Wheezing On Exhalation When Lying Down: Causes and Treatments

Medically reviewed by Dr. Mandy Liedeman

Key Takeaways

  • Wheezing on exhalation when lying down can be caused by various respiratory and cardiac conditions such as asthma, heart failure, GERD, allergies, obstructive sleep apnea, COPD, pleural effusion, bronchitis, and pneumonia.
  • Adjusting your sleeping position, avoiding meals before bedtime, avoiding caffeine and alcohol, using a humidifier, maintaining a clean sleeping environment, managing allergens, and avoiding triggers can help alleviate wheezing symptoms when lying down.
  • Following your asthma or respiratory condition management plan, staying hydrated, and seeking medical advice if wheezing persists or worsens despite self-care measures are essential.
  • When lying down on the left side, wheezing may be caused by conditions such as GERD, heart failure, positional asthma, left-sided lung conditions, or environmental triggers.
  • If wheezing is severe, accompanied by chest pain, difficulty breathing, fever, or other concerning symptoms, it is essential to seek immediate medical attention. A doctor can evaluate your symptoms, conduct necessary tests, and provide appropriate treatment


As we lay down to rest after a long day, the world around us grows quiet, and our bodies seek solace in the embrace of sleep. However, for some individuals, this seemingly peaceful transition can be disrupted by an unexpected and unsettling phenomenon: wheezing on exhalation when lying down. It’s a perplexing issue that can leave many wondering about its causes, implications, and potential remedies. In this article, we will discuss in detail on this topic.

Causes of a Wheeze When Exhalating on Lying Down

Expiratory wheezing, commonly known as wheezing on exhale, is a typical symptom of several respiratory disorders. It happens when the airways get constricted or blocked, turbulence in the airflow results, and a whistling or high-pitched sound is made when exhaling.

Let’s delve into the details of the possible causes behind wheezing on exhale when lying down:

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Asthma and Wheezing

Asthma is a chronic respiratory issue characterized by airway inflammation and constriction. Gravity impacts the distribution of mucus and can cause more airway resistance, resulting in wheezing when lying down. This could indicate uncontrolled asthma, and it’s critical to visit a healthcare practitioner to examine and, if required, change therapy. Chest tightness, coughing, and shortness of breath are all possible asthma symptoms.

Heart Failure Causing Wheeze

While uncommon, wheezing on exhalation while lying down has been linked to heart failure. The heart’s pumping ability is reduced with this illness, resulting in fluid buildup in the lungs. Wheezing may occur due to the presence of fluid when breathing. This makes it harder to breathe when lying down. Additional symptoms such as shortness of breath, exhaustion, limb swelling, and rapid weight gain should be noted, as these may suggest the need for quick medical intervention.

GERD (gastroesophageal reflux disease) and Wheezing in Sleep

It is when stomach acid runs back into the esophagus, causing symptoms like heartburn, regurgitation, and, in rare cases, coughing and wheezing when lying down. Because of changes in body position when lying down, the probability of acid reflux increases. Acid reflux can irritate the airways, causing wheezing on exhalation. It’s crucial to note that acid reflux-related wheezing is usually not accompanied by other respiratory symptoms like coughing or shortness of breath.

Allergies Leading to Wheezing When Sleeping

These occur when the immune system reacts abnormally to harmless substances, such as pollen, dust mites, pet dander, or certain foods. When an allergic individual comes into contact with an allergen, their immune system perceives it as a threat and releases chemicals like histamine, leading to various allergic symptoms.

Allergic Rhinitis

Allergy rhinitis, sometimes known as hay fever, is a common allergy illness linked with wheezing on exhalation when lying down. Allergic rhinitis is characterized by nasal passage inflammation caused by airborne allergens like pollen or mould spores.

The nasal passages can become swollen and congested when an allergic reaction occurs. This congestion can worsen when lying down due to gravity, leading to postnasal drip, which is the excess mucus dripping down the throat. This postnasal drip can irritate the airways, causing wheezing on exhale.

Additionally, allergic rhinitis can lead to nasal congestion and blockage, making air passage through the nose difficult. This can result in a switch to mouth breathing, contributing to wheezing during exhale.

Pulmonary Edema leading

Pulmonary edema, characterized by fluid accumulation in the lungs, can cause wheezing when lying on exhale.

It occurs when there is an abnormal fluid buildup within the air sacs (alveoli) and the surrounding tissues in the lungs. This fluid accumulation interferes with the customary exchange of carbon dioxide and oxygen, leading to respiratory symptoms such as wheezing, shortness of breath, and coughing.

