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Shortness of Breath in the Shower: Why It Happens With Pulmonary Hypertension

Medically reviewed by Steven C. Pugliese, M.D.
Written by Sarah Winfrey
Posted on May 15, 2023

Shortness of breath is a common and sometimes frightening symptom of pulmonary hypertension (PH) — and it can occur at unexpected times, such as during a common daily activity like taking a hot shower.

Members of myPHteam sometimes discuss how a hot shower can make breathing difficult. One member said, “I have a shortness of breath problem when taking a shower. Does anyone else have that problem?” Several other members chimed in with support, with one noting, “I, too, get short of breath in the shower.”

The symptom can be worrisome enough that some people with PH decide to give up hot showers entirely. It’s important to understand why a shower might cause shortness of breath so you can manage your PH and make a decision that works best for you. There are also some techniques you can try that can let you continue taking hot showers safely and comfortably.

What Is Shortness of Breath?

Pulmonary hypertension occurs when pulmonary arteries — the arteries that move blood between the heart and the lung — get narrow for any reason. There are different types of PH with varying reasons for blood vessel narrowing. It can be related to other conditions like chronic obstructive pulmonary disease (COPD), connective tissue diseases, liver disease, and others.

Narrowed arteries make it harder to achieve optimal blood flow and cause high blood pressure in those specific vessels. People with PH have a higher risk of blood clots (often in the lungs, which are called pulmonary embolisms), which can lead to heart disease and even heart failure.

PH causes shortness of breath because the blood doesn’t flow properly between the heart and the lungs. High blood pressure in those arteries makes it harder for the right side of the heart to pump blood to the lungs. Since that’s where your heart picks up oxygen to distribute throughout your body, you end up not having enough oxygenated blood. This leads to feeling short of breath — even when your lungs are taking in enough air.

Damage to your heart can further interfere with getting oxygenated blood throughout the body, leading to more shortness of breath.

Why Hot Showers Can Cause Shortness of Breath

Hot showers can cause shortness of breath for a couple of reasons.

For some people, the heat itself can trigger breathing difficulties. In fact, people living with certain types of PH have more and worse symptoms on hot days than they do on milder ones.

Hot water might be worse for some people than external heat. In fact, when people sit in hot tubs or take warm showers, their cardiovascular systems act differently. Heat makes the blood vessels dilate, which can lower blood pressure. While that might seem good for people living with PH, it actually means there’s even less blood flowing between the heart and the lungs. That, in turn, means there are lower levels of oxygen being distributed throughout the body.

It’s important to note that not everyone living with pulmonary hypertension experiences shortness of breath when they take a hot shower. If you don’t experience this, you don’t need to worry about it — but do keep an eye out for symptoms.

How myPHteam Members Experience Shortness of Breath

Hot showers aren’t the only cause of shortness of breath in PH. You may also experience it from being at high altitudes, participating in physical activity, or standing up.

Many myPHteam members have shared their experiences with shortness of breath. Some experience it all the time, like one who said, “I have shortness of breath with slight movement. Sometimes, it goes away in a few minutes, but it usually stays for several hours. Sometimes, I even wake up with it.”

However, other members only experience it in specific situations. A member shared, “I get short of breath when bending over to pick something up,” and another said, “I have noticed that it is really hard to take a deep breath or walk very far outside in the cold air.”

People may even experience shortness of breath when they sleep: “I didn’t sleep last night, and then I tried to sleep today,” one member wrote. “I had problems breathing, but at least I got a couple hours.”

Shortness of breath can interfere with your ability to complete daily tasks, which can affect quality of life. For instance, it may cause problems when they try to do things around the house: “I get short of breath when I exert my energy to do chores or anything,” a member noted.

Another member replied, “I have breathing problems mainly upon exertion or when getting out of our vehicle or shopping.”

People often feel afraid when they can’t breathe. Even when they understand it, it can be emotionally difficult, like for one member who shared, “Sometimes, it is terrifying because it feels like I am suffocating.”

Managing Shortness of Breath Caused by Hot Showers

If you love hot showers and you don’t want to give them up, there are some effective ways to manage your symptoms. Keep in mind that you should always talk to your cardiologist or health care provider about new or changing symptoms of PH. That way, they can give you medical advice specific to your diagnosis and experiences.

That said, there are a few things you can do to manage your shortness of breath in the shower.

Avoid Hot Showers Entirely

If a hot shower isn’t as important to you, try avoiding it entirely. Bathe another way, or, like some of our members, lower the water temperature. As one member says, “It’s not a cold water shower, but I use tepid water.”

Increase Bathroom Airflow

If you want to increase the temperature of your shower, it might help to also increase the airflow in your bathroom. Most of the time, the air you let in — whether from outside or through an open door — will be cooler than your shower. This may lower the temperature in the room enough that you don’t experience low blood pressure and shortness of breath.

One myPHteam member uses this technique, saying, “I usually keep the vent fan on to pull the steam out.”

Use Oxygen in the Shower

If your doctor has put you on oxygen therapy, you can try using that in the shower. You can drape the tube over the door, if you have one that closes, then use the oxygen as you normally do. This may compensate for any change in blood pressure so you can enjoy your hot shower while breathing normally.

One member who uses this method explains, “I have to take my oxygen into the shower. It used to be an option, now it’s a must.”

Get a Shower Chair

If you find it difficult to maintain a proper blood pressure while standing, using a shower chair or bench may help prevent shortness of breath. This approach has helped members preserve their hot shower time. “I have to have a shower chair. It helps a lot,” said one member.

Shower chairs start at around $25 but can cost hundreds or thousands of dollars, depending on features.

Try a Different Handheld Shower Head

Finally, try using a shower head that you hold in your hand, rather than one that pours water down on top of you. This gives you more control over when and where you experience heat, so you may not get as warm and may not have to deal with shortness of breath. As one member explained, “I find some relief with a spray hose instead of a regular shower head.”

Talk With Others Who Understand

On myPHteam, the social network for people with pulmonary hypertension and their loved ones, more than 50,000 members come together to ask questions, give advice, and share their stories with others who understand life with pulmonary hypertension.

Do you experience shortness of breath when you shower? Do you have any tips to share? Let other members know in the comments below, or start a conversation by posting on your Activities page.

    Posted on May 15, 2023

    A myPHteam Member

    I no longer suffer with SOB in the shower. After taking siladenfil and amaridone (sp?) I noticed that I can breathe and shower without being SOB.

    July 26
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    Steven C. Pugliese, M.D. is affiliated with the Hospital of the University of Pennsylvania in Philadelphia, serving as the director of the pulmonary embolism response team, co-director of the comprehensive pulmonary embolism program, and an assistant professor of clinical medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
    Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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