At night, when recumbent for an extended period, this fluid is reabsorbed, increasing total blood volume and blood pressure, leading to pulmonary hypertension in people with underlying heart failure. This fluid typically rests in the legs ( peripheral edema) during the day when the individual is upright. PND is caused by increasing amounts of fluid entering the lung during sleep and filling the small, air-filled sacs ( alveoli) in the lung responsible for absorbing oxygen from the atmosphere. It was first described by Charles Lepois in the 1500s. Also unlike orthopnea, it does not develop immediately upon lying down. PND is often relieved by sitting upright, but not as quickly as simple orthopnea. PND commonly occurs several hours after a person with heart failure has fallen asleep. It is most closely associated with congestive heart failure. Paroxysmal nocturnal dyspnea (PND) is defined as sudden, severe shortness of breath at night that awakens a person from sleep, often with coughing and wheezing. Synonyms and keywords: Cardiac asthma PND Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS
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