By keeping a journal, I’ve identified 6 causes of shortness of breath

While every PH patient is different, here's what triggers breathlessness for me

Jen Cueva avatar

by Jen Cueva |

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Shortness of breath is one of the most common symptoms of pulmonary hypertension (PH). It can have many triggers, and if you’re a patient just starting to learn about PH, you might be wondering what they are.

Each person is different, of course, so something that might trigger shortness of breath in one person might not affect others the same. As a PH patient myself, I’ve experienced this symptom for years, and I’d like to share six of the common triggers I’ve discovered.

1. Stress

Stress doesn’t only mess with us emotionally, but also physically. How our bodies respond varies, but we can be certain that stress will leave its mark. It could leave us gasping for air or weaken our immune system’s ability to defend against illnesses like the common cold. And as a person with PH, I know that a simple cold is far more complicated for us than it is for otherwise healthy individuals. That’s why it’s vital to learn methods to process and reduce our stress.

2. Strong odors

It’s curious, but those of us with PH can be hypersensitive to strong odors. They can steal our breath away! Some common sources include cleaning products, heavy perfumes, and even certain foods.

I’ve found that it’s important to have a heart-to-heart chat with loved ones who may not fully grasp how strong odors can affect our breathing. Meanwhile, we should avoid anything with an overpowering fragrance so we can stay fresh and stay breathing.

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3. Large meals

Feasting on big meals can leave little room for your lungs to stretch and take a satisfying breath. The body also exerts extra effort to digest large quantities of food.

I’ve discovered that nibbling on smaller portions throughout the day suits me best. I chow down from a lovely toddler plate and graze throughout the day. Trust me, as a food lover and an avid cook, I find this method challenging. But it’s worth it.

4. Allergies

Allergies can cause a full-blown flare-up of symptoms. For me, the first crucial step in dealing with allergies is to identify the triggers. If cats are your trigger, for example, keeping your distance is like a breath of fresh air.

If the great outdoors during the spring or fall seasons causes a perfect storm with your allergies and PH, it might be time to cozy up indoors. I don’t enjoy staying indoors for extended periods, but sometimes we must when we’ve identified problematic seasons. Avoidance might be necessary.

You can also discuss possible allergy medication or other strategies with your doctor.

5. Air quality

Our ability to breathe is dependent upon the air quality around us. On those not-so-great days of poor air quality, the remedy again is to stay indoors. While it might appear beautiful outdoors, poor air quality can make breathing a difficulty, and no fun at all.

Again, staying inside is not my preference. But if it’s between breathing better or not, I’ll make the sacrifice and do it.

6. Altitude

Altitude can have a significant impact on PH patients’ ability to breathe properly. If living at a lower altitude is crucial for your well-being, consider moving.

I usually experience altitude sickness at 4,000 feet or more above sea level, which causes me shortness of breath, heart palpitations, headaches, lightheadedness, and nausea. When that happens, I must descend to lower altitudes to increase my oxygen levels.

Learn your triggers

Discovering your triggers is a powerful defense against breathlessness attacks. Some triggers hit like a lightning bolt, leaving no doubt that adjustments are needed. Identifying your other triggers, however, may require time and experimentation. So be patient, my PHriend.

One way to identify and keep track of your triggers is to keep a journal with basic information about how you’re feeling, as well as your diet, food portions, stress levels, and activities throughout the day. This record can help to identify patterns you can discuss with your healthcare team. Knowing what to avoid can provide you with a sense of control.

Have you noticed any other triggers that affect your breathing symptoms? Please share in the comments below. 

Note: Pulmonary Hypertension News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Hypertension News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary hypertension.


JohnNightingale avatar


Great tips thanks Jen.
I have also found that bending down makes me short of breath also, eg doing shoes or picking up things and gardening
New Zealand

Jen Cueva avatar

Jen Cueva

Hi John, Of course bending down to do those pesky tasks like tying shoes will cause an increase in shortness of breath. Have you tried using one of those handy grabber tools that may help you pick up things on the floor and in the garden. I'll share a picture and link in case you aren't familiar with them.

Grabber- Amazon

How have you been doing? We've been missing you in the PH News forums.

I appreciate you taking the time to read my column and inclined to leave your feedback. I'm grateful you found this piece helpful and hope to chat with you soon in the forums. Take care, my PHriend.

Paul Moore avatar

Paul Moore

How about nasal versus mouth breathing? Does that make a difference? How about humidity? Does moist air make a difference?

Jen Cueva avatar

Jen Cueva

Hi Paul. Yes , that humidity certainly impacts my breathing. When I lived in Texas, that was challenging. But, I'm now in CA and do much better with my breathing. Cold also burns my lungs and is not a great combination.

I'm grateful you took the time to read this piece, but also inclined to leave your thoughts. Thank you so much for your feedback. I hope that you are doing well. Take care and hope to see you soon in the forums, my PHriend.

Allen kosowsky avatar

Allen kosowsky

I find lying down flat causes shortness of breath. Also working for over two or three hours outside makes me short of breath. I lose stamina and shortness. Of breath follows often.

Jen Cueva avatar

Jen Cueva

Hi Allen, I can certainly relate to lying flat. I'm fortunate to have an adjustable bed that I can elevate my head. Still, I use two to three pillows. But it helps so much more.

Working outdoors can be exhausting, especially for several hours. You may need to do this in smaller increments to not experience as much SOB. What are you doing working outside for so long doing? Yardwork?

If you haven't yet, we would love to have you join the PH News forums. I am one of the forum moderators, so we would be excited for you to come in and communicate with others in the PH community. I'll share a link below so you can create a simple account and start conversing.

PH News forums

I also appreciate the time you took to read my column and offer your feedback. This means more than you know.

Hildi avatar


Certain food content specific species like peppers 🌶️ 🫑, their taste causes me to have cough abruptly, they are almost like allergic reactions for my airways that make me go breathlessness. When I dinning out I avoid spicy 🌶️ food, no salt no pepper, mission accomplished. They caused release of histamine like reaction, don’t forget that airway and food share space in the back of the throat. That histamine like reaction will cause swelling in that area that will feel like narrowing down in the entrance of the airway air flows that will increase the coughing. I learned my lesson the hard way, oh well!!!! Live and learn from experiences, love you all ❤️❤️❤️🌹🌹

Jen Cueva avatar

Jen Cueva

Hi Hildi,
Thank you for sharing your experience with certain food, specifically peppers. I love spicy food, but at times, it can be too much. Other days, I am fine. I'm sure it's also depending on how I am feeling overall and the level of shortness of breath before I begin eating. Have you experienced this or is it anytime you eat the peppers?

Yes, unfortunately we do learn these lessons the hard way.

Wishing you a feel good week. If you haven't yet checked out our newly redesigned PH News forums, we would love to have you join. I am one of the forum moderators there. The link to create a login is below. Hope to see you there.

PH News forums

Again, thanks for taking the time to read my column. It means so much that you also felt compelled to comment. 💜


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