conditions, and the symptom pattern cannot confirm one diagnosis.

Sit upright, loosen tight clothing, and try to stay calm while checking whether the breathing settles. Use a prescribed reliever inhaler exactly as directed, if you have one. Avoid lying flat again until you feel able to breathe comfortably, and arrange prompt clinical review if episodes repeat.

Record the time, duration, position, cough, wheeze, fever, chest symptoms, palpitations, and any exposure to smoke or allergens. This information helps assess conditions such as [Asthma](/conditions/asthma/) and [COPD](/conditions/copd/).

Call emergency services for severe or rapidly worsening breathlessness, blue or grey lips, inability to speak in full sentences, fainting, confusion, or severe chest pain. Sudden breathlessness with facial or tongue swelling may indicate [Anaphylaxis](/conditions/anaphylaxis/) and needs immediate help.

Ask whether you need oxygen measurement, a chest examination, breathing tests, or heart tests. Discuss whether symptoms change when lying down, whether you snore or stop breathing during sleep, and how your medicines, allergies, smoking, or recent infection may contribute.