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Evidence Based

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What to Do if You Have Trouble Breathing at Night

Written by Dr. Michael Ruscio, DC on June 9, 2022

Written by Dr. Michael Ruscio, DC on June 9, 2022 — Reviewed by Hilary Watts

How to Get Fast Relief for Your Nighttime Breathing Problems

• Causes of Trouble Breathing at Night|
• Home Remedies|
• When It’s Time to See A Doctor|
• Put an End to Your Trouble Breathing at Night|

If you’ve been struggling with getting a good night’s rest, you’re not alone. Research shows that one in four people don’t get enough sleep, and insomnia rates in the United States are nearly three times higher than that of other countries [1]. While chronic stress, hormonal imbalances, and a host of other medical conditions can be to blame, many people’s poor sleep quality is due to trouble breathing at night. 

Allergies, asthma, anxiety, and obstructive sleep apnea (OSA) are just a few of the various conditions that are behind sleep-disordered breathing. Many of these concerns cause changes in the upper and lower airways that can lead to snoring, gasping for air during the night, feeling excessively tired during the day, and an overall decreased quality of sleep (and life). 

While identifying and addressing the root cause of your nighttime breathing difficulties are essential for improving your sleep, there are several simple, safe, and effective treatments that you can try at home. Breathing techniques, positional therapies, and exercise can all help to improve breathing at night. Even better, they’re safe, effective, and inexpensive. 

But when at-home treatments don’t seem to resolve your symptoms, your symptoms are severe, or you’re dealing with a chronic health condition (like lung or heart disease), it’s probably best to see a doctor for your trouble breathing at night. 

What Is Causing Your Trouble Breathing at Night? 

There are many factors that can contribute to trouble breathing at night (and during the day). Some culprits of nighttime breathing difficulties include: 

• Asthma [2]
• Chronic obstructive pulmonary disease (COPD) [3]
• Obstructive and central sleep apnea [4, 5]
• Panic attacks/anxiety [6, 7, 8, 9]
• Allergies [10]
• Congestive heart failure [11]
• Heart attack [12]
• Bronchitis [13]

Obstructive sleep apnea (OSA) is one of the most common causes of nighttime dyspnea (shortness of breath) and is created by a partial collapse of the tissue in the upper airway. This causes oxygen levels to drop, often leading to frequent nighttime awakenings [5].

Signs You’re Not Getting Enough Air at Night

There are many warning signs that you may be dealing with sleep apnea, or another type of sleep-disordered breathing, but the following are some of the most common: 

• Waking up gasping for air [5]
• Snoring [5]
• Waking during the night with an elevated heart rate
• Night sweats [5]
• Excessive daytime sleepiness
• Nighttime reflux [5]

Obstructive sleep apnea can range from mild to severe, and for many it significantly affects their quality of life. In fact, even those with mild sleep apnea may be at an increased risk for cardiovascular disease, including hypertension, stroke, and coronary artery disease. OSA is even linked to certain mental health disorders, like depression, and puts you at an increased risk for driving-related accidents [5].

Taking your sleep seriously is not only important for relieving sleep-related complaints and fatigue, but is crucial for improving your overall health and well-being. However, getting a sleep study can be time-consuming, expensive, and a little invasive (who really wants someone watching you while you sleep?). 

I’ve put together a guide that reviews the research behind a few at-home treatments that may help resolve your trouble breathing at night, and which can be tried before seeing your doctor. Please keep in mind that if you have severe sleep apnea symptoms, heart disease, COPD, asthma, or any other chronic health condition, it’s best to keep your healthcare provider in the loop while trying out the below therapies.

Home Remedies for Trouble Breathing at Night

There are several at-home treatments that can help relieve nighttime breathing problems, especially if you suspect that you may have sleep apnea.

When your trouble breathing at night is linked to a clear underlying cause, like obesity, allergies, or anxiety, the best place to start is with treating the root cause. Changing your diet, meditation, weight loss, and healing your gut can all be helpful for relieving your symptoms and improving your sleep. We have several articles on these topics, so feel free to check them out. 

But first, let’s see what you can do at home to help you breathe better at night.

Oropharyngeal Rehabilitation

Oropharyngeal rehabilitation is an umbrella term for a group of exercises that tone and re-educate the muscles and nerves of the upper airway. These exercises help keep your airway open and can improve nighttime breathing [14].

These techniques may be especially effective with those who have diagnosed or suspected obstructive sleep apnea. However, as the following therapies all help to improve overall airflow, you may find the following to be helpful if your trouble breathing at night is due to another cause as well.

