Sleep Care

Life and Breath: How Asthma Affects Sleep

Coughing, wheezing, tightening chest – Anyone with asthma knows all too well the discomfort that asthma brings. In fact, with asthma the very basic function of breathing does not always come easily and for some it can be worse at night. Asthma is a chronic lung condition that affects about 20 million Americans according to the National Heart, Lung and Blood Institute. Symptoms occur when the airways become inflamed making breathing difficult. Currently, it is not known what causes asthma or why it is on the rise, but regardless of the causes it is a serious and sometimes fatal condition that needs to be carefully managed. For some sufferers asthma symptoms worsen at night. Most research indicates that breathing tests are worse about four to six hours after you fall asleep. Consequently, the chances of experiencing asthma symptoms are higher during sleep. When asthma symptoms appear at night this is called nocturnal asthma. Many people often underestimate the seriousness of nocturnal asthma, but it is a significant issue. Studies show that most deaths related to asthma symptoms occur at night. Additionally it can cause substantial problems sleeping. The end result is sleep deprivation, daytime sleepiness, fatigue, and irritability. These problems can then make

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it more difficult to control daytime asthma symptoms and make managing life or school difficult. Although the exact cause of nocturnal asthma is unclear, there are a number of situations that can impact and even worsen the condition. These include, but are not limited to, sleeping in a reclining position, acid reflux (or GERD), sinusitis and hormones. For instance, hormones that circulate in your blood have distinct circadian rhythms. Epinephrine, a hormone that helps keep your airways relaxed and suppresses allergic reactions, is at its lowest at 4 a.m. As a result, this could trigger nocturnal asthma attacks. Sleep apnea, a sleep-related condition also can worsen nighttime asthma. This sleep disorder is characterized by repeated pauses in breathing throughout the night. By itself sleep apnea is a very serious problem, but it can also set off or worsen asthma symptoms. A recent study by the Cincinnati Children’s Hospital Medical Center showed that women with asthma were twice as likely to have symptoms of sleep apnea compared to those without asthma. If you or your child are having trouble sleeping due to asthma, here are some suggestions for improving your situation:

  • Monitor and record symptoms in a sleep journal. Record fatigue, excessive daytime sleepiness, frequent napping and any other related symptoms.
  • Talk to your doctor about nighttime problems and anything noted in the sleep journal. Asthma needs to be controlled during the day and at night in order to maximize quality of life – and breathing.
  • Discuss medications with your doctor. Be sure you are taking the proper medications and dosages for your symptoms. If dealing with a child’s asthma, be sure that he or she is taking all the doses on time. If you suffer from GERD, ask about medications that reduce acid production in the stomach.
  • Avoid potential allergy-triggering items like dust mites, animal dander and down pillows and comforters, especially in the hours before bedtime.
  • Talk to your doctor about the possibility of additional sleep issues. You may find that you or your child needs to have a sleep study conducted.

Remember, asthma doesn’t have to keep your family from getting the sleep it needs. Work with your doctors to determine what’s causing the sleep problems and together come up with a plan to solve them.  

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