Nocturnal Asthma

Asthma symptoms that occur while you are asleep are called nocturnal (nighttime) asthma. Symptoms of nocturnal asthma include:

  • Cough
  • Wheezing
  • Chest tightness
  • Shortness of breath

Many people who note only mild asthma symptoms during the day may have an increase in severity of symptoms only at night. Your body has certain biorhythms that change throughout the day. This rhythm occurs in many bodily functions including your body temperature and lung function. Your lung function is greatest at approximately 4 pm , at least at about 4 am.

Your asthma may be well controlled during the day, but you may experience cough, wheezing, chest tightness, or shortness of breath at night. If you experience these nighttime symptoms, your asthma may be more serious and under less control than you think. Not only does nocturnal worsening of asthma affect your sleep, it also indicates poorly controlled asthma. Several studies have shown that such symptoms are associated with increased emergency room visits, need for hospitalization, and even death from asthma.

How Common Is Nocturnal Asthma?

Unfortunately, these symptoms are extremely common. Almost all patients with asthma are awakened by an episode of worsening asthma at least one night every month. As many as 50% of people with asthma are awakened three times each week and 33% are awakened because of their asthma every night.

What Causes Asthma Symptoms at Night?

Neither sleep nor dreaming is responsible for nocturnal worsening in asthma. However, there are several probable reasons for this phenomenon:

  • Allergic triggers: Contact with substances in your bedroom that cause an allergic reaction, such as cat or dog dander and dust, may be responsible. Irritating fumes from kerosene heaters and wood-burning stoves can also cause an asthma attack. Exposure to these or other triggers from earlier in the day may also cause a delayed reaction in which your asthma symptoms appear during the night.
  • Hormones: Levels of hormones in your body also change through the day. In people with asthma, the changing levels of hormones during the night may predispose the muscles in our lungs to contract, resulting in narrowing and inflammation of the bronchi.
  • Stomach acid reflux: If you notice a burning in your lower chest area or a bitter taste in your mouth when you awake in the morning, you may have stomach acid reflux.

What Can Be Done for Nocturnal Asthma?

These symptoms are a warning sign for you. Your doctor may suggest that your medical treatment needs to be intensified. He may also recommend improving your bedroom environment, or dietary controls for your stomach reflux.

This information is provided with permission from:

Protocol Driven Healthcare, Inc. (PDHI)
75 Claremont Road, Suite 201
Bernardsville, NJ 07924-2262, USA

Date: 2/4/2005

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