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Why Does My Chest Hurt When I Lie Down

Have you ever experienced a sensation of chest heaviness or tightness when you lie down? If so, you're not alone. Your discomfort may be related to a variety of causes, ranging from anxiety and stress to more serious medical conditions like respiratory or heart disease.

What Does Chest Tightness Feel Like?

Chest tightness often creates the sensation of pressure or constriction around the area. Some people describe it as a heavy weight on their chest, making it difficult to take a deep breath. Others describe it as a squeezing sensation, similar to wearing a wrap around your chest wall.

Although you can experience chest tightness while standing up, you may notice it more when lying down due to the body's horizontal position and the effects of gravity. When lying down, you may also notice that your body is more relaxed, and therefore, aware of this physical discomfort.

In this article, we'll review the many causes of chest pressure when lying down, accompanying symptoms to watch out for, home remedies to consider, and when to talk to your clinician about treatment.

Table to Content
Causes
Symptoms
Home Remedies
Treatments
When to Contact a Doctor

Causes of Chest Pain When Lying Down

Every person is different, so you may experience chest pain or tightness more (or less) frequently than others. Let's review the common reasons chest pain can occur: some may be environmental and preventable, while others may be due to an underlying condition that requires medical intervention.

Anxiety or Stress

We all live with stress, but that doesn't mean our bodies react the same way to it or that we use the same coping techniques to find relief. Therefore, some may be experiencing stress more often than others.

When we're stressed or anxious, our bodies release stress hormones, causing a range of physical symptoms, including chest pain or tightness ¹. And since our minds are usually less distracted at night, we may become more attuned to these physical sensations, making chest pain hard to ignore.

Stress may also trigger a panic attack, which is a sudden and intense episode of fear that is accompanied by a range of physical sensations, such as sweating, rapid heartbeat, and shortness of breath.

Again, not everyone who experiences stress will have a panic attack, but if you notice you feel anxious all the time, have difficulty sleeping, or are experiencing breathing difficulties, you'll need to find effective coping mechanisms and talk to your doctor about your symptoms.

Chronic Respiratory Conditions

Asthma, COPD (chronic obstructive pulmonary disease), and bronchiectasis are all chronic lung diseases that we've written about frequently. Though they are all different conditions, they share many similar symptoms, including chest tightness, wheezing, and shortness of breath.

If you have an underlying condition like bronchiectasis, you may experience chest pain when lying down more frequently, due to mucus buildup in the lungs, inflammation in the airways, and repeated respiratory infections.

Heart Conditions

Heart conditions such as angina or heart failure can cause chest tightness due to inadequate blood flow to the heart muscle.

Angina is a type of chest pain that occurs when the heart muscle doesn't receive adapate blood flow, usually due to a blockage in one or more of the coronary arteries. ² This can cause a feeling of heavy pressure or tightness in the chest.

Heart failure occurs when the heart is unable to pump enough blood to meet the body's needs. The result is often fluid buildup in the lungs and other parts of the body, leading to shortness of breath, fatigue, and chest tightness. ³

Acid Reflux Disease
Acid reflux disease, also known as gastroesophageal reflux disease (GERD), causes a reflux of stomach acid into the esophagus, irritating the lining of the esophagus and causing a burning sensation in the chest. ⁴

Allergies or Hay Fever

When a person comes into contact with an allergen, such as pollen, dust, or pet dander, the immune system may react by releasing chemicals like histamine. These chemicals can cause inflammation in the airways, leading to symptoms such as coughing, wheezing, and chest tightness. ⁵

In some cases, allergies can also trigger asthma symptoms.

Pulmonary hypertension

Pulmonary hypertension is a type of high blood pressure that affects the arteries in the lungs and the right side of the heart. The blood vessels in the lungs become narrowed, blocked, or destroyed, making it harder for blood to flow through them. ⁶

As a result, the right side of the heart has to work harder to pump blood, leading to chest pain or tightness, shortness of breath, fatigue, and other symptoms.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a sleep disorder that causes interruptions in breathing during sleep. During an episode of sleep apnea, the airway becomes blocked, causing the person to stop breathing for a brief period of time.