The primary causes of pulmonary edema can be categorized into two main types: cardiogenic and non-cardiogenic.

Cardiogenic Pulmonary Edema

Cardiogenic pulmonary edema occurs due to problems with the heart’s ability to pump blood effectively. It is commonly caused by congestive heart failure (CHF), a condition in which the heart becomes weakened or damaged, leading to inadequate circulation. 

Non-Cardiogenic Pulmonary Edema

Non-cardiogenic pulmonary edema occurs without directly affecting the heart’s pumping function. It can be caused by various factors, including:

  • Acute Respiratory Distress Syndrome (ARDS): ARDS is a severe lung condition often triggered by lung injury, such as pneumonia, sepsis, trauma, or inhalation of harmful substances. The lung injury triggers an inflammatory response, leading to increased permeability of blood vessels in the lungs. This increased permeability allows fluid to leak into the air sacs and surrounding tissues, resulting in pulmonary edema and wheezing.
  • High Altitude Pulmonary Edema (HAPE): HAPE can occur in individuals who ascend rapidly to high altitudes. It is characterized by fluid accumulation in the lungs due to changes in pulmonary blood vessel pressure at higher altitudes. HAPE can cause wheezing and other respiratory symptoms.
  • Kidney Failure: Severe kidney dysfunction or failure can lead to fluid overload in the body, including the lungs, resulting in pulmonary edema.

Obstructive Sleep Apnea (OSA)

A type of sleep disorder in which repeated episodes of upper airway partial or complete obstruction occurs while the person is asleep. The tongue muscles and throat relax when lying down, which causes the airway to collapse. Affected breathing patterns from this blockage include pauses in breathing, snoring, and wheezing at night. People with OSA frequently have exhaustion, difficulty concentrating, and excessive daytime sleepiness.

Chronic Obstructive Pulmonary Disease (COPD) and Exhalation Wheeze.

It is a lung condition that encompasses emphysema and chronic bronchitis. In COPD, the airways become inflamed, and the lung tissues lose elasticity. When lying down, the already compromised airways can further narrow, leading to coughing and wheezing at night only in adults. Reduced lung capacity in COPD makes it harder for air to flow in and out of the lungs, exacerbating symptoms when lying flat.

Pleural Effusion

Pleural effusion refers to the accumulation of fluid between the layers of the pleura, which are the membranes surrounding the lungs. When fluid accumulates, it can compress the lungs and compromise their function. When lying down, gravity causes the fluid to shift, potentially leading to increased pressure on the airways and wheezing.

Bronchitis Leads to Wheezing on Exhale. 

It is an inflammation of the bronchial airway, which carries air to and from the lungs. It can be acute or chronic. In acute bronchitis, often caused by viral infections, the airways inflame and produce excess mucus, leading to coughing and wheezing. The accumulated mucus can further obstruct the airways when lying down, resulting in wheezing during exhalation.

Pneumonia and Wheezing

The air sacs in one or both lungs become inflamed due to the infection. Bacteria, viruses, or fungi can cause it. Pneumonia leads to inflammation and fluid accumulation in the lungs, which can cause wheezing when lying down. The infection can also cause bronchospasm, narrowing the airways and producing wheezing sounds during exhalation.

Shortness of breath when lying down that is relieved by sitting up is known as orthopnea. It can be caused by underlying conditions such as heart failure, pulmonary edema, obstructive sleep apnea, chronic obstructive pulmonary disease (COPD), or certain respiratory infections.

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How to Sleep with Wheezing?

Wondering how to get rid of wheezing? Sleeping with wheezing can be challenging, but some strategies can help improve sleep quality and alleviate wheezing symptoms. Here are some tips:

Adjust your Sleeping Position

Elevating your upper body can help you breathe better and stop wheezing. This can be accomplished by utilizing an additional pillow or raising the head of your bed using risers. Sleeping in a semi-upright position can help reduce wheezing and improve breathing.

Avoiding Meals Before Going to Bed

People suffering from GERD should eat at least 2-3 hours before lying down. This can minimize acid reflux at night, minimizing esophageal irritation.

Avoid Caffeine and Alcohol

Caffeine and alcohol both increase the likelihood of experiencing asthma symptoms. Caffeine might aggravate acid reflux as well.

Keeping Medications Nearby

While lying down or sleeping, have drugs or inhalers that aid with breathing close. People might utilize them as soon as they wake up owing to wheezing.