Breathing Training and Oropharyngeal Exercises

Exercises that strengthen the muscles involved in breathing, like the diaphragm and muscles in the back of the throat, can lessen sleep apnea by nearly 40%, improve sleep quality, and reduce snoring in both children and adults [15]. These exercises are inexpensive (often at no cost) and can be completed at home.

The Buteyko method uses breathing techniques that encourage nasal over mouth breathing and focuses on increasing breathing awareness and control. This method (along with other types of oropharyngeal exercises) may help improve nighttime breathing in those with sleep apnea [16].

While more research is needed to determine the effectiveness of this particular breathing protocol, there are many types of breathing training and oropharyngeal exercises that are easy to incorporate into your daily routine. 

EMST150 (Expiratory and Inspiratory Muscle Strength Training)

A novel device called the EMST150 may be an effective and quick way to improve your sleep apnea or other sleep-disordered symptoms, without having to undergo a sleep study first. It’s far less invasive than a continuous positive airway pressure (CPAP) device (the first-line therapy for sleep apnea), is inexpensive, and easy to do at home. 

This tube-shaped device works by strengthening your primary breathing muscles, like the diaphragm, abdominal muscles, and rib muscles, while tonifying your muscles in the back of the throat [17, 18, 19]. This helps restore normal breathing and can prevent the upper airway collapse at night that can lead to sleep apnea.

Preliminary research suggests that these types of muscle-training devices may improve sleep apnea, sleep quality, and daytime sleepiness in those with OSA, and improve breathing in other chronic health conditions, like COPD and asthma [14, 19, 20, 21]. It can even improve difficulties with swallowing [18], which is believed to contribute to trouble breathing at night. 

For the best results, breathe into this device over five breath cycles and repeat five times, taking a brief rest between each set. It’s recommended that you try this daily over five weeks to see if it works for you. This device may not be safe for everyone, and its use is contraindicated in:

• Pregnancy
• History of abdominal hernias or hernia surgery
• Uncontrolled/untreated high blood pressure, asthma, or acid reflux
• Ruptured eardrum

While it doesn’t require a prescription, it may be best to consult with your healthcare provider if you have an underlying health condition and are interested in using this device to make sure that you’re a good candidate. 

Diet and Exercise

Changing your diet and engaging in physical activity may be particularly beneficial for those who have sleep apnea due to excess weight [22, 23]. However, the effects of diet and exercise likely extend to many other causes of sleep-disordered breathing, due to their numerous health effects. If finding the right diet to suit your needs seems intimidating, try starting with an anti-inflammatory diet, like the Paleo diet, to see if it works for you.

Regular, daily exercise has been shown to help adults sleep nearly 20% better, overall [24]. Research shows that physical exercise can improve obstructive sleep apnea and the excessive daytime sleepiness that is frequently associated with OSA [25, 26].

It can even help those whose disordered breathing comes from asthma, as exercise can improve both general and nighttime symptoms of asthma [27, 28]. Of course if you have moderate-to-severe or uncontrolled symptoms of asthma you should consult with your doctor before beginning an exercise routine, and always keep your rescue inhaler on-hand. 

Limit Alcohol Use

One simple and effective way to help improve your breathing while you sleep is by cutting back on your alcohol consumption (especially before bed). Alcohol relaxes the soft tissues and muscles of the throat and can lead to sleep-disordered breathing. 

While many people use alcohol for its sleep-promoting effects, it actually can be highly disruptive to your natural sleep cycles and is one of the biggest risk factors for obstructive sleep apnea [5, 29].

Other Strategies to Improve Breathing

A proper diet, exercise, and breathing rehabilitation exercises are a great foundation for improving your breathing while you sleep. However, below you’ll find a few other simple and effective strategies that you can try at home when you have trouble breathing at night. 

Mouth Taping

A few alternative medicine circles are promoting the use of “mouth tape” to improve nighttime breathing. This technique uses tape to secure the lips shut just before bed, in order to encourage breathing through the nose.

One physician’s anecdotal experience found this method helpful in reducing his snoring and improving energy [30], but so far there’s insufficient research to back up this at-home therapy. While I personally have experimented with mouth taping and did not find it effective for improving my sleep, that doesn’t necessarily mean that it won’t work for you.

