Chest Pain When Lying Down To Sleep

Written by in Sleep Health

Quick Overview

If you are experiencing chest pain when lying down, the reasons why you may experience it, vary widely in seriousness. Several risk factors can contribute to experiencing chest pain while lying down. These risk factors represent a wide range of medical conditions. Some are more serious than others. However, any time you experience unexpected chest pain, a visit to the doctor is in order.

Chest Pain Risk Factors

  • Family History
  • Aging
  • Obesity
  • High Cholesterol
  • High Blood Pressure
  • Smoking
  • Diabetes
  • Stress
  • Poor Sleep Hygiene

When we think of chest pain, we often think of cardiovascular disease, but that is not always true. Chest pain can also be symptomatic of lung conditions (pulmonary embolism), GI issues (gastroesophageal reflex), or anxiety disorders.

Never ignore chest pain that occurs with shortness of breath. Although it may not be a medical emergency, do not ignore these symptoms and consult with your doctor immediately.

Common Causes of Chest Pain When Lying Down To Sleep

There’s a wide range of causes that may result in chest pain when you lie down. Here are some common culprits:

  1. Anxiety/Panic Disorder
  2. Sleep Apnea
  3. Chronic Obstructive Pulmonary Disease (COPD)
  4. Pneumonia
  5. Chest Wall or Rib Cage Injury
  6. Pleuritis
  7. Acid Reflux
  8. Obesity

Anxiety or Panic Disorder

Sometimes when a person experiences sudden overwhelming anxiety or fear, they may experience a panic attack. The individual may experience:

  • Palpitations
  • Shortness of breath
  • Dizziness
  • Nausea and vomiting.

Some people experience extreme anxiety and the effects of anxiety can be disabling. There are available groups or one-on-one therapy that can teach you coping measures. Your doctor may also prescribe medications along with therapy.

Sleep Apnea

If your partner alerts you that you are snoring at night, it might be that you are experiencing sleep apnea. In this situation, your tongue often falls back as you sleep causing airway obstruction. This may be remedied by sleeping with your head in an elevated position or on your side. Sometimes, the person may need a special mouthguard or a CPAP (Continuous Positive Airway) machine. There have been times when symptoms of obstructive sleep apnea manifested as suspected angina.

Chest Pain When Lying Down

Whenever sleep apnea is causing chest pain when lying down to sleep, you can use a mouth guard or Continuous Positive Airway Pressure machine at night.

The symptoms of sleep apnea include:

  • Snoring during sleep
  • Headaches upon awakening
  • Having problems staying asleep
  • Exhaustion and fatigue during the day
  • A sore throat upon awakening

Chronic Obstructive Pulmonary Disease or COPD

COPD is a chronic inflammatory lung disease that results in a blockage of airflow to the lungs to the degree that it interferes with normal breathing. It is not fully reversible or curable. But, it is treatable with breathing treatments and medications. A common symptom of COPD is difficulty breathing. Symptoms include:

  • Difficulty breathing
  • Severe coughing
  • Wheezing
  • Chest tightness, discomfort or pain
  • Fever
  • Anxiety
  • Low pulse
  • Dizziness when standing or sitting down
  • Change in sputum color
  • Palpitations

COPD tends to be a progressive disease. The individual is also at higher risk for developing lung cancer and heart disease. Chronic bronchitis and emphysema are the two most common conditions that contribute to COPD. Chronic bronchitis is an inflammation of the lining of the bronchial tubes. Emphysema occurs when the alveoli (smallest part of the air passages in the lungs) are destroyed.


Pneumonia is an infection that causes an inflammation of the air sacs in the lungs. It can develop in one or both lungs. The air sacs may even fill with fluid or other pus-filled material.

Chest Pain When Lying Down

Symptoms include:

  • Chest pain
  • Fever
  • Chills
  • Shortness of breath
  • A cough that includes phlegm or pus
  • Palpitations

Bacteria, viruses, and fungi can cause pneumonia. Medical treatment is required.

Chest Wall or Rib Cage Injury

Chest wall pain can after an accident, injury, or by movement resulting in a strain. If you have chest wall pain, you may experience pain when lying down to sleep, especially if you often change positions. Treatment may involve rest and over-the-counter pain medications.

