People with the genetic condition known as Alpha-1 Antitrypsin Deficiency can suffer from a breakdown of elastin and collagen which can lead to airway collapse such as tracheomalacia (weakness in the windpipe cartilage). This condition is sometimes referred to as ‘floppy airways’.
This type of airway obstruction can lead to breathing challenges and is sometimes present in people with chronic obstructive pulmonary disease (COPD), bronchitis, Gastroesophopageal relux (GERD) and Asthma too.
Why Sleeping Lying on Your Back Can Make Breathing Difficult
Lying on your back (supine position) while sleeping can add pressure to a weak airway (i.e. the tracheal wall), with the weakness and gravity making the airway collapse inward – narrowing the airway sometimes up to 90%.
Options to Consider if You Are Waking Up Struggling to Breath
- A sleep study
- Dynamic flexible bronchoscopy
- Imaging such as a CT scan
Potential Interventions to Consider
- Airway clearance in the afternoon/evening to reduce airway mucus/sputum before bed
- Side-sleeping to keep the airways open
- Use of a CPAP machine to keep the airways open (prescribed by your respiratory specialist)
- In more severe cases, stents or splints can be placed in the airway.
Conclusion
Ensuring a good supply of oxygen to your organs is important as is a good night’s sleep. Knowing the severity and type of airway collapse can assist a respiratory physician determine what medical investigations and treatment options are best for you if you are struggling to breath at night from airway obstruction.
References
Buitrago DH, Wilson JL, Parikh M, Majid A, Gangadharan SP. Current concepts in severe adult tracheobronchomalacia: evaluation and treatment. J Thorac Dis. 2017 Jan;9(1):E57-E66. doi: 10.21037/jtd.2017.01.13. PMID: 28203438; PMCID: PMC5303067.
McGinn J, Herbert B, Maloney A, Patton B, Lazzaro R. Quality of life outcomes in tracheobronchomalacia surgery. J Thorac Dis. 2020 Nov;12(11):6925-6930. doi: 10.21037/jtd.2020.03.08. PMID: 33282396; PMCID: PMC7711398.