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Why Am I Getting Asthma At Night

Why Is Asthma Keeping Me Awake

Why Certain People Get Asthma

Its common for asthma symptoms to come on at night, but you shouldnt have to put up with them. Night-time asthma symptoms are a sign that your asthma isnt well controlled, and you may be at risk of an asthma attack.

If your symptoms come on early in the morning, it could be a sign your asthma has been difficult through the night, even if you werent aware of it.

Here are some reasons why your symptoms may come on at night:

There is also evidence to suggest that a lack of sleep can make your asthma symptoms worse. If youre struggling with sleep and its affecting your asthma, speak to your GP or asthma nurse.

Bodys Response When Sleeping

The bodys response to asthma is the lowest mostly during the wee hours of the morning. Reason being, the production of hormones varies as per the body clock and the asthma fighting hormone is at its lowest point at this time. Its very common to hear nocturnal asthma patients complaining of waking up fighting for breath in the early morning hours.

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How To Ease Breathing Problems At Night

  • Keep allergens at bay: your difficulty breathing at night may be caused by tiny particles in your bedding. Eliminate house dust mites and dust mite allergens from your sleep environment by cosying up in a wool bedding set. This natural fibre is highly effective at repelling dust mites and keeping them out of your bed, so you can get a better nights sleep.
  • Sleep on extra pillows: if lying down flat seems to trigger an episode of wheezing and coughing at night, try propping yourself up on an extra pillow or two. This can help to ease problems associated with catarrh and reduced lung capacity.
  • Maintain a good sleeping routine: while a regular bedtime routine wont alleviate the symptoms of an asthma cough at night, it can help you to settle down to sleep more easily, increasing your chances of getting a good nights rest.
  • Watch out for other triggers: pet hair, pollen and stress can all cause difficulty breathing at night. Its important to identify any triggers that cause breathing problems at night for you so you can take steps to minimise these.
  • Ask your GP or asthma nurse about changes to medication: if you regularly experience coughing and wheezing at night, or if your symptoms get worse, see your GP or nurse to review your medication. If possible, take along a record of your recent peak flow readings for them to better understand your sleep and asthma issues.

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How Do Healthcare Providers Diagnose Asthma

Your healthcare provider will review your medical history, including information about your parents and siblings. Your provider will also ask you about your symptoms. Your provider will need to know any history of allergies, eczema and other lung diseases.

Your provider may order spirometry. This test measures airflow through your lungs and is used to diagnose and monitor your progress with treatment. Your healthcare provider may order a chest X-ray, blood test or skin test.

When To See The Doctor

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A good rule of thumb is you should visit your doctor if you have asthma and you wake up in the night more than once per week after using treatments. Your doctor can evaluate what may be causing your symptoms and help modify your treatment plan. Checking your breath in a peak flow meter at night may also be helpful.

If you are not diagnosed with asthma but have asthma-like symptoms at night, you should report the episodes to your doctor. While you may not have asthma, your doctor can point you in the right direction for treatment.

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Asthma Symptoms In Children

Most children with asthma have symptoms before they turn 5. In very young children, it may be hard for parents, and even doctors, to recognize that the symptoms are due to asthma. The bronchial tubes in infants, toddlers and preschoolers are already small and narrow, and head colds, chest colds and other illnesses can iname these airways, making them even smaller and more irritated.

The symptoms of pediatric asthma can range from a nagging cough that lingers for days or weeks to sudden and scary breathing emergencies.

Common symptoms to watch for include:

  • Coughing, especially at night
  • A wheezing or whistling sound when breathing, especially when exhaling
  • Trouble breathing or fast breathing that causes the skin around the ribs or neck to pull in tightly
  • Frequent colds that settle in the chest

Your child might have only one of these symptoms or several of them. You may think its just a cold or bronchitis. If the symptoms recur, thats a clue that your child might have asthma. In addition, symptoms may worsen when your child is around asthma triggers, such as irritants in the air or allergens like pollen, pet dander and dust mites.

Side Effects Of Steroid Tablets

Oral steroids carry a risk if they are taken for more than three months or if they are taken frequently . Side effects can include:

  • muscle weakness

With the exception of increased appetite, which is very commonly experienced by people taking oral steroids, most of these unwanted effects are uncommon.

However, it is a good idea to keep an eye out for them regularly, especially side effects that are not immediately obvious, such as high blood pressure, thinning of the bones, diabetes and glaucoma.

You will need regular appointments to check for these.

Want to know more?

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What Should I Know About Covid

If you have asthma that is moderate-to-severe, or if your asthma symptoms arent well controlled, youre at greater risk of having to be hospitalized if you get COVID-19. Therefore, you should wear a mask if you go to indoor spaces with other people, get vaccinated and avoid exposure to people who have the virus.