The lack of research isn’t to say that mouth taping doesn’t have clinical benefits, but it does highlight the importance of having a little bit of skepticism when reading about and trying out new healthcare trends. Unless you have a nasal obstruction or other condition that restricts nasal breathing, mouth taping likely doesn’t cause any harm. If you’re just experimenting with ways to improve your sleep (or smartwatch sleep scores) it could be worth a try.

However, if you’re dealing with a chronic health condition like OSA or another type of sleep-disordered breathing, it’s probably best to work with more research-backed techniques.

Air Purifiers

If your trouble breathing at night stems from seasonal allergies or asthma, an air purifier may help you get a better night’s rest by filtering allergens and dander. Research shows that air purifiers can reduce inflammation and asthma symptoms while improving overall quality of life [31]. While there’s no research that directly correlates the use of air purifiers with better sleep, if your trouble breathing at night stems from inflammation (e.g. allergies and asthma) it’s safe to assume that you’ll likely benefit. 

HEPA filters appear to show the most health benefits over other types of air purifiers [31], and be sure to place it in the same room that you sleep in for the best effects.

Positional Therapy 

In those with sleep apnea, using a special pillow or mattress that encourages you to sleep on your stomach can eliminate the need for a CPAP and improves the flow of oxygen three times more than those who sleep on their backs [32]. Even better, positional therapy may disrupt your sleep less than a traditional CPAP device [33].

When It’s Time to See a Doctor

When home remedies don’t seem to work, your symptoms are severe, or they continue to worsen, it’s probably time to seek out medical advice for sleep disorders. A sleep specialist, ENT, dentist, or specialized physical therapist can all assist in diagnosing and treating upper airway disorders that can contribute to trouble breathing at night. 

If your difficulty breathing is related to a significant chronic health condition like lung disease or heart disease, it’s best to find a healthcare provider right away, rather than waiting to see if home remedies work first. These conditions require immediate, specialized attention. 

Below I’ll discuss some treatment options that your doctor may prescribe for sleep-disordered breathing. 

Mandibular Advancement Devices And CPAP Machines

Continuous positive airway pressure (CPAP) machines and mouthguards that improve airflow in the upper respiratory tract are often the first-line treatments for sleep apnea. These require a prescription from a sleep specialist or dentist, are frequently prescribed after undergoing a sleep study, and once you have been diagnosed with sleep apnea. 

A CPAP device uses a hose attached to a mask that fits over your mouth and/or nose to deliver constant airflow throughout the night [25, 26]. This helps to keep your airway open and delivers outside oxygen directly into your respiratory tract. While the CPAP does effectively improve signs and symptoms of sleep apnea [25], it’s more invasive than other treatments and can be expensive and cumbersome to use. 

If you have mild-to-moderate sleep apnea, you may want to try out less invasive (and cheaper) therapies, like strengthening your breathing muscles or making dietary changes, before moving onto a CPAP machine. 

If your doctor determines that you’re a good candidate, a mandibular advancement device is a type of mouthguard, fitted by a dentist, that repositions the soft tissue in your upper airway to improve airflow at night. It’s less invasive than a CPAP device and can improve symptoms of OSA and increase oxygen levels during sleep [25, 26, 34]. While they can still be expensive, they’re more convenient than a CPAP machine.

Myofunctional Physical Therapy 

Myofunctional therapy is a specialized type of physical therapy that corrects the muscles involved in breathing, swallowing, sucking, chewing, and speech [35]. It’s shown to be effective in lessening the number of apneas (pauses in breathing during sleep), and can help reduce snoring and daytime fatigue [36, 37].

Keep in mind that this type of physical therapy may not be covered by insurance and can be expensive and time-consuming. However, if you’re dealing with moderate-to-severe sleep apnea this may be a great adjunctive therapy to standard treatments, like a CPAP machine.

Put an End to Your Trouble Breathing at Night

If you’ve been waking up gasping for air or your partner has complained about your persistent snoring, you may have sleep disordered breathing. Fortunately, there are several at-home treatments you can try before having to see a sleep specialist to undergo a sleep study. 

Oropharyngeal exercises, breathing techniques, and positional therapies are just a few of the research-backed treatments that can help with your trouble breathing at night. However, if your symptoms are severe, home remedies don’t seem to do the trick, or you have a chronic health condition that affects your breathing, it’s probably time to see a healthcare professional. 

For help with disrupted sleep, daytime fatigue, or any other health concerns, don’t hesitate to reach out to our clinic at the Ruscio Institute for Functional Medicine for help from one of our highly experienced providers. You can also learn all about how our gut affects sleep in my book, Healthy Gut, Healthy You. 

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.