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What Is Paroxysmal Nocturnal Dyspnea?

First of all, yes, this is tongue-in-cheek, I had to go through it a few times before I could say it right, and the zombie death scene is pretty scary! So, what does it really mean? To break it down simply- Paroxymal means a sudden burst or attack; nocturnal means nocturnal and dyspnea is shortness of breath. Paroxysmal Nocturnal Dyspnea (PND) is a condition in which there is insufficient oxygen during sleep, the lack of oxygen causes a person to cough and wheeze, and the diastolic pressure increases significantly.

So it’s not a zombie apocalypse, but most would say it’s scary. PND is a common symptom of heart failure. A person suffering from PND can be treated quickly – calling an ambulance is always the first step, but other treatments to relieve the episode include taking nitroglycerin and diuretics.

PND has similar symptoms to obstructive sleep apnea syndrome (OSA), but it is not a separate disease. PND is very different, a serious clinical condition associated with heart failure.

People who suffer from obstructive sleep apnea have a marked reduction in the sound of their breathing muscles during sleep, which obstructs the airways. An episode of apnea occurs when breathing stops.

During these breaks, the oxygen content of the blood decreases, and signals are received in the respiratory center that the tissues are in a state of hypoxia. After 10-20 seconds, the level of oxygen in the blood drops to a minimum, and the body reacts to this situation. Microstimulation of the brain increases muscle tone in the upper respiratory tract which helps with breathing. For a few seconds after that, the sleeper’s breathing is steady and deep. At this time, the person will also feel shortness of breath, even if he is not awake.

Paroxysmal Nocturnal Dyspnea Causes?

Paroxysmal nocturnal dyspnea is common among the elderly and those with heart problems, but it can affect anyone with:

• left ventricular failure during exacerbation;

• acute myocardial infarction;

• acute myocarditis;

• aneurysms of the heart;

• cardiomyopathy after birth;

• cardiosclerosis;

• mitral stenosis;

• aortic insufficiency;

• the presence of a large intracardiac thrombus or tumor.

Factors that can trigger a PND episode in a person with the medical conditions listed above include:

• pneumonia;

• kidney disease;

• problems of cerebral circulation;

• increased heart rate;

• eat a lot at night;

• hypervolemia;

• Quickly changing from a vertical to a horizontal body position.

What are the symptoms of Paroxysmal Nocturnal Dyspnea?

The most common symptoms of PND include the following:

• intermittent sleep;

• dyspnea with physical activity;

• dyspnea at night in the supine position, but relief in the sitting position;

• coughing and wheezing;

• production of sputum, sometimes with blood;

• whistling in the lungs;

• lack of air;

• pain in the chest;

• arrhythmia;

• swelling of the legs;

• tiredness and sleepiness.

Often there is an episode like this: when a person wakes up from a night dream, he feels pressure in the chest and wants to sit down, breathing is deep and difficult. The narrowing of the bronchioles causes shortness of breath, making it difficult for people to speak. When sitting, the person leans slightly forward. Their skin becomes pale due to dilated facial vessels, and sometimes sweat breaks out. PND can start suddenly and end within half an hour. People still suffer from fog when they wake up in the morning.

What Paroxysmal Nocturnal Dyspnea Causes These Symptoms?

When a person with heart disease sleeps, body fluid begins to flow from the tissues into the blood, during the day it collects in the legs or abdominal cavity. This process does not happen very quickly so after sleep there are no alarming symptoms. Paroxysmal dyspnea usually worsens after a long period of time after sleep.

In people with heart failure, the left side of the heart does not work as hard, so the small circle of blood circulation cannot affect the amount of water. This volume resides in the pulmonary arteries. This excess volume moves from the vessels into the lung tissue, leading to the development of interstitial pulmonary edema.

The most serious form of paroxysmal dyspnea is acute pulmonary edema, which occurs due to increased pressure in the pulmonary capillaries and leads to alveolar edema. Symptoms of pulmonary edema include shortness of breath, wheezing, and wheezing. Pulmonary edema causes rapid death.

How to treat Paroxysmal Nocturnal Dyspnea?

Before treatment, it is important to perform a medical assessment to determine the cause of paroxysmal nocturnal dyspnea. A proper examination, medical history, chest X-ray, ECG, cardiac ultrasound and cardiac Doppler are very important for an accurate diagnosis.

During paroxysmal nocturnal dyspnea, it is important to call an ambulance because of the high risk of pulmonary edema. The first aid for the person is to keep calm, put him in a comfortable position, and put his feet in a hot bath. Give the person sublingual nitroglycerin and repeat the medication every 5-10 minutes. If the attack is accompanied by pain and dyspnea, analgesics can also be used. Other medications may be administered depending on the cause of the disease.

The recommendation for the prevention of paroxysmal nocturnal dyspnea is smoking cessation, weight reduction in obese people and adjustment of blood pressure levels. A diet rich in fresh fruits and vegetables and avoiding highly salted foods. Air therapy is an effective way to control the disease, for use not only in the hospital but also at home.

Disease prevention includes treatment during coronary heart disease and heart failure, blood transfusion, maintaining a fluid-salt regimen, and prevention of infectious diseases.

A medical assessment should be carried out to make sure that the correct diagnosis is made, so if you think you have the symptoms of sleep apnea, it could be PND, so get it checked out by a doctor.

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