Nocturnal asthma: Symptoms and causes

If you have asthma, you may wonder why the symptoms often get worse at night. Cough, chest tightness, and shortness of breath at night are all symptoms of nocturnal asthma or nighttime asthma. Nocturnal asthma can lead to poor quality of sleep due to all these symptoms. If you won’t get at least seven to eight hours of leave, you will feel tired the following day. On World Asthma Day, observed on the first Tuesday in May, we tell you all about nocturnal asthma or nighttime asthma.

What is asthma?

Asthma is a chronic respiratory condition, which is characterised by narrowing of the airways and inflammation, shares pulmonologist Dr Sachet Dawar. Wheezing, breathing difficulty, chest tightness, and coughing are its common symptoms.

What is nocturnal asthma?

Nocturnal asthma or nighttime asthma frequently interferes with sleep patterns and is also characterised by coughing, wheezing, shortness of breath, and chest tightness. About 60 percent of people who have asthma experience nocturnal symptoms, as per a 2006 study published in the Journal of Asthma. Asthma at night can cause sleep disturbances, which can lower the quality of life overall.

What are the symptoms of nocturnal asthma?

Symptoms of nocturnal asthma and asthma symptoms during the day are generally the same. It is just that these symptoms become worse at night. The symptoms are:

• Shortness of breath
• Coughing
• Wheezing

They make sleep impossible, causing the following issues during the day:

• Worsened asthma symptoms during daytime
• Sleepiness
• Feeling tired
• Lack of concentration

What are the causes of nocturnal asthma?

While allergens, physical activity, or stress are often the cause of asthma symptoms during the day, sleep is frequently the catalyst for asthma exacerbations at night, says the expert. The following are causes of nocturnal asthma:

1. Circadