Answer:

Experiencing shortness of breath after exercise or strenuous activity is normal. However, sudden shortness of breath an hour or two after falling asleep, forcing you awake and requiring 10-15 minutes of sitting upright to breathe comfortably, could be paroxysmal nocturnal dyspnea (PND). "Paroxysmal" signifies a sudden onset that quickly resolves, distinguishing it from acute shortness of breath, which can last for hours or days, and chronic shortness of breath, which persists for weeks.

PND can be accompanied by coughing, wheezing, and a rapid heartbeat, often leading to fear and anxiety. Some individuals seek fresh air by opening a window or going outside to feel safer. They may be hesitant to go back to sleep or find comfort only by sleeping in an upright position. Several conditions can cause PND, including congestive heart failure, pulmonary arterial hypertension, chronic obstructive pulmonary disease (COPD), asthma, pulmonary edema, Parkinson's disease, obesity, psychological disorders, and sleep apnea.

A doctor consults with a patient experiencing shortness of breath. Photo illustration: Tam Anh General Hospital

A doctor consults with a patient experiencing shortness of breath. Photo illustration: Tam Anh General Hospital

A medical examination is crucial for accurate diagnosis. Doctors typically check blood pressure and weight, listen to the heart and lungs, and may order a chest X-ray, MRI, or CT scan to examine the lungs. Blood tests, echocardiograms, and electrocardiograms (ECGs) can help screen for heart conditions, particularly congestive heart failure.

Treating the underlying condition can alleviate PND, improving sleep quality and reducing anxiety. For example, patients with COPD or pulmonary edema may benefit from oxygen therapy, mechanical ventilation, or diuretics. Those with heart failure might be prescribed beta-blockers, diuretics, or medications to strengthen heart muscle contractions. Asthma sufferers can use inhaled medications or corticosteroids to manage nighttime symptoms. Maintaining a healthy lifestyle through regular exercise, abstaining from smoking and limiting alcohol, improving diet, and managing stress can also help reduce PND.

MSc. Dr. Le Thi Hong Tham

Respiratory Department

Tam Anh General Hospital, Hanoi