Use a Humidifier

Dry air can aggravate wheezing symptoms by irritating the airways. Using a humidifier in your bedroom to assist in minimizing wheezing by adding moisture to the atmosphere. To avoid mould growth, choose a cold mist humidifier.

Maintain a Clean Sleeping Environment.

Dust mites, pet dander, and other allergens can trigger wheezing. Keep your bedroom neat and dust-free by regularly vacuuming, dusting surfaces, and washing bedding in hot water. Consider using allergen-proof covers for pillows and mattresses.

Manage Allergens.

If you have known allergies, minimize exposure to allergens that can trigger wheezing. This may include keeping windows closed to prevent pollen from entering, avoiding contact with pets if you’re allergic to animal dander, and regularly cleaning and dusting your bedroom.

Avoid Triggers Before Bedtime.

Certain factors can worsen wheezing, such as exposure to smoke, strong odours, or cold air. Avoid these triggers before bedtime to minimize wheezing symptoms during sleep.

Follow Your Asthma or Respiratory Condition Management Plan

You must adhere to your treatment plan if a persistent respiratory ailment causes your wheezing. Take your meds as your doctor prescribes, and make sure your condition is well-managed to reduce nighttime wheezing.

Stay Hydrated.

Drinking enough water can help thin mucus discharges and improve breathing. Maintain appropriate hydration during the day, but avoid excessive fluid consumption close to bedtime to minimize sleep interruptions.

Seek Medical Advice

If wheezing during sleep persists or worsens despite self-care measures, it’s essential to consult with your healthcare provider. They can evaluate your symptoms, determine the underlying cause, and adjust your treatment plan.

Can mucus in throat cause wheezing? Speak with Online Doctor

Wheezing When Lying Down on Your Left Side

It can be caused by conditions such as

Gastroesophageal Reflux Disease (GERD)

Acid reflux can worsen when lying on the left side, leading to irritation of the airways and wheezing.

Heart Failure

Fluid accumulation in the lungs due to heart failure can cause wheezing, and lying on the left side can exacerbate this symptom.

Positional Asthma

Some individuals with asthma may experience wheezing triggered by specific positions, including lying down on the left side. They may complain of wheezing in the throat when lying down. 

Left-Sided Lung Conditions

Certain lung conditions that primarily affect the left lung, such as pulmonary fibrosis or tumours, can lead to wheezing when lying on the left side.

Environmental Triggers

Exposure to allergens or irritants present in the sleeping environment when lying on the left side can trigger wheezing in susceptible individuals.

When should you go to the doctor for wheezing?

Wheezing while lying down could indicate major medical issues, so consult your doctor immediately. Prepare to explain your symptoms and provide medical history information. To check your heart and lung condition, your doctor may order a chest X-ray and an echocardiography.

Severe difficulty breathing while lying down needs immediate medical attention, mainly if any of the following symptoms accompany it:

  • Shooting pains in the arms and neck
  • Increased heart rate
  • Acute chest pain
  • Dizziness
  • Fever
  • Weak pulse
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Why is Wheezing Worse at Night?

You may wonder, “Why do I wheeze at night?” Wheezing worsens at night due to muscle relaxation in the throat and airways, narrowed upper airway, increased lung resistance, and the effects of gravity when lying down. Conditions like asthma, allergies, or respiratory infections can trigger airway inflammation and wheezing during sleep. Allergen exposure in the bedroom can also worsen night-time wheezing.

How do I know if my wheezing is serious?

Severe or persistent wheezing, along with symptoms such as shortness of breath, chest pain, a blueish tint to the skin, fever, or a history of asthma or other lung diseases, should be taken seriously and evaluated by a medical specialist. These signs may indicate a more serious underlying condition of wheezing on lying down that requires medical attention.

How to stop asthma wheezing without an inhaler?

When faced with asthma wheezing without an inhaler, Staying calm and relaxed is essential. Maintaining an upright posture and sitting up straight, practicing controlled breathing, taking slow breaths through the nose and exhaling slowly through pursed lips can help regulate breathing and reduce wheezing. Drinking warm, caffeine-free liquids like water or herbal tea can help soothe the airways. Additionally, using a humidifier or sitting in a steamy bathroom can add moisture to the air and ease airway inflammation.

How to stop wheezing without an inhaler?

To alleviate wheezing without an inhaler, sit upright to open your airways, take slow, deep breaths, and stay calm to prevent anxiety from worsening wheezing. Move away from triggers like pollen or allergens if possible. Drink warm liquids to loosen mucus, use a humidifier or hot shower to moisten the airways, and consider using a spacer with a rescue inhaler for more effective medication delivery.

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