Which dyspnoea symptom is relieved by sitting upright after sleep?

Which dyspnoea symptom is relieved by sitting upright after sleep?

• A. Paroxysmal nocturnal dyspnoea is relieved by sitting upright.
• B. Orthopnoea is relieved by sitting upright.
• C. Dyspnoea on exertion is relieved by rest.
• D. Chronic dyspnoea is relieved by lying flat.

Answer: (A)

Postural changes influence breathlessness because lying flat increases venous return and left-sided heart pressures, which raises pulmonary congestion and triggers dyspnea at night. Sitting upright reduces venous return and helps the lungs expand, relieving the symptoms. The nocturnal, sleep-related dyspnea that improves with sitting up is paroxysmal nocturnal dyspnea, a classic sign of left-sided heart failure. While orthopnea also improves with sitting up, the scenario describes episodes after sleep, which aligns with paroxysmal nocturnal dyspnea. Dyspnea on exertion relieved by rest and chronic dyspnea relieved by lying flat don’t fit this nocturnal postural pattern.

Postural changes influence breathlessness because lying flat increases venous return and left-sided heart pressures, which raises pulmonary congestion and triggers dyspnea at night. Sitting upright reduces venous return and helps the lungs expand, relieving the symptoms. The nocturnal, sleep-related dyspnea that improves with sitting up is paroxysmal nocturnal dyspnea, a classic sign of left-sided heart failure. While orthopnea also improves with sitting up, the scenario describes episodes after sleep, which aligns with paroxysmal nocturnal dyspnea. Dyspnea on exertion relieved by rest and chronic dyspnea relieved by lying flat don’t fit this nocturnal postural pattern.