If you wake up at night coughing that makes it difficult to sleep, wheezing (a squeaky sound that occurs due to constricted airways), have chest
tightness, and feel breathless (dyspnea), you could have
nocturnal (nighttime) asthma.
This is a type of asthma that gets worse at night after
dark. It can occur with any form of
asthma, including occupational, allergic, and exercise-induced. Even in healthy
people, the best lung function is between noon and 4 pm. It’s at its worst
between 3 and 4am. 60% of people with continuous asthma
have nocturnal symptoms at some point.
One
reason for the decline in lung function is your body’s circadian rhythm, (or
natural clock), which causes hormone production to ebb and flow. During the early
hours of the morning, levels of the hormones that protect against
asthma symptoms are at their lowest. If you have asthma, you're more likely to
wake up coughing and wheezing as these levels
fall.
A
sinus infection (or postnasal drip)
could be another cause of nocturnal asthma. When you lie down, nasal secretions can accumulate in
your airways and make it harder for you to breathe. If you have allergies to pet dander, sleeping in the same
room as your animal can make your asthma worse at night. Dust mites lurking in
your mattress or bedding could be another trigger. Doctors
are not sure what causes nocturnal asthma, but the following factors are
thought to contribute to it:
·
“7 Tips to Prevent Nighttime Asthma Attacks”
By Beth W. Orenstein
·
“What Is Nocturnal
Asthma?” Beth W. Orenstein
·
A
reclining position during sleep
·
Increased
mucus production
·
Increased
drainage from sinuses (sinusitis)
·
Lower
levels of the hormone epinephrine (helps relax and widen airways)
·
Higher
levels of the hormone histamine (restricts airways)
·
A
late (or delayed) phase response to an allergen encountered during the daytime
·
Exposure
to allergens such as dust mites in the mattress at night
·
Gastroesophageal
Reflux Disease (GERD)
·
Psychological
stress
·
Sleep-related
conditions (such as obstructive sleep apnea)
·
Inhaling
a greater level of cold air from an air conditioner (or outside source)
·
Obesity
(and excess fat)
In
addition to taking asthma
medications as prescribed, here are steps you can take to lower your chances of
having a nocturnal asthma attack:
·
Clean
your bedroom regularly. Use a
vacuum with a high-efficiency particulate air (HEPA) filter to trap mites and
their waste. Get them out of your bedroom. If your vacuum doesn’t have a HEPA
filter, you can buy one from an allergy supply company.
·
Don’t sleep
with pets. If you have pets, keep them out of
the bedroom so their dander doesn’t collect or stick to the carpeting and
bedding. You may need to keep the door to your bedroom shut to keep your pet
(and its dander) out.
·
Get tested
for sleep apnea. People with asthma may be at
increased risk for sleep apnea. Sleep apnea causes repeated breaks in your
breathing while you sleep. It can also worsen asthma symptoms. Talk with your
doctor about testing and treatment if necessary.
·
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. Dust mites thrive in low humidity so boosting humidity
by using a humidifier in your bedroom can lessen dust mites.
·
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 houseware stores.
·
Keep your head up. If you have a
cold or a sinus infection, lying flat can exacerbate postnasal drip, which can
trigger an asthma attack. If you have acid reflux, lie slightly elevated.
·
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.
“I know from my constituency
what is going on. Doctors that are told begged, by mothers, 'Please don't write
down that my child as asthma. Please lie and say it's bronchitis, because if
you write down asthma, when my child turns 18 or 20 and has to get his or her
own insurance, it will be a pre-existing condition.'” (Barbara Boxer) [i]
[i] Sources used:
·
“7 Tips to Prevent Nighttime Asthma Attacks”
By Beth W. Orenstein
·
“What Is Nocturnal
Asthma?” Beth W. Orenstein
·
“What You Should Know About Nocturnal Asthma” by Neel Duggal
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