As the diaphragm's primary role is in respiration, the main symptoms of diaphragm paralysis are shortness of breath (dyspnea) and respiratory difficulty. These symptoms can be exacerbated, particularly when lying flat (orthopnea), during physical activity (e.g., walking), or when entering water (due to hydrostatic pressure). Bilateral diaphragm paralysis can lead to respiratory disturbances during sleep due to a drop in blood oxygen levels. Furthermore, secondary symptoms may also be observed depending on the underlying etiological causes of the paralysis.