Awakening short of breath/needing more pillows

People with heart failure may experience breathlessness when resting or lying down. The feeling that you cannot breathe may come on suddenly and can even wake you from your sleep.

You may feel more breathless lying down because the fluid in your lungs (congestion) moves with gravity, making more of your lungs wet (think of liquid in a bottle upright and then lying on its side).

You can ease your breathing in this case by using extra pillows to prop you up. If this is constantly happening, or you need more pillows, your heart failure may be getting worse. Awakening due to shortness of breath is serious. You should consult your doctor or nurse. Adjustments in your treatment may be necessary.

ESC Guidelines for Heart Failure

What patients need to know

This guide for patients from the European Society of Cardiology aims to provide an overview of the latest evidence-based recommendations for the diagnosis and treatment of heart failure.

In particular, it should help patients to understand the:

  • main types of heart failure
  • medicines used to treat heart failure
  • devices that may be appropriate
  • importance of rehabilitation
  • management by a multidisciplinary team
  • importance of self-care in managing your own condition

Learn more


A series of 9 simple, captivating animations explaining heart failure and its treatment.

These narrated animations explain how a healthy heart works, what happens to it in heart failure and how various treatments work to improve your health.


In this section you can watch, listen or read interviews with other people with heart failure and their caregivers.


and share your own views and experiences with other patients, families and caregivers. is a European Society of Cardiology website

The website was developed under the direction of the Heart Failure Association of the European Society of Cardiology (ESC). The ESC is a world leader in the discovery and dissemination of best practices in cardiovascular medicine. Our members and decision-makers are healthcare professionals who volunteer their time and expertise to represent professionals in the field of cardiology in Europe and beyond.

Back to top