Platypnea: Why do we breathe more easily while we’re lying down than when we’re standing?

Platypnea is a medical ailment marked by shortness of breath that is made worse by standing up and made better by lying down. The diagnosis of this ailment might be difficult and it is quite uncommon.

When a person is standing or sitting up straight, they normally get enough oxygen into their lungs. Platypnea patients, on the other hand, have a respiratory system anomaly that results in an imbalance between the distribution of air and blood flow in the lungs.

Platypnea can result from a number of underlying disorders, including liver disease, lung conditions such as pulmonary embolism or chronic obstructive pulmonary disease (COPD), heart failure, and a few congenital anomalies. Platypnea may develop as a result of surgery in some instances, such as after abdominal or lung transplantation.

Platypnea is a very uncommon illness marked by shortness of breath that worsens when standing up straight. Even though it can be difficult to identify, the illness can be effectively managed with the right examination and treatment of the underlying cause. A healthcare practitioner should be consulted if you think you might have platypnea or if your shortness of breath is chronic in order to receive an accurate diagnosis and the best course of treatment.

Causes of platypnea

  • Cirrhosis in particular is a liver condition that can cause platypnea to develop. In this instance, changes in the liver’s blood flow may have an impact on the flow of blood via the pulmonary vessels, causing platypnea.
  • Platypnea can be brought on by certain lung conditions, including pulmonary embolism, chronic obstructive pulmonary disease (COPD), and pulmonary hypertension. These ailments can impair the lungs’ normal ability to exchange carbon dioxide for oxygen, making it harder to breathe when standing upright.
  • Cardiac problems: Several heart disorders can cause platypnea to develop. For instance, fluid buildup in the lungs brought on by heart failure can make breathing difficult. Platypnea can also be brought on by structural flaws in the heart, such as atrial or ventricular septal defects.
  • Platypnea is a post-operative complication that can happen during some surgical operations. A platypnea-causing imbalance in ventilation and blood flow, for example, can result from changes in the location or form of the transplanted lung after lung transplantation.
  • Anatomical anomalies: Respiratory function may be impacted by congenital or acquired anatomical anomalies in some people. Platypnea can occur as a result of several conditions, such as a diaphragmatic hernia, in which the diaphragm weakens or develops a hole.
  • Medication: Platypnea is a side effect that can occur after taking some drugs, including bronchodilators that are used to treat asthma or chronic obstructive pulmonary disease.

Platypnea’s consequences

  • Breathlessness: Platypnea’s main side effect is a feeling of shortness of breath, which gets worse when standing up straight. This can make it difficult to carry out daily work, strain oneself physically, or even do simple things like walking or climbing stairs.
  • Reduced capacity for exercise: Platypnea patients may have a reduced capacity for exercise as a result of their poor respiratory function. Activities that need physical effort or prolonged periods of standing or walking may be difficult for them to complete.
  • Weakness and fatigue: These conditions can be brought on by the body receiving less oxygen and the greater effort necessary to breathe. People could get weary more quickly and have less stamina.
  • Sleep disruption: Platypnea can affect the quantity and quality of your sleep. Many people find that their shortness of breath gets worse when they lie down, which can make it difficult to fall asleep or cause many nighttime awakenings. This may aggravate general exhaustion and drowsiness during the day.
  • worry and emotional distress: Coping with persistent breathlessness can result in emotional anguish, worry, and emotions of powerlessness or irritation. People may be concerned about their illness, and how it will affect their daily lives and the future.
  • A person’s total quality of life may be greatly impacted by a combination of physical restrictions, a decreased capacity for exercise, disturbed sleep, and emotional anguish. Their capacity to work, engage in social interactions, and take part in hobbies and leisure activities may all be impacted.

Symptoms of platypnea

  • The defining symptom of platypnea is dyspnea (shortness of breath), which is difficulty breathing, particularly while standing up. It could be described as a feeling of being out of breath, of needing more oxygen, or of being unable to breathe.
  • Platypnea is frequently accompanied by the condition known as orthodeoxia. When someone is standing up straight, their blood’s oxygen content decreases. Lightheadedness, vertigo, and disorientation are a few symptoms that may result from this.
  • Weakness and exhaustion: The body may become weak and exhaustion may result from the increased effort needed to breathe and the lower oxygen supply. There may be diminished stamina for physical activity and a tendency to get tired easily.
  • Pain in the head: Platypnea sufferers occasionally report having headaches, especially upon standing up. Reduced oxygen levels or modifications in blood flow may be connected to this.
  • Dizziness and lightheadedness: Platypnea may make you feel woozy or lightheaded, especially while standing or sitting up. Changing blood flow patterns or decreased oxygenation may be to blame for this.
  • Cyanosis: When there is a sharp drop in blood oxygen levels due to severe platypnea, cyanosis may happen. Lips, fingertips, or other body parts may become blue in color as a result of cyanosis.
Symptoms of platypnea

Natural remedies for Platypnea

  • Maintain a healthy weight because obesity can make breathing difficult and make platypnea symptoms worse. Regular exercise and maintaining a healthy weight can assist to strengthen the lungs and lessen breathlessness.
  • Practice deep breathing techniques: Deep breathing techniques, such as pursed-lip breathing or diaphragmatic breathing, can assist to relax you by strengthening your breathing muscles and improving your oxygenation. Regular practice of these exercises can improve respiratory capacity.
  • Identify and stay away from potential triggers and irritants that may exacerbate respiratory problems. Cigarette smoke, air pollution, allergies, or specific compounds may all fall under this category. Better breathing can be supported by maintaining a clean and healthy environment.
  • Keep hydrated: Drinking enough water promotes healthy lung function and thins mucus discharges. Drinking enough water can help reduce respiratory symptoms and enhance general respiratory health.
  • Control your stress: Anxiety and stress can make breathing problems worse. Relaxation and general well-being can be enhanced by practicing stress-relieving activities like yoga, meditation, or taking up a hobby.
  • Keep a straight spine: Pay close attention to your posture, especially when you’re standing or sitting. By preserving an upright position, one may improve lung function and airflow and lessen the severity of platypnea symptoms.

