What Causes Low Oxygen While Lying Down?

Last updated: January 28th, 2024

Have you ever woken up in the middle of the night, gasping for air? Or experienced a sudden shortness of breath while lying down? If so, you’re not alone. These are common symptoms of low oxygen levels, a health concern that affects countless individuals worldwide.

This post will shed light on what causes low oxygen while lying down, the signs, and management of this issue, arming you with the knowledge you need to take control of your health.

Key Takeaways

  • Low oxygen levels, or hypoxia, can be caused by conditions such as sleep apnea, heart failure, and COPD, leading to symptoms like fatigue, dizziness, and shortness of breath.

  • Specific lifestyle changes, sleeping positions, and medical treatments including CPAP machines, can manage and improve low oxygen levels while lying down.

  • Recognizing the signs of a medical emergency related to low oxygen levels is vital for prompt treatment, with critical symptoms including blue discoloration of the skin or lips, chest pain, and severe shortness of breath.

Understanding Low Oxygen Levels

Pulse oximeter measuring blood oxygen levels

Low oxygen levels, or hypoxia, is a condition where the body or a region of the body is deprived of adequate oxygen supply. It varies from mild to severe, with the typical range for normal blood oxygen level being between 95-100%.

Low oxygen levels can trigger a variety of symptoms, such as:

  • fatigue

  • distraction

  • dizziness

  • nausea

  • breathing difficulty

It’s important to monitor blood oxygen saturation levels as persistent low levels can inflict harm on vital organs and even pose a risk of fatality. Oxygen saturation can be measured using pulse oximetry, a non-invasive method that uses a small clip on the finger. For a more precise measurement, arterial blood gas analysis can be employed.

Oxygen levels can be affected by diseases such as asthma or COVID-19. Moreover, during sleep, natural slowing of breathing can cause oxygen levels to drop, reducing the oxygen transported in the blood.

Common Causes of Low Oxygen While Lying Down

Person using a CPAP machine for sleep apnea

While several factors can cause blood oxygen levels drop while lying down, some of the most common include sleep apnea, heart failure, and chronic obstructive pulmonary disease (COPD). These conditions often lead to disrupted sleep and pose significant health complications.

Sleep Apnea

Sleep apnea, specifically obstructive sleep apnea, is a medical condition characterized by repeated interruptions in breathing during sleep, leading to decreased oxygen levels in the body and excessive daytime drowsiness. This primarily happens due to the relaxation of the muscles in the throat that obstructs the airways, especially when lying on the back.

Individuals suffering from sleep apnea may exhibit symptoms such as:

  • Snoring

  • Difficulty maintaining sleep

  • Waking up with a dry mouth or sore throat

  • Experiencing daytime fatigue

The condition results in fragmented sleep and can lead to excessive sleepiness during the day.

Treatments may range from simple nasal decongestants to the use of breathing devices such as a mouthpiece or a continuous positive airway pressure (CPAP) machine.

Heart Failure

Heart failure is another condition that can cause low oxygen levels while lying down. It leads to fluid buildup in the lungs, known as pulmonary edema, which results from increased pressure in the heart. This accumulation of fluid can lead to shortness of breath when lying down.

Indications of reduced oxygen levels in individuals with heart failure include:

  • Headache

  • Difficulty breathing

  • Rapid heart rate

  • Bluish skin

  • Nausea

  • Lack of appetite

  • Difficulty concentrating

  • Decreased alertness

  • Chest pain if heart failure is caused by a heart attack

The impact of heart failure on oxygen saturation levels is substantial, leading to reduced pulse oxygen saturation and heightened risk of mortality.

Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease, or COPD, is a group of lung diseases such as emphysema and chronic bronchitis. These diseases result in impaired air movement out of the lungs or cause airway inflammation and excessive mucus production, leading to difficulty in breathing.

