This nightly symptom could be an early sign of heart failure.
It's not always easy to sleep through the night. Unfortunately, not getting a good night's rest can not only cause health problems—it could also be a sign of existing health concerns, especially if it's happening often. In fact, if you find yourself waking up at night in one specific way, your body may be trying to tell you that your heart is in danger.
If you wake up at night from shortness of breath, you may be experiencing heart failure.
Bobbi Bogaev, MD, a cardiologist and medical director for Abiomed, says people with heart failure "often wake up in the middle of the night with severe shortness of breath," also known as paroxysmal nocturnal dyspnea (PND). If you're experiencing this kind of shortness of breath, you will likely wake up coughing and/or wheezing and experiencing a rapid heart rate, Bogaev explains. She also says it may feel as if you are "being suffocated," and you can only find relief by sitting up. "The shortness of breath generally goes away after a few minutes of sitting up," she continues.According to Harvard Medical, shortness of breath is actually an early warning sign of heart failure. "This means it is a symptom that occurs relatively early on but gets worse over time if left untreated," says Seema Sarin, MD, the medical director of Lifestyle Medicine at EHE Health.
This is because heart failure causes shortness of breath when lying down.
Vicken Zeitjian, MD, a board-certified internist who has treated numerous patients with heart failure, says the shortness of breath waking you up at night comes from the heart being unable to pump out the amount of fluid coming in while you're laying down. "When the heart is unable to pump enough volume forward, the fluid becomes congested in the heart and lung circulation, which ultimately causes shortness of breath," he explains. "Patients who are in heart failure often state they need more than one pillow to sleep or need to sleep in a reclining chair."Stephen T. Sinatra, MD, a board-certified cardiologist, says worsening shortness of breath when lying down is what indicates that this symptom is coming from a heart problem and not something else. "When lying down, the blood is distributed throughout the vasculature, thus putting more strain on the heart," he explains. Mehmet Oz, MD, a cardiothoracic survey specialist and host of The Dr. Oz Show, says fluid buildup in the lungs usually wakes up people with heart failure around one to two hours after they fall asleep.
If you're experiencing heart failure, you may also notice swollen ankles during the day.
If you have heart failure, you may also notice a peculiar symptom during the day. Sinatra says that "when you are sitting up, much of the blood volume is in your legs due to the association of gravity." This can often be seen by the swelling of your ankles or lower legs during the course of the day, says Spencer Kroll, MD, a board-certified internal medicine specialist. According to Oz, other symptoms indicative of heart failure include the need to urinate more often at night, weight gain, and a dry hacking cough.
Doctors say heart failure can often be mistaken for sleep apnea.
You will definitely want to talk to your doctor to make sure you get the correct diagnosis. Bogaev notes that shortness of breath in relation to heart failure is "often mistaken for sleep apnea." According to the American College of Cardiology, heart failure and sleep apnea share several overlapping symptoms, making it difficult to tell which is occurring or if they are comorbidities. "Sleep apnea is commonly associated with heart failure and if you are waking up with any heart palpitations or severe coughing, be sure to call your doctor," Bogaev says. "There is a simple blood test that can help distinguish if your symptoms are due to heart failure."
Kali Coleman