What Causes Difficulty In Breathing When I Lie Down?
All the conditions combined, producing symptoms
Detailed Answer:
Hello and welcome to HCM. I understand your concerns. Thank you for your questions.
Well, indeed sleep apnoea and obesity may cause you to have difficulty breathing when lying down, but it is more proeminent while you are asleep, which causes snoring and the "choking" episodes during sleep. However, in this case, I think that the enlarged heart (dilated cardiomyopathy) has played a great role.
During dilated cardiomyopathy, the heart has the insufficiency to throw the destinated amount to the periphery, thus keeps more blood in it, in comparison with people with a normal heart. This containment of blood means pressure to the "upper floors" of the heart, which means the lungs. This pressure to the lungs is especially reflected when one is going from standing position to lying down and it is reflected as a sudden difficulty to catch a breath, which is relieved when one sits up - paroxysmal nocturnal dyspnea.
In this regard, I would recommend you to consult your cardiologist about adding a diuretic (furosemide and/or spironolactone) to your therapy, which relieves pressures to the heart and lungs, also discontinue the beta-blocker that you may be on, since this is a class of drugs that constricts the bronchi.
Also, in the end, suction bronchodilator pumps should be prescribed to ameliorate the sleep apnea, or, after a consult with a pulmonologist, continues oxygen therapy throughout the night.
I hope my insight helps. I am happy to help, if you have any follow-up questions.
Kind regards,
Dr. Meriton