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Paroxysmal nocturnal dyspnea or paroxysmal nocturnal dyspnoea (PND) is an attack of severe shortness of breath and coughing that generally occurs at night. [1] It usually awakens the person from sleep, and may be quite frightening. [2]
Orthopnea or orthopnoea [1] is shortness of breath (dyspnea) that occurs when lying flat, [2] causing the person to have to sleep propped up in bed or sitting in a chair. It is commonly seen as a late manifestation of heart failure, resulting from fluid redistribution into the central circulation, causing an increase in pulmonary capillary pressure and causing difficulty in breathing.
Shortness of breath can manifest as orthopnea (inability to breathe sufficiently when lying down flat) and/or paroxysmal nocturnal dyspnea (episodes of severe sudden breathlessness at night). These are common presenting symptoms of chronic and cardiogenic pulmonary edema due to left ventricular failure.
The most common findings of cardiac asthma are the presence of wheeze, cough, or shortness of breath (predominantly occurring at night or when lying down) in a patient that possesses signs of congestive heart failure. [4] [5] [6] [7]
A wheeze is a clinical symptom of a continuous, coarse, whistling sound produced in the respiratory airways during breathing. [1] For wheezes to occur, part of the respiratory tree must be narrowed or obstructed (for example narrowing of the lower respiratory tract in an asthmatic attack), or airflow velocity within the respiratory tree must be heightened.
There are ways to get a good night’s rest and avoid daytime sleepiness, from better sleep hygiene to regular exercise and putting screens away earlier. Talk to your healthcare provider .
Some cases have been reported on rhythmic movements during wakeful activities like driving. When occurring in sleep, RMD episodes are more likely to onset during non-REM, stage 2 sleep. Roughly 46% of sleep-RMD episodes occur only in non-REM sleep; 30% in non-REM and REM; and only 24% strictly in REM sleep. [12]
Image credits: Jiggly_Love #2. For context, my aunt always needed the spotlight, always an attention seeker. This was at her own daughter's wedding for context where she didn't get attention.