This phenomenon is called orthopnea. Patients may
also have paroxysmal nocturnal dyspnea (PND), which refers to the sudden
development of severe shortness of breath at night that awakens the patient from
sleep. All of the pervious symptoms are related to pulmonary congestion with
accumulation of fluid in the interstitial and alveolar spaces that occasionally might
lead to the development of acute pulmonary edema. Other symptoms common
in patients with CHF are peripheral edema, fatigue, anorexia, early satiety, liver
congestion, confusion, sleeping disorders, and nocturia, frequent awakenings
throughout the night in order to urinate.