Struggling with Breathing: Sleep Disruptions and Solutions

Shortness of breath?

I have a history of nasal allergies, but previously, nasal congestion did not affect my sleep.
About a month ago, I experienced difficulty breathing for three to four consecutive days, which prevented me from falling asleep.
I kept getting up to adjust my breathing and couldn't sleep peacefully.
I then visited the pulmonology department at Taoyuan Hospital, where an X-ray was taken, and the doctor said there were no abnormalities.
They prescribed bronchodilators and antihistamines, which provided some relief.
At that time, I also frequently experienced heartburn after meals and suspected it might be due to irregular eating habits leading to gastroesophageal reflux disease (GERD).
About a week ago, I went to a small clinic and received medication for GERD, which significantly improved the heartburn symptoms.
However, three to four days ago, the breathing difficulties returned.
I feel a tightness and dryness in my throat, and my breathing is shallow and short.
The air I inhale feels somewhat irritating and uncomfortable, making it hard to take deep breaths.
The more anxious I become, the worse the discomfort feels, and I struggle to relax my breathing.
As a result, I often find myself in a state of panic.
During sleep, my breathing feels unnatural, and I can only fall asleep when I am completely exhausted, which is truly distressing.
What kind of tests or adjustments should I consider? Should I undergo pulmonary function tests, an endoscopy, or consult a psychiatrist? 😢😢

Mr. Yang, 20~29 year old female. Ask Date: 2020/04/12

Dr. Chen Junwei reply Pulmonology

I recommend that you discuss the above situation with your attending physician to determine if further examinations are necessary.
Thank you, and wishing you good health!

Reply Date: 2020/04/12

More Info

It sounds like you are experiencing significant sleep disruptions, primarily due to breathing difficulties that may be exacerbated by anxiety and possibly related to your allergies and gastroesophageal reflux disease (GERD). Understanding the interplay between these factors is crucial in addressing your symptoms effectively.

Firstly, your history of nasal allergies and the recent onset of breathing difficulties suggest that your upper airway might be contributing to your sleep issues. Allergies can lead to nasal congestion, which may cause you to breathe through your mouth while sleeping, leading to dryness and discomfort. This can also trigger a cycle of anxiety, making it harder to relax and fall asleep. It’s important to manage your allergies effectively, which may include using antihistamines or nasal corticosteroids as prescribed by your doctor.

The sensation of tightness in your throat and the feeling of shallow breathing can also be linked to anxiety. When we are anxious, our body tends to enter a fight-or-flight mode, which can lead to rapid, shallow breathing and a heightened awareness of bodily sensations. This can create a feedback loop where the more you focus on your breathing, the more anxious you become, making it even harder to breathe comfortably. Techniques such as mindfulness, meditation, or cognitive behavioral therapy (CBT) can be beneficial in managing anxiety and improving your overall sleep quality.

Your mention of experiencing heartburn and the subsequent diagnosis of GERD is also significant. GERD can cause discomfort that may disrupt sleep, particularly if you lie down shortly after eating. It’s advisable to avoid large meals before bedtime, and consider elevating the head of your bed to reduce nighttime symptoms. Medications such as proton pump inhibitors or H2 blockers can help manage GERD symptoms, but it’s essential to follow up with your healthcare provider to ensure that your treatment plan is effective.

Given your symptoms, it would be prudent to undergo a comprehensive evaluation. A pulmonary function test can help assess if there are any underlying respiratory issues, such as asthma, that may be contributing to your breathing difficulties. Additionally, a sleep study (polysomnography) could be beneficial to evaluate your sleep patterns and identify any potential sleep disorders, such as sleep apnea, which can cause significant disruptions in breathing during sleep.

If your symptoms persist despite these interventions, or if you find that anxiety is significantly impacting your ability to function, it may be worthwhile to consult with a mental health professional. They can provide strategies to help manage anxiety and improve your coping mechanisms, which can, in turn, enhance your sleep quality.

In summary, addressing your breathing difficulties involves a multifaceted approach that includes managing allergies, treating GERD, and potentially seeking help for anxiety. A thorough evaluation by your healthcare provider will help determine the best course of action tailored to your specific needs. Remember, improving sleep quality often requires patience and a willingness to explore various treatment options.

Similar Q&A

Understanding Sleep Disruptions: Causes and Solutions for Better Rest

Hello, doctor. For the past 4 to 6 months, I have been waking up in the middle of the night almost every day (going to bed at 11 PM and waking up at 2 or 3 AM). Sometimes I can fall back asleep, but other times I become too concerned and find it difficult to do so. My daytime ale...

Dr. Cai Yunlin reply Psychiatry
Hello, I suggest that you keep a simple record of your sleep patterns and daytime activities for two weeks. This will help you identify any daily habits and behaviors that may be affecting your sleep. Common recommendations include the following: 1. Regardless of how well you sl...

Overcoming Sleep Disorders: Tips for Managing Insomnia and Nighttime Anxiety

Dear Dr. Ding, Thank you for patiently answering my questions last time. However, I have a few more inquiries: 1. I have difficulty maintaining sleep and often wake up twice during the night, which makes it hard for me to fall back asleep (sleep disturbance). What can I do to r...

Dr. Ding Shuyan reply Psychiatry
Hello, the difference between sleep and being awake during the day lies in the level of alertness of the brain. Ideally, before sleeping, the brain's level of arousal should gradually decrease, and it is best to minimize cognitive activities to create an environment conduciv...

Overcoming Sleep Disturbances: Solutions for Breathing Issues at Night

I have been experiencing long-term sleep disturbances and have reflected on possible issues. It seems that my breathing becomes obstructed when lying flat due to nasal congestion and allergies, which often leads to dark circles under my eyes and prevents me from sleeping well. I ...

Dr. Chen Yuying reply Psychiatry
Hello KiKi: If you have significant nasal issues affecting your sleep, it is recommended to visit an otolaryngologist for examination and treatment to check for conditions such as rhinitis or other structural problems in the nasal area. Wishing you a speedy recovery.

Difficulty Breathing While Sleeping: Understanding Anxiety and Insomnia

I have been experiencing insomnia for about five years. Recently, in the past year, I have been suddenly unable to breathe properly in my chest while trying to sleep. This sensation has been occurring almost every day for the past few days, and sometimes it happens just as I am a...

Dr. Wang Yaoting reply Psychiatry
Hello: It sounds like it could be a case of obstructive sleep apnea. I recommend visiting an otolaryngologist or a sleep center for an evaluation, where an examination of the upper airway obstruction can be arranged. If the results are normal or show only minor abnormalities that...