COPD symptoms can include chronic coughing or wheezing, as well as experiencing shortness of breath during regular activities. These symptoms may also be accompanied by frequent respiratory infections and fatigue. The main factors contributing to the development of COPD are prolonged exposure to lung irritants such as cigarette smoke, air pollution, chemical fumes, or dust, with smoking being the predominant cause.

COPD results in decreased oxygen levels in the body, primarily due to a ventilation/perfusion mismatch caused by progressive airflow limitation, which impairs the proper exchange of oxygen in the lungs.

Less Common Causes of Low Oxygen While Lying Down

There are also less common causes of low oxygen levels while lying down, such as panic disorder, high altitudes, and pregnancy. Each of these conditions can lead to disrupted sleep and other health complications.

Panic Disorder

Panic disorder is a form of anxiety characterized by anxiety or panic attacks, accompanied by a sense of losing control, intense fear, and detachment. Symptoms include:

  • Shortness of breath

  • Tightness in the throat

  • Chills

  • Hot flashes

  • Nausea

  • Abdominal cramping

  • Chest pain

  • Headache

  • Dizziness

  • Sudden high anxiety

  • Racing heart

  • Feeling weak or faint

  • Shaking

  • Tingling or numbness in the hands

Panic disorder can lead to low oxygen levels as a result of rapid, shallow breathing and decreased carbon dioxide levels in the blood during panic attacks, resulting in breathlessness and reduced oxygenation. The disorder is typically diagnosed by primary care providers or mental health professionals according to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders.

High Altitudes

High altitudes can also lead to a decrease in oxygen levels due to lower air pressure and reduced oxygen availability. During sleep at high altitudes, blood CO2 levels can decrease significantly, potentially leading to a suppression of the respiratory drive and lower than normal blood oxygen levels.

To adapt to high altitude environments, the body undergoes physiological changes such as inducing breathing instability, with periods of deep and rapid breathing alternating with normal breathing, and it may also produce more red blood cells to improve oxygen supply.


In pregnancy, decreased oxygen levels when lying down can be attributed to:

  • Minimal nocturnal oxygen saturation

  • Sleep-disordered breathing

  • The expanding uterus causing alterations in lung volume and chest wall, such as diaphragm elevation, impacting lung function and leading to reduced oxygen levels.

Furthermore, hormonal changes can influence the upper respiratory tract and airway mucosa, potentially contributing to respiratory challenges. Conditions such as interstitial lung disease can exacerbate the reduction in arterial oxygen levels. Moreover, the supine position can lead to reduced oxygen levels due to heightened oxygen consumption in the early stages of the first trimester.

Monitoring Your Oxygen Levels

Person doing breathing exercises to improve lung health

To detect any signs of hypoxia and guide appropriate treatment, regular monitoring of your oxygen levels is necessary. This can be done using a pulse oximeter, a device that uses a small clip on the finger to transmit light through the blood and assess oxygen saturation levels. For a more precise measurement, arterial blood gas analysis can be employed, which involves drawing blood and provides a snapshot of the blood’s composition at that specific moment.

In addition to oxygen levels, pulse oximeters can track metrics such as heart rate, activity levels, and sleep patterns. Monitoring blood oxygen levels overnight is especially important for individuals with conditions such as sleep apnea and lung diseases, as it plays a crucial role in effectively managing their health concerns.

Managing Low Oxygen Levels While Lying Down

Healthy diet and exercise for managing low oxygen levels

A variety of strategies can be employed to manage low oxygen levels while lying down, depending on the root cause. These can range from lifestyle changes, adjusting sleeping positions, to medical treatments such as the use of a CPAP or BiPAP machine.

Lifestyle Changes

Significant improvement in oxygen levels can be achieved through lifestyle changes. Here are some ways to increase oxygen levels:

  • Regular exercise enhances the strength of the lungs, muscles, and heart, leading to improved efficiency in delivering oxygen to the muscles and organs.

  • Breathing exercises like pursed-lip breathing and deep breathing can increase oxygen levels and enhance lung function.