Treatment options for Platypnea

  • In order to effectively manage platypnea, it is important to treat the underlying condition that is causing or aggravating it. Depending on the exact diagnosis, this can entail medication, surgery, or other procedures. Platypnea symptoms, for instance, might be lessened by treating heart failure, liver disease, pulmonary embolism, or lung conditions.
  • Supplemental oxygen therapy may be provided to those who have platypnea in order to raise their oxygen levels and reduce their symptoms of shortness of breath. A healthcare practitioner may advise employing oxygen concentrators or portable oxygen tanks for this.
  • Diaphragmatic plication: When diaphragmatic anomalies are the root of platypnea, diaphragmatic plication surgery may be an option. It entails plicating or suturing the diaphragm in order to get it back to where it should be and enhance breathing.
  • Positional changes: Platypnea can be managed by altering body postures to ease symptoms. This may entail adopting a specific sleeping or resting position, such as reclining on one side or using cushions to elevate the upper body.
  • Pulmonary rehabilitation: Programmes for pulmonary rehabilitation may be suggested for people whose underlying lung problems are spiritual. In order to improve respiratory function and general quality of life, these programs frequently include exercise training, breathing methods, and education.
  • Medication: Depending on the underlying reason, several drugs may be recommended to help relieve symptoms and enhance respiratory performance, including diuretics for fluid management, bronchodilators for lung issues, and medications to manage heart function.
Treatment options for Platypnea

Prevention of platypnea

  • Make an appointment for routine medical checkups to monitor your overall health and identify any potential underlying illnesses as soon as possible. Identifying and managing illnesses like heart or lung diseases that can exacerbate platypnea can be facilitated by routine visits to your doctor.
  • Manage chronic conditions: If you have a chronic medical condition, such as heart disease, liver disease, lung disease, or another respiratory disorder, you should work closely with your healthcare team to properly manage and treat it. To stop these diseases from getting worse and lower your chance of developing platypnea, adhere to the recommended treatment programs, take your medications as prescribed, and show up for scheduled follow-up appointments on time.
  • Modifications to one’s way of life: Leading a healthy lifestyle can help avoid or treat diseases that could result in platypnea. This includes avoiding smoking or exposure to secondhand smoke, eating a balanced diet, exercising frequently, managing stress, and consuming only moderate amounts of alcohol.
  • Workplace safety precautions: Take the proper precautions if your workplace has possible respiratory irritants or risks. Reduce exposure to dangerous compounds and support respiratory health by wearing protective gear, such as masks or respirators.
  • Maintain a healthy weight because obesity raises the chance of developing or aggravating platypnea and can cause breathing problems. To improve lung function and overall respiratory health, maintain a healthy weight with a balanced diet and regular exercise.
  • In the event that you suffer recurring respiratory symptoms, such as breathing difficulties or shortness of breath, contact your doctor right once. Finding and treating underlying disorders that may cause platypnea can be made easier with early evaluation and diagnosis.

Diagnosis of platypnea

Medical history: The healthcare professional will start by gathering information about your medical history, including any symptoms you have had, how frequently and how long they have persisted, as well as any circumstances that have made them worse or better. They will also ask about any past medical issues, operations, or lifestyle choices that might be relevant.

Physical examination: A complete physical examination with special attention to the respiratory and cardiovascular systems will be performed. The medical professional will check vital signs, listen to the heart and lungs, and look for any indications or symptoms of cardiac or respiratory irregularities.

Positional assessment: One of the distinguishing characteristics of platypnea is the positional nature of the symptoms, which are worse while you’re standing up and get better when you’re lying down. Any symptom changes brought on by changes in position will be evaluated and recorded by the healthcare professional.

Imaging tests may be prescribed to evaluate the anatomical makeup and physiological state of the heart and lungs. Chest X-rays, CT scans, and magnetic resonance imaging (MRI) are a few examples of these. These examinations can aid in locating any structural issues or diseases that cause platypnea.

Testing for pulmonary function: Testing for pulmonary function assesses lung health and can reveal any underlying respiratory conditions. These exams evaluate lung function, airflow, and the movement of gases within the lungs.

Ultrasound technology is used in echocardiography to evaluate the structure and operation of the heart. It may reveal details on heart valve anomalies, heart failure, or other cardiac disorders that could be a factor in platypnea.

*Disclaimer: This article is for informational purposes only and should not substitute professional medical advice. Please consult a healthcare professional for a thorough evaluation of your symptoms and appropriate treatment.

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Author Contribution: Reviewed by Dr. Ram Reddy, MD – General Physician, and Rajeshwar Rao, Pharm D.

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