This can lead to a drop in oxygen levels and an increase in carbon dioxide levels in the blood. The body responds to these changes by increasing heart rate and blood pressure, which can cause a feeling of tightness or pressure in the chest. ⁷

Symptoms To Keep an Eye On

Chest pain, heaviness, or tightness can also be accompanied by other symptoms that include ⁸:

Shortness of Breath
Wheezing
Nausea
Dizziness

If you're living with an underlying condition like bronchiectasis, you may also be battling mucus buildup or respiratory infection. In contrast, if you're experiencing anxiety or a panic attack, you may develop a rapid pulse and begin sweating.

Since chest pain when lying down is typically caused by an underlying condition, remember to pay close attention to other symptoms. Doing so will help you inform your clinician who can then identify and diagnose the cause and recommend the best treatment for your individual situation.

Remember to be aware of how long your chest pain lasts and any triggers that make it worse.

Ask yourself:

Does it only happen when lying down?
Does it get worse when I roll over onto my side or does it feel better?
Does it last for a few minutes or hours?
Does it occur every night or less frequently?

Home Remedies for Chest Pain When Lying Down

Are you experiencing chest pressure when lying down? If you think it might be caused by environmental factors like stress or seasonal allergies, consider the following home remedies that may provide some relief and help you fall asleep.

Adjust your sleep position
Try sleeping with your upper body elevated, using a wedge pillow or stacking regular pillows to create an incline. Doing so helps keep acid from backing up into your esophagus.

Practice relaxation techniques
If you're struggling to calm down at night or feel anxious, which is triggering a heavy sensation in your chest, consider practicing relaxation techniques like deep breathing, meditation, or yoga.

There are many helpful video tutorials on breathing exercises that only take a few minutes.

Use a Heating Pad
Applying a heating pad or warm compress to your chest may help relieve some pain and discomfort.

Drink warm liquids
Drinking broth or decaffeinated tea can help soothe your throat and reduce inflammation in your chest. Herbal teas may also help calm your muscles and help you relax.

Avoid triggers
If you know certain foods, drinks, or activities cause you to experience heartburn, acid reflux, or make your heart race (i.e., caffeinated products), try to avoid them as much as possible and consider alternative options.

Treatment for Chest Pain and Tightness

If your chest pain or tightness is caused by a respiratory condition like bronchiectasis, a clinician may recommend a combination of antibiotics and airway clearance techniques.

High-frequency chest wall oscillation (HFCWO) therapy, for example, is an airway clearance device that helps remove excess mucus from the airways using a vest you wear that is connected to an air pulse generator. The generator produces high-frequency air pulses that are transmitted to the vest, which then vibrates the chest wall, thinning and loosening mucus in the lungs so it's easier to cough up and out of the airways.

Is an airway clearance vest right for you?

With HFCWO therapy devices like The SmartVest Airway Clearance System, the frequency and intensity of the air pulses can be adjusted based on your needs and tolerance. Therapy typically lasts for 30 minutes and may be performed 2 times per day, depending on your clinician's recommendations.

If your chest pain is caused by a heart disease, treatment options may include lifestyle changes, medications to reduce cholesterol levels or blood pressure, and surgery depending on the severity of the condition. ⁹

When to See Your Clinician

Do you feel chest pressure when lying down? It's important to talk to your clinician right away, especially if your pain is accompanied by difficulty breathing or other symptoms that are impacting your quality of life or ability to fall asleep.

Remember, some causes of chest pain when lying down may be due to environmental factors that you can overcome with the right coping techniques. However, if you have a serious underlying condition, early intervention is key to effective treatment that allows you to manage symptoms and get back to living life the way you were meant to.

Think your chest pain is due to bronchiectasis?

You can connect with our respiratory therapists to learn more about this chronic lung condition, get advice on how to obtain an accurate diagnosis, and tips for talking to your clinician about prescribing SmartVest to help you manage your symptoms.

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