  • Moderate exercise, such as walking, is highly recommended for improving oxygen levels in healthy older individuals.

Diet also plays a crucial role in preventing upper respiratory infection. A healthy diet, especially one abundant in antioxidant-rich foods, elevates oxygen levels in the bloodstream and safeguards healthy cells from free radicals. Furthermore, consuming sufficient protein helps maintain robust respiratory muscles.

Sleeping Positions

Altering your sleeping positions can also contribute to improved oxygen levels. Sleeping on the left side leverages gravity to enhance airflow and alleviate pressure on the airway, leading to a notable improvement in oxygenation. Even sleeping on the right side can help maintain high oxygen levels by easing breathing, which is beneficial for individuals with respiratory issues.

Numerous scientific research studies have demonstrated that specific sleeping positions, such as side sleeping or sleeping at an incline, can measurably improve oxygen levels and promote more consistent breathing during sleep.

Medical Treatments

For some individuals, medical treatments may be necessary. A CPAP machine, for instance, functions as a medical intervention to alleviate symptoms of sleep apnea, which can lead to low oxygen levels while in a supine position. This is achieved by delivering a consistent air pressure to prevent the airways from collapsing during sleep.

Different types of CPAP machines, such as BiPAP machines and oxygen concentrators, can be used for treating low oxygen levels while lying down. On the other hand, supplemental oxygen therapy improves oxygen levels by delivering a continuous supply of additional oxygen to aid individuals with respiratory conditions in breathing more effectively. However, it’s important to be aware of potential adverse effects linked to these treatments, which may include discomfort, skin irritation, claustrophobia, and more.

Recognizing a Medical Emergency

Person experiencing sudden shortness of breath seeking medical attention

Being able to recognize the signs of a medical emergency plays a key role in managing low oxygen levels. Symptoms that may signal a medical emergency include chest pain, swelling of ankles and feet, and lips turning blue. The blue discoloration of the skin or lips is a serious medical concern as it indicates a lack of oxygen in the blood.

In addition to these evident symptoms, other significant signs include:

  • Confusion

  • Changes in breathing and heart rate

  • Rapid breathing

  • A fast or pounding heartbeat

  • Chest pain

  • Low blood oxygen levels below 90%

Recognizing these symptoms and seeking medical attention promptly can significantly decrease the risk of complications.


In conclusion, low oxygen levels while lying down is a common health concern that can result from various conditions, including sleep apnea, heart failure, COPD, panic disorder, high altitudes, and pregnancy. It’s crucial to understand the causes, signs, and management strategies to effectively manage this condition. Monitoring your oxygen levels, making lifestyle changes, adjusting sleeping positions, and seeking medical treatments when necessary can greatly improve your health and wellbeing. Remember, recognizing the signs of a medical emergency and seeking prompt medical attention can be lifesaving.

Frequently Asked Questions

Why does my oxygen level drop when I lay down?

Your oxygen levels naturally drop during sleep because of reduced breathing and non-functioning alveoli, but if your waking oxygen saturation is above 94 percent, it's unlikely to fall below 88 percent during sleep. This is a normal occurrence.

What is the most common cause of low blood oxygen?

The most common cause of low blood oxygen is an underlying illness that affects blood flow or breathing, such as heart or lung conditions. Certain medications can also contribute to this condition.

What is a dangerously low oxygen level at night?

A dangerously low oxygen level at night is typically considered to be below 88%, requiring prompt medical attention to address the issue.

What is sleep apnea and how does it impact oxygen levels?

Sleep apnea is a medical condition that causes repeated interruptions in breathing during sleep, leading to decreased oxygen levels in the body and excessive daytime drowsiness. This can impact overall health and quality of life.

What is Chronic Obstructive Pulmonary Disease (COPD) and how does it affect oxygen levels?

COPD is a group of lung diseases that make it difficult to breathe due to impaired air movement and excessive mucus production, which affects oxygen levels.


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