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Regarding sleep disorders, the disease “Paroxysmal Nocturnal Dyspnea” (PND) is a terrifying condition. This blog aims to give a complete picture of PND disease, including its causes, symptoms, diagnosis, treatment, and lifestyle factors. Let’s explore this unusual sleep issue.

What is Paroxysmal Nocturnal Dyspnea?

Paroxysmal nocturnal dyspnea (PND) is shortness of breath that happens during sleep and comes on rapidly, awakening the person from sleep when gasping for air. Notably, PND often arises between the first and second hours of sleep.

The meaning of the disease’s name can also tell us a lot about it:

“Paroxysmal” means that the symptoms occur rapidly and can occur again.

“Nocturnal” implies that it happens at night.

“Dyspnea” is a medical term for shortness of breath, feeling like you can’t get enough air, or having difficulties breathing.

However, It is different from general dyspnea or shortness of breath, which can happen anytime during the day. Even though it’s normal to have breathlessness during the day sometimes, like after a hard workout, PND is not normal and could be a sign of a health problem.

Paroxysmal Nocturnal Dyspnea vs Sleep Apnea

Several diseases affecting the lungs or blood flow can cause Paroxysmal nocturnal dyspnea (PND), an indicator.

However, on the other hand, sleep apnea, most often obstructive sleep apnea, is a separate medical disease. It’s worth noting that sleep apnea can cause PND, but it can’t do the opposite.

People with sleep apnea have numerous moments during the night when their breathing slows down or stops. Consequently, sometimes, your breathing stops long enough to cause PND and wake you up.

In obstructive sleep apnea, a hard layer of tissue blocks the upper airway, causing breathing to slow or stop. In contrast, in central sleep apnea, breathing slows down or occurs because the brain doesn’t send the right messages for breathing.

Both kinds of sleep apnea can cause PND. But sleep apnea isn’t always the cause of PND.

Paroxysmal Nocturnal Dyspnea vs Orthopnea

Both paroxysmal nocturnal dyspnea (PND) and orthopnea mean a lack of breath. However, PND typically occurs a few hours after a person goes to sleep, while orthopnea can manifest whenever a person is lying down, even if they are awake. Similar to PND, orthopnea can cause shortness of breath that improves when standing or sitting up. Consequently, when they happen together, they are called signs of heart failure.

Heart failure is a cause of orthopnea. When a person lies down and fluid builds up in the lungs, this is what happens.

Heart failure is often caused by PND. But it is linked to other illnesses as well.

What are the Paroxysmal Nocturnal Dyspnea Symptoms?

Paroxysmal nocturnal dyspnea(PND) is a feeling of pressure when you’re not doing anything physically demanding, like sleeping. These Symptoms of heart failure may include this sensation. However, it’s important to note that shortness of breath isn’t always caused by the heart, so it’s crucial to talk to your doctor for a correct diagnosis.

Some people may have bronchospasms, similar to asthma, in that it narrows and blocks the airways in the lungs. You don’t always feel better right away when you sit up straight. In fact, your body can take up to an hour or more to return to normal.‌

Some other signs are:

  • Rapid Heartbeat
  • Shortness of breath
  • Sleep difficulty
  • Sleeplessness (Insomnia)
  • Waking up suddenly with a cough or wheeze

What are the Paroxysmal Nocturnal Dyspnea causes?

A lung or heart problem causes dyspnea nearly 90% of the time. Some possible reasons for PND are:

  • Sleep apnea
  • Having asthma
  • Failure of Heart
  • Psychiatric illness
  • Getting pneumonia
  • Abnormal fluid in the lungs
  • COPD means “chronic obstructive pulmonary disease.

Sleep Apnea

There may also be a link between Paroxysmal nocturnal dyspnea (PND) and sleep apnea. Specifically, up to half of people with severe heart failure could develop a form of sleep apnea and consequently experience PND. Notably, people with sudden heart failure that hasn’t been fixed may be more likely to develop PND if they also have sleep apnea.


Symptoms of asthma often get worse at night. Consequently, if a person’s lungs become fluid, they may experience an asthma attack and subsequently develop PND. Furthermore, people with severe asthma may also be more likely to have obstructive sleep apnea, further increasing their risk of PND.