Pleuritis (Pleurisy)

Pleuritis is a medical condition caused by an inflammation of the lining around the lungs (the pleura.) Causes include viral, bacterial or fungal infections, certain medications, or autoimmune disorders, or rib fractures. Symptoms include:

  • Sharp chest pain that gets worse with breathing, coughing, sneezing or lying down
  • Shortness of breath
  • Cough
  • Fever
  • Shoulder or back pain

Pulmonary Embolism

This is considered a medical emergency. It occurs when a blood clot travels to the lungs. Typically, the clot originates from a deep vein in the legs. The individual may experience:

  • Chest pain
  • Back pain
  • A cough
  • Shortness of breath
  • Fever
  • Sweating

Coronary Artery Disease

Coronary artery disease is the most common form of heart disease. It is caused by plaque building up in our blood vessels leading to a partial or complete blockage. Plaque is made up of cholesterol, fat, calcium and other substances. Angina chest pain is a type of chest pain caused by narrowing of the coronary arteries. A complete blockage of blood flow in one of the coronary arteries can cause a heart attack.

Symptoms include:

  • Shortness of breath
  • Irregular heartbeat (palpitations or a “flip-flop” feeling)
  • Angina
  • Dizziness
  • Weakness
  • Fatigue


The pericardium is the two layers that surround the heart. A small amount of fluid keeps the layers separated. Sometimes the pericardium becomes inflamed. The condition can result as a result of an infection, injury, medication, heart attack, heart surgery, autoimmune disorders, as well as a number of other medical conditions. Complications of pericarditis include chronic pericarditis.

Aortic Dissection

This is a medical emergency that occurs when a tear develops in the major artery carrying blood out of the heart (aorta.) Blood can flow between the layers of the blood vessel wall. Causes include chronic high blood pressure that can stress the aortic tissue, an enlarged aorta, or medical conditions such as Marfan syndrome. Symptoms include:

  • Sudden, severe chest, upper back pain or stomach pain
  • Loss of consciousness
  • Leg pain/paralysis
  • Difficulty with walking
  • Weak pulse on one side of the body
  • Shortness of breath
  • Stroke symptoms: difficulty speaking, vision loss, weakness/paralysis on one side of the body

Acid Reflux

Acid Reflux also is known as gastroesophageal reflux disease (GERD) occurs when occurs when the acid around the stomach flows back towards the esophagus. Discomfort can increase when you lie down as the levels of acid are heightened backflow straight to the esophagus. The lower esophageal sphincter, a group of muscles at the low end of the esophagus where it meets the stomach, is responsible for keeping your food and acid from regurgitating. When it does not close properly, stomach contents can creep back up the esophagus. This condition can worsen at night.
Chest Pain When Lying Down
Symptoms include:

  • Bloating
  • Burping
  • Hiccups
  • Bloody/black stools
  • Nausea
  • Heartburn
  • Severe chest pain
  • Squeezing or crushing chest sensation


If you are on overweight or obese, you can experience chest pain and when lying down to sleep. This is due to the excess weight that places too much pressure around the lungs and diaphragm area of the body. Or, obesity can be a symptom of cardiac or lung conditions that cause chest pain while lying down to sleep.

You can try to sleep on your side with your head elevated by pillows or by using an adjustable bed. Consult with your physician about weight loss plans. Losing excessive weight can help prevent any further health complications.

Alzheimer’s Disease

In a study published in the medical journal of the American Academy of Neurology, people with Alzheimer’s Disease who have high blood pressure, chest pain, or an irregular heartbeat may lose their memories faster than those who have Alzheimer’s without those symptoms.

When To Seek Help?

Any time you have chest pain with shortness of breath, you should seek immediate medical care.

The physician will conduct a history and physical. It can be really challenging to determine the origin of chest pain when lying down to sleep, as it is a symptom of several disease processes. It’s essential to determine the characteristics of the pain (aching vs sharp), location if the pain worsens with different positioning, any other signs, and symptoms that accompany the chest pain. The doctor may also order blood and heart tests.

Chest pain when lying down to sleep can be acute or chronic. It can be indicative of a medical emergency or aging. Depending on the cause, chest pain may be corrected with medication or a change in sleep positions.
Determining the cause of your chest pain is necessary to avoid poor sleep. Proper sleep hygiene is necessary to be able to obtain a restorative night’s sleep.

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Frequently Asked Questions

Can sleeping position cause chest pain?

Chest pain can be made worse by your sleeping position, particularly when you are lying down. It’s best to consult a doctor if you experience chest pain to determine the root cause, as it could be resulting from any number of issues including sleep apnea, an injury, pleuritis, acid reflux, obesity, and other serious conditions.

Why does my chest hurt only at night?

Chest pain often occurs at night because that is when you are lying down. The lying down position can cause flare ups of pain caused by certain conditions, like acid reflux. The pain could also be due to a cardiac or lung condition, obesity, or an injury, all of which should be discussed with a doctor.

Why does my chest hurt after waking up?

There are a number of acute and chronic reasons why your chest might hurt when waking up. These range from a minor issue like indigestion to the effects of sleep apnea or obesity. It could also be a sign of a more serious lung or cardiac condition.