From the Research
COPD and Orthopnea
- Chronic Obstructive Pulmonary Disease (COPD) can cause orthopnea, which is characterized by shortness of breath when lying down 1, 2, 3.
- Studies have shown that patients with advanced COPD experience an increase in breathing discomfort, inspiratory work of breathing, and inspiratory effort when in a supine position, leading to orthopnea 1.
- The mechanisms of orthopnea in COPD are complex and involve changes in lung mechanics, including dynamic lung compliance and inspiratory neural drive 1, 2.
Key Factors Contributing to Orthopnea in COPD
- Tidal expiratory flow limitation (FL) is a key factor in the development of orthopnea in patients with stable COPD 2.
- Dynamic pulmonary hyperinflation and increased inspiratory threshold load due to intrinsic positive end-expiratory pressure also contribute to orthopnea in COPD patients 2.
- Increased airway resistance in the supine position may also play a role in the genesis of orthopnea 2.
Management of Orthopnea in COPD
- Effective management of orthopnea in COPD requires a comprehensive approach, including interventions that reduce inspiratory neural drive, improve respiratory mechanics, and address the affective dimension of dyspnea 4.
- Therapies such as bronchodilators, exercise training, ambulatory oxygen, inspiratory muscle training, and opiate medications may help alleviate orthopnea and improve exercise tolerance in COPD patients 4.