Heart Failure

Congestive heart failure, which affects about 2% of Americans, is highly linked to PND. When someone lies down, blood from other body parts moves to the lungs. Consequently, people with healthy hearts pump their hearts as much as they need to send blood back to the rest of the body. However, when someone has coronary artery disease, the heart can’t do this either, which causes fluid to build up in the lungs and shortness of breath when sleeping or lying down. Furthermore, people with heart failure also have higher amounts of renin, an enzyme that makes the body hold on to fluid.

Psychiatric Illness

Psychogenic diseases are health problems that can come up because of stress. A person who is otherwise healthy but feels like they can’t breathe and has sensations in their mouth, fingers, and toes could have these symptoms.


Pneumonia can cause PND. Along with fever, cough, and chest pain, shortness of breath is among the most common signs of pneumonia in older people.

Pulmonary Edema (Abnormal Fluid in Lungs)

People with pulmonary edema often have PND orthopnea or shortness of breath when sitting down. Pulmonary edema happens when fluid builds up in the lungs’ air sacs, called alveoli. Heart failure or a recent heart attack can cause this situation.

Chronic Obstructive Pulmonary Disorder (COPD)

Chronic obstructive lung disease (COPD) can cause PND. COPD is a lung disease that gets worse over time and makes it harder to breathe. Smoking, directly or by breathing in smoke from other people, most often causes COPD.

How can Paroxysmal Nocturnal Dyspnea be diagnosed?

Your Doctor will try to figure out why you are having Paroxysmal nocturnal dyspnea (PND). They will ask you about your medical background and symptoms and do tests to check your heart and lungs.

One or more of the following can be part of diagnostic tests:

  • Biopsies.
  • Lung X-ray
  • chest MRI
  • Blood tests
  • chest CT scan
  • Bronchoscopy
  • Echocardiogram
  • X-ray of the chest
  • Cardiac ultrasound
  • The heart stress test
  • Coronary artery angiogram
  • 12-lead electrocardiogram
  • Lung function test (spirometry testing)

Paroxysmal Nocturnal Dyspnea Treatment

Treatments for Paroxysmal nocturnal dyspnea (PND) depend on what’s causing it. Based on your feelings, your Doctor can help you determine the best way to improve.

When heart failure is the cause of PND, there are several ways to treat the symptoms. Firstly, as part of medical care, diuretic medications can be used to remove extra fluid and cardiac medications can be employed to protect the heart or lower blood pressure or heart rate. Secondly, other treatments, such as surgery, may help lighten the load on the heart and improve air circulation to the cells. Additionally, PND may also see improvement if you sleep propped up on several pillows.

When a lung or other respiratory system issue is the source of PND, addressing the disorder typically helps to reduce symptoms. Specifically, for example, asthma medicines taken for a long time can help reduce shortness of breath at night. Moreover, in cases of sleep apnea, a continuous positive airway pressure (CPAP) machine, which may also provide extra oxygen, may help improve breathing.

Antibiotics and lifestyle modifications are effective treatments for gastrointestinal diseases.

Changes to your lifestyle and Coping with PND

People with heart-related PND can benefit from a heart-healthy diet low in salt and saturated fats. Less salt in your diet can help you deal with excess fluids and ease symptoms.

Do More Physical Activities

Regular exercise can help your lungs work better, ease the signs of heart failure, and help you sleep better. Talk to your doctor about a training plan that will work for you.

Managing Stress

Stress can make PND symptoms worse. Focusing meditation, yoga, and other relaxation techniques can help you manage stress and sleep better.

Avoid Alcohol and Cigarettes

Smokers and alcoholics should be encouraged to change their habits if they have heart failure. Smoking and drinking can also make it hard to sleep. If you stop smoking, you might also avoid getting COPD.

Keep a Regular Sleeping Schedule

Go to bed and wake up at the same time every day. Set up a sleep plan that gives you at least seven hours of sleep per night.

When to see a Doctor?

Even though paroxysmal nocturnal dyspnea (PND) doesn’t always mean a significant health problem, it is an important symptom that should be considered. Make an appointment with the Doctor if you wake up gasping for air, which is a sign of PND.

To Wrap it up

Paroxysmal nocturnal dyspnea (PND), which causes sudden and severe breathlessness at night, may appear inexplicable but can be overcome. Firstly, understanding its causes and symptoms, and secondly, seeking medical help, are crucial steps in managing this illness. Moreover, exploring their treatment choices can help people manage this illness. There are many ways to get a better night’s sleep and feel better about yourself. For instance, taking medicine for heart problems, using CPAP tools to treat sleep apnea, or changing how you live are all viable options.

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