Night Asthma » Causes, Symptoms, Treatment

This article explains details about Night Asthma, its symptoms, causes of Night Asthma or Nocturnal Asthma such as Excessive mucus or sinusitis, Internal pathogens, Horizontal position of the body, Air-conditioned air, GERB (Gastroesophageal reflux disease), Late reaction of the organism, Hormones, and treatment.

Night Asthma

Can nighttime asthma disturb sleep? Nighttime asthma with its symptoms, such as chest compressions, dyspnoea, coughing and wheezing, cannot sleep at all. Symptoms of night asthma can disturb sleep, do not give a good rest, and as a result, the whole next day you will feel tired and listless. It is impossible not to pay attention to nocturnal asthma. This is very serious – and you need an accurate diagnosis and effective treatment.

Asthma and sleep disorders

Symptoms of asthma are 100 times more severe when they worsen during sleep. Night wheezing, coughing and breathing problems are common symptoms, but also potentially life-threatening. Most people underestimate the seriousness of nocturnal asthma.

Studies have shown that most of the deaths due to asthma occur at night. Nighttime asthma attacks can cause serious problems with sleep, and, consequently, lack of sleep, drowsiness, fatigue, and irritability during the day. These problems can affect your life in general and make it more difficult to control symptoms during the day.

Causes of Night Asthma

  • Excessive mucus or sinusitis
  • Internal pathogens
  • Horizontal position of the body
  • Air-conditioned air
  • GERB (Gastroesophageal reflux disease)
  • Late reaction of the organism
  • Hormones

Let’s study all the above factors in detail.

The exact reasons why asthma symptoms progress during sleep are unknown. But still, there are many hypotheses explaining what can cause an exacerbation of the disease. These include close contact with allergens during sleep, severe airway cooling, horizontal body position, or hormonal secretions that disrupt the circadian rhythm. Even sleep itself changes the working capacity of the lungs and airways. For reasons you can also include:

Excessive mucus or sinusitis

During sleep, the airways severely narrow, and mucus blocks them. This can cause a cough during sleep, which can trigger an even greater compression of the airways. Increased sinuses from the sinuses can also cause an asthma attack in the hypersensitive airways. Sinusitis in asthma is very common.

Internal pathogens

Exacerbation of asthma can occur only during sleep, no matter at what time of day the dream comes. For example, asthmatics working on the night shift may suffer from asthma symptoms during the day when they are sleeping. Most researchers suggest that the performance of the lungs worsen after 4-6 hours after the onset of sleep. This shows that there are internal pathogens provoking asthma during sleep.

Horizontal position of the body

The horizontal position of the body can provoke an exacerbation of asthma. The cause of this may be various factors, for example, the accumulation of secretions in the airways (congestion of the sinuses or postnasal congestion), increased volume of circulating blood in the lungs, a decrease in lung volume and increased respiratory resistance.

Air-conditioned air

Cold air from the air conditioner can cause severe cooling of the respiratory tract. The respiratory tracts cool down and become drier, and this is the main cause of exacerbation of asthma tension. And it also aggravates nighttime asthma.

GERB (Gastroesophageal reflux disease)

If you often suffer from heartburn, acid reflux from the stomach into the esophagus and larynx can cause a reflex called bronchospasm. Reflux intensifies when you take a horizontal position or, if you take certain medications to treat asthma, weaken the valve between the esophagus and stomach. Sometimes gastric acid irritates the lower part of the esophagus and activates the vagus nerve, which sends signals to the bronchial tubes, thereby provoking bronchoconstriction (constriction of the bronchus lumen). If the gastric juice constantly rises up the esophagus to the larynx and a few drops fall into the trachea, bronchi and lungs, then the body’s reaction will be very serious. The result can be severe irritation of the respiratory tract, increased production of mucus and bronchoconstriction. If correctly and on time to begin to treat GERB and asthma.

Night Asthma
Night Asthma

Late reaction of the organism

After close contact with the allergen or asthma causative agent, the airways severely narrow or exacerbate allergic asthma. But sometimes it happens with some delay. This aggravation of the disease can last about an hour. About 50% of those who encounter a sudden exacerbation of asthma, and there is a second phase of narrowing of the airways three to eight hours after contact with the allergen. This phase is called the belated reaction of the body. A belated reaction is characterized by an increase in the sensitivity of the airways, the development of inflammatory processes in the bronchi and a longer blocking of the airways.

Most studies have shown that if contact with an allergen occurred in the evening, rather than, say, in the morning, then the belated reaction of the organism is more likely, and the asthma attack can be very serious at the same time.


Hormones circulating in the blood have characteristic circadian rhythms that differ in people who suffer from asthma. Epinephrine is one of such hormonal substances that has an important effect on the bronchi. This hormone helps maintain the muscle tissue surrounding the airways in a relaxed state and thus the airway clearance remains wide enough. In addition, epinephrine inhibits the action of other substances, for example, histamine, which is the cause of the formation of mucus and bronchospasm. The level of epinephrine in the body and the maximum volumetric expiratory flow rate decrease by 4 am, and the level of histamine, on the contrary, rises. Lowering the level of epinephrine and leads to an exacerbation of symptoms of nocturnal asthma during sleep.



Treatment of Night Asthma

There is still no way to completely cure asthma. But daily use of drugs such as inhaled steroids is very effective in reducing inflammation and preventing the onset of symptoms of nocturnal asthma.

Since the symptoms of asthma can worsen at any time during sleep, treatment should be such as to protect the body during these hours. A long-acting bronchodilator that goes into inhalers can be effective enough to prevent bronchospasm and exacerbation of asthma symptoms. If you suffer from nocturnal asthma, then for sure you will appreciate the effect of a long-acting inhaled corticosteroid. If in addition to asthma you have GERD, you need to consult a doctor about a medicine that would reduce the formation of stomach acid.

It is also important to avoid contact with potentially dangerous allergens such as dust mites, animal hair or bird feathers, this will help prevent an allergic reaction, exacerbation of asthma symptoms and nighttime attacks.

In addition to the above, do not forget to use a pneumotachometer, which will help to constantly monitor the condition of the lungs and make a schedule of changes in their performance. Based on this schedule, the doctor will be able to draw up a program of actions that will help to avoid night attacks. Depending on the type and complexity of asthma (minor symptoms, moderate and severe), the doctor prescribes a treatment that normalizes your sleep.

Night Asthma » Causes, Symptoms, Treatment
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