Prather Pediatric and Allergy Center - Ask Doctor Brent

Printer Friendly Version

Title: Night Time Asthma

Category: Asthma and Allergy


Asthma occurring while you sleep is called "nighttime asthma "or "nocturnal asthma". The symptoms can include typical wheezing and shortness of breath or just coughing. Many patients with nocturnal asthma have asthma in the day also but some patients only experience asthma at night. There are several reasons for nocturnal asthma. One is the body's rhythm and cortisone cycle. Patients have greater cortisone produced by their adrenal glands in the day time and less late at night. They also have changes in other body rhythms including temperature. They also are lying flat which makes it harder for their lungs to expand fully as opposed to standing or sitting upright. Another frequent cause of asthma is gastro-esophageal reflux. Patients with GE reflux frequently experience heartburn and sometimes burning and coughing only when lying down. The symptoms are worse after eating a large fatty meal and then lying down. Other possible factors increasing asthma at night can include several environmental triggers such as dust mite, mold, animal danders, cigarette smoke, feathers in the pillow or mattress and other irritants such as gas or kerosene or smoke from a wood burning stove or fireplace.

What should one do if they have nocturnal asthma? First of all discuss your symptoms with your doctor particularly if you are waking up regularly with coughing or wheezing. You may need to have better environmental control measures in your home environment and to be more aggressive with your medicines particularly using anti-inflammatory medicines for better 24 hour control such as inhaled cromalin or inhaled corticosteroid sprays (Azmacort, Beclovent, Vanceril or Aerobid). You may need to take long acting bronchodilator medicines which carry you through the night time, including 12 and 24 hour theophylline preparations or 12 hour beta-aganists such as Proventil Repetabs. If reflux is a problem your doctor can recommend several measures like elevating the head of your bed, eating a less fatty meal at night and not lying down until three hours after eating, avoiding such foods as chocolate and peppermint and heavy fatty foods and, if necessary, taking medicines ranging from antacids (Maalox, Mylanta) to histamine blockers (as Tagamet or Zantac). In summary, nocturnal asthma is a very common occurrence both in children and adults and consists of coughing, wheezing, chest tightness and shortness of breath. It occurs regularly at night. If you suspect you have this condition, work with your pediatrician, family doctor, internist or pulmonologist to better control your overall asthma condition and to begin sleeping the night through in good health.