Some people find that their wheezing gets worse when lying down. This can occur because lying down may adversely affect the ability of the chest to rise and fall, making it difficult to breathe.

Lying down may also cause problems with mucus drainage from the nose, which could trigger a cough.

Wheezing is a common symptom of asthma, allergies, chronic obstructive pulmonary disease, and obstructive sleep apnea.

In this article, we will take a closer look at the potential causes of wheezing when lying down and their treatments. We will also provide tips on how to sleep while experiencing this symptom.

A woman wearing a black top experiencing wheezing when lying down on a bed.Share on Pinterest
Photographer, Basak Gurbuz Derman/Getty Images

Asthma is a chronic condition that affects over 300 million people worldwide. It is characterized by coughing, wheezing, or shortness of breath. It is common for asthma symptoms to affect people at night. This is known as nocturnal asthma.

The symptoms of nocturnal asthma can include:

  • chest tightness
  • shortness of breath
  • coughing
  • wheezing

According to the United Kingdom charity, Asthma UK, nocturnal asthma can be a sign that a person’s asthma is not well-controlled. People with asthma symptoms at night may be at risk for asthma attacks.

Doctors can prescribe preventive inhalers to improve breathing. People can use these regularly to maintain reduced asthma symptoms. Emergency inhalers can help with sudden and sometimes severe symptoms. Those with allergies may find that identifying and removing the allergen helps, along with taking an antihistamine.

OSA is a serious medical condition that causes a decrease or abrupt halt in airflow while sleeping. This occurs due to the relaxation of the pharyngeal muscles and soft tissues, which are located at the back of the throat. This blocks the airways, disrupting breathing.

The symptoms of sleep apnea include:

  • frequent or loud snoring, which may stop and start
  • choking, snorting, or gasping sounds
  • waking with a dry mouth or sore throat
  • morning headache
  • difficulty concentrating during the day

Treatment for OSA may include wearing a device over the mouth at night to help keep the airways open. Continuous positive airway pressure (CPAP) machines are often the best option, but in complex cases where a CPAP machine is not suitable, surgery may be necessary.

Anxiety disorders are a common mental health condition. A 2015 study from Germany found that they affect up to 33.7% of the population.

In addition to causing emotional changes, anxiety can cause physical symptoms. Examples include:

  • rapid or shallow breathing (hyperventilation)
  • sweating
  • rapid heart rate, heart palpitations, or both
  • a suffocating or choking sensation

If a person feels anxious at night, they may find that the feeling of additional pressure of gravity on the chest leads to bronchospasm (narrowing of the airways) that can cause a wheezing noise. Anxiety and stress can also make it more likely a person will react to allergens, which can trigger asthma.

Treatment typically involves talking therapy, but can also include medications to manage symptoms.

Learn more about the treatments for anxiety.

Another potential cause for wheezing is obesity.

A randomized study of just over 86,000 adults found that a higher body mass index (BMI) was associated with wheezing, while a 2019 study found that a higher BMI was associated with fat deposits in the lungs. This may explain why individuals with obesity can experience wheezing, as well as other breathing difficulties.

People can reach a moderate weight by making dietary changes, doing regular exercise, and treating any underlying conditions that may be contributing to excess weight.

Bronchitis refers to the inflammation of the bronchi, which are the large air passages inside the lungs. In 95% of all cases, acute bronchitis occurs because of a viral infection, such as a cold. Bronchitis can also occur due to bacteria, allergens, or pollutants, such as smoke.

The symptoms of acute bronchitis include:

  • a productive cough
  • loud wheezing or difficulty breathing
  • sore throat, runny nose, or other symptoms of a viral infection
  • low-grade fever

Acute bronchitis that is caused by a virus will often get better on its own. The cough may last 10–20 days.

Treatments for bronchitis will vary depending on the cause. For viral infections, doctors typically recommend rest and treatments that can reduce a cough. This could include throat lozenges, hot tea, or over-the-counter (OTC) cough medications.

Learn more about home remedies for bronchitis, and when to see a doctor.

GERD occurs when stomach contents, including stomach acid, flow back up into the esophagus. The symptoms of GERD include:

  • acid reflux
  • heartburn
  • difficulty or pain when swallowing
  • regurgitation of food
  • bad breath
  • chronic sore throat
  • a recurring or chronic cough
  • wheezing

There is a greater risk for GERD to occur in people with asthma. This is because asthma episodes can cause the lower part of the esophagus to relax, allowing stomach acid into the esophagus. Stomach acid can also cause asthma or COPD symptoms, such as wheezing, by entering and irritating the airways.

Lifestyle changes, such as avoiding foods that contribute to flare-ups, can reduce GERD symptoms. Doctors can also prescribe medications to reduce stomach acid production.

COPD is a condition that progressively makes it more difficult to breathe. The main cause is tobacco smoking, although around 25% of cases are not linked to smoking. The symptoms of COPD include:

  • chronic, productive cough
  • wheezing, whistling, or a squeaky sound when breathing
  • shortness of breath
  • chest tightness

Some people with COPD have different symptoms to these. Some can also have mild symptoms that they do not notice to begin with.

There is no cure for COPD, but there are things doctors can do to relieve symptoms and slow the progression of the disease. These include prescribing medications to help open the airways, pulmonary rehabilitation, supplemental oxygen therapy, and surgery.

Heart failure prevents the heart from pumping enough blood to support organ health and normal breathing. It is a serious condition that can be fatal. The potential symptoms of heart failure include:

  • shortness of breath
  • persistent cough
  • decreased tolerance for exercise
  • swelling of the limbs and extremities due to fluid overload

Many of these symptoms may not be noticeable until the condition has become advanced.

People can reduce the symptoms of heart failure through medications, such as diuretics, beta-blockers, ACE-inhibitors, and aldosterone antagonists. Some drugs, as well as devices such as implantable cardioverter defibrillators, can prolong a person’s life.

People who experience wheezing when lying down may find it difficult to sleep. To improve quality of sleep, people can try:

  • Avoiding food before bed: People with GERD should aim to eat at least 2–3 hours before lying down. This can reduce acid reflux at night, reducing irritation in the esophagus.
  • Avoiding caffeine and alcohol: Both caffeine and alcohol make it more likely a person will experience asthma symptoms. Caffeine can also worsen acid reflux.
  • Removing allergens: If a person has asthma or bronchitis caused by allergies, identifying and removing allergens that may be present while sleeping could help. For example, if a person allows a pet to sleep on their bed, the dander may cause wheezing at night.
  • Trying decongestants: OTC chest decongestants may help with breathing at night, particularly for people with acute bronchitis. Decongestants may also help people with asthma, though some find that they can make symptoms worse.
  • Elevating the head: Elevating the head, neck, and shoulders may help to open the airways during sleep, preventing wheezing. It can also reduce acid reflux.
  • Keeping medications nearby: Keep medications or inhalers that help with breathing nearby while lying down or sleeping. This allows people to use them as soon as they wake due to wheezing.

It is important for people who regularly wheeze while lying down to seek medical attention. Doctors can help pinpoint the exact cause of the wheezing, and recommend treatments.

If someone experiences any of the following symptoms, dial 911 or the local emergency department:

  • difficulty breathing
  • pain in the chest, arm, neck, or jaw
  • blue or white lips
  • loss of consciousness or difficulty staying awake

Wheezing while lying down is a common symptom of conditions such as asthma. It can also be the result of anxiety at night, GERD, or obesity. Some people may have a combination of several conditions. For example, those with GERD and asthma may find that acid reflux triggers their asthma symptoms when lying down.

People who experience regular wheezing should seek medical advice.