A note from Cleveland Clinic

Many people live fulfilling lives with asthma. Some professional athletes with asthma have set records in their sports. Your healthcare provider can help you find the best way to manage your asthma. Talk to your healthcare provider about how to control your symptoms.

Last reviewed by a Cleveland Clinic medical professional on 01/19/2022.


What Are Symptoms And Complications Of Nighttime Asthma

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Any other type of asthma can also be nighttime asthma. Nighttime asthma has similar symptoms to other types of asthma, including:3

  • Shortness of breath
  • Chest tightness

The key difference with nighttime asthma is that symptoms get worse at night. They may wake you up several times. Sleep disturbance can happen several times per week. This can cause you to get tired during the day.2

Waking up even a few nights every month from asthma symptoms can impact work and school performance. Nighttime asthma can cause other long-term effects. It can worsen lung function and asthma symptoms. It also increases the risk of heart disease and other health problems.2,4

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Factors That Contribute To Nocturnal Asthma

The most common reasons asthma is worse at night:

  • Exposure to allergens. Bedbugs. Pet dander. Dust mites. All are common in the bedroom, and all can trigger asthma attacks. You probably spend 6 to 9 hours in bed every day thats a long time to be exposed to potential allergens. Some people also experience delayed allergic reactions at night. Its not uncommon for an allergic response to occur 3 to 8 hours after exposure to an allergen. If youre exposed to pollen, for instance, in the early evening, you might experience shortness of breath and wheezing when youre trying to fall asleep.

  • Supine position and acid reflux. When we lie down, its easier for stomach acid to travel back up into the esophagus, the tube connecting the mouth and stomach.Instead of being swallowed, some of this fluid can enter the large airways and provoke an irritating cough. Reflux of stomach acid can also cause the airways to constrict, which leads to more difficulty breathing.

  • Postnasal drip. People are more susceptible to postnasal drip at night. When you lie flat, its easier for fluid to drip down the back of your throat and cause coughing. Lying down also causes fluid to shift from the legs to the chest, which can lead to increased fluid accumulation in the airway walls and narrowing of the breathing passages.

  • Medication timing. If your asthma medication wears off during the night, youre likely to experience nocturnal asthma.

Asthma And Obstructive Sleep Apnea

Obstructive sleep apnea is a disorder in which the airways narrow or collapse during sleep. Asthma and OSA share similar symptoms and appear to have a bidirectional relationship. This means that having one of these respiratory conditions increases the likelihood of being diagnosed with the other. OSA is particularly common in people with asthma who also snore and those with poorly-controlled asthma symptoms.

People with asthma may find it helpful to talk to their doctors about obstructive sleep apnea. Because asthma puts a person at an increased risk of developing OSA, research suggests that periodic evaluations for OSA may help patients with asthma. Fortunately, treating OSA can often reduce asthma symptoms.

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What Triggers An Asthma Attack

People with asthma have different triggers. Some people are triggered due to exposure of allergens like dust mites or grass. Other people can be triggered by irritants in the air like chemicals or strong odors. Carrillo notes that respiratory illnesses with mucus drainage like sinus infections or colds increase the likelihood of an asthma attack. Exercise and changes in the weather also trigger attacks as well. Some people may find that more than one thing increases their chances of having an attack, and any type of asthma can get worse at night.

Symptoms And Dangers Of Nocturnal Asthma

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The chances of having asthma symptoms is higher during sleep. Nocturnal asthma symptoms of a tight chest, shortness of breath, wheezing, and coughing accompanied by sleep disturbance is commonplace, but serious. Most deaths related to asthma happen during the nighttime.

A child with nocturnal asthma is chronically sleepy during the daytime making them more susceptible to falling asleep at school, suffering from decreased concentration and performance. In addition, when a child is overtired, they can be cranky and misbehave.

Parents are likely sleep deprived too, so speak with Kids First Pediatrics of Raeford and Fayetteville about specific treatments for nocturnal asthma.

No one knows exactly why it is worse during sleep, but there are some known triggers.

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How To Sleep Better With Severe Asthma

In addition to taking asthma medications as prescribed, here are seven steps you can take to lower your chances of having a nighttime asthma attack:

1. Clean your bedroom regularly. Use a vacuum with a high-efficiency particulate air filter to trap mites and their waste and get them out of your bedroom. If your vacuum doesnt have a HEPA filter, you can buy one from an allergy supply company, according to the Asthma and Allergy Foundation of American .

2. Wash your bedding in hot water weekly. Make sure the water is at least 130 degrees Fahrenheit so it will kill dust mites. Finish the job in a hot dryer.

3. Invest in dust-proof mattress and pillow protectors. These zippered covers are woven tightly to keep dust mites out of bedding. You can find them at bedding and housewares stores, the AAFA says.

4. Invest in a humidifier. Cold air is drier and more troublesome for people with severe asthma. Depending on where you live, you might benefit from a humidifier to add moisture to the air in your bedroom in the winter, Bose says. Whats more: Dust mites thrive in low humidity, so boosting humidity by using a humidifier in your bedroom can help keep dust mites at bay.

5. Dont sleep with pets. If you have pets, keep them out of the bedroom so their dander doesnt collect or stick to the carpeting and bedding, Bose says. You may also need to keep the door to your bedroom shut to keep your pet and its dander out.

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Suddenly, your chest tightens, and your breathing starts to resemble wheezing. Asthma attacks can be a startling experience, especially if they happen while you are asleep or nearly asleep. Genny Carrillo, MD, ScD, associate professor at the Texas A& M School of Public Health, director of the Program on Asthma Research and Education, discusses how nighttime asthma attacks can be avoided.

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More Sleep Hygiene Tips

I realize that not everyone is going to want to try taping their mouth shut, at least at first blush. Thats why Ive enlisted my wife Emma, a reformed insomniac, to share whats helped her sleep better.

Since the best way to treat asthma is through lifestyle changes, improving your sleep hygiene in general might have a bigger impact on your symptoms that youd expect!

Heart Failure And Related Conditions

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You may experience shortness of breath because your heart cant pump blood at a sustainable level. This is known as heart failure. You may develop this condition for many reasons. Risk factors include poor diet, diabetes, certain medications, smoking, and obesity.

One condition that can lead to a heart attack is coronary artery disease. You may experience shortness of breath from a heart attack as well as chest pain and tightness, sweating, nausea, and fatigue. You should seek medical care right away if you suspect youre having a heart attack.

Other conditions associated with heart failure include high blood pressure or if your heart experiences trauma, inflammation, or irregular heart rate.

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Youre Coughing And Wheezing More During The Day

Another sign that your severe asthma may be getting worse is if youre coughing or wheezing more often. Talk to your doctor about adjusting your treatment plan if you constantly feel like youre about to cough. If you find yourself wheezing with a whistle-like sound more than once a day, seek your doctors opinion as well.

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What Causes Shortness Of Breath

Many conditions cause shortness of breath at night. Chronic shortness of breath occurs when you experience the symptom for more than a month. According to an article in American Family Physician, 85 percent of conditions that trigger chronic shortness of breath relate to your lungs, heart, or mental health.

Shortness of breath can occur if your body cant adequately pump oxygen into your blood. Your lungs may be unable to process the intake of oxygen or your heart may not able to pump blood effectively.

Shortness of breath when you lie down is called orthopnea. When the symptom occurs after a few hours of sleep, it is called paroxysmal nocturnal dyspnea.

Different lung conditions can cause shortness of breath. Some are chronic or life-threatening and others can be treated.

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How Is An Asthma Flare

The best thing to do first if your asthma symptoms are getting worse is to use your rescue or quick-relief medicine. Ask your doctor if youre not sure what to use for quick-relief medicine. The usual inhaler dose is two to four puffs every 20 minutes for a total of three doses, or one nebulizer treatment if you have a home nebulizer.

You should be able to tell how serious the flare-up is after you use your quick-relief medicine. If you have a peak flow meter, check your PEF again after you use the quick-relief medicine. If your PEF is still very low, your flare-up is serious.

Your doctor may have given you a written Asthma Action Plan with directions for treating mild, moderate and severe flare-ups. If you dont have an action plan, ask your doctor for written directions about treating asthma flare-ups. If you have the symptoms of a serious flare-up or if your PEF is less than 50 percent of your personal best, call your doctor right away or go directly to the nearest hospital emergency room .

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Medically reviewed in August 2021

If you battle your worst asthma symptoms at night, you could have nocturnal asthma, also called nighttime asthma. As the name implies, this is when asthma strikes at night, interrupting sleep. These symptoms can negatively impact a persons quality of life in a number of ways, from hindering performance at work and school, to needing to visit a healthcare provider more frequently, to increased irritability, anxiety and numerous health risks associated with getting too little sleep.

There’s usually not one specific trigger that causes nocturnal asthma. If you’re struggling with symptoms of a sleep disorder or nocturnal asthma, it is important to work with your healthcare provider to identify the specific causes and determine how best to address your symptoms so you can get the rest you need.

In the meantime, here are some potential causes of nocturnal asthma and what you can do about them.

Allergies Allergy triggers that exist in your bedroom can lead to a nighttime asthma attack. These include dust mites, mold, pet dander and seasonal allergens that become trapped in your clothing, bedding and hair. Studies also show that if you’re exposed to an allergen before bed, there’s a good chance that you could experience a delayed second response at night. So do what you can to allergy-proof your home and avoid triggers throughout the day.

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