During the day, shortness of breath, wheezing and coughing are very disturbing. Waking up in the middle of a coughing fit or being unable to catch your breath in the quiet of the night is downright distressing. Unfortunately, about 30 to 70% of people with asthma experience nocturnal asthma or worsening of asthma symptoms. Not everyone with asthma feels bad at night, but many do.
Learn more about nocturnal asthma and what to do if you have nocturnal asthma along with cough and other symptoms.
The most common reasons asthma gets worse at night:
Exposure to allergens. Bedbugs. pet dander. dust particles. All are normal in the bedroom, and all can trigger asthma attacks. You probably spend 6 to 9 hours in bed every day; That’s a long time to be exposed to potential allergens. Some people also experience late night allergies. It is not uncommon for an allergic reaction to occur 3 to 8 hours after exposure to the allergen. For example, if you are exposed to pollen, for example, in the evening, when you are trying to fall asleep, you may experience shortness of breath and wheezing.
supine position and acid reflux. When we lie down, it is easier for stomach acid to flow back up into the esophagus, the tube that connects the mouth and stomach. Instead of swallowing, some of this fluid can enter the large airways and provoke an irritating cough. Reflux of stomach acid can also constrict the airways, making breathing more difficult.
post nasal drip. People are more sensitive to postnasal drip at night. When you lie flat, it is easy for fluid to drip down the back of your throat and cause a cough. Lying down also causes fluid to shift from the legs to the chest, which can increase the accumulation of fluid in the walls of the airways and narrow the airway.
Circadian changes in lung function. Our lungs work differently at night. Perhaps because humans have evolved to be active during the day, our lung function is at its best during the day. Airway resistance increases overnight, and this effect is more pronounced in people with asthma.
Tension. At least one study has found a link between stress and nocturnal asthma. Hormones released by the body during times of stress can cause inflammation, so researchers believe that stress may cause constricted airways, at least in some people.
If you wake up in the middle of an asthma attack, use your rescue inhaler. (It’s a good idea to keep it within reach of your bed, especially if you have nocturnal asthma.) Adopting a more upright position can also help. Some people find that drinking water can ease a cough.
If you regularly experience nocturnal asthma symptoms, talk to your healthcare provider about the problem. Adjusting the timing of your asthma medicine can help. For example, some studies have shown that an 800 microgram dose of inhaled triamcinolone (Azmacort) at 3 p.m. is more effective than taking 200 micrograms four times a day.
Your healthcare provider may also need to increase or add medication. Asthma gets worse over time, and if you are having symptoms at night, your asthma may be poorly controlled. Making changes to your asthma management plan may help eliminate your nocturnal symptoms.
Exercise can also help reduce nocturnal asthma. Studies have found that physical activity at least twice a week for 6 to 8 weeks reduces symptoms of nocturnal asthma in children. Ten to 12 weeks of physical exercise also decreased nocturnal asthma and improved sleep in adults.
People whose asthma is worse at night should see a healthcare provider and ask about treatment for nocturnal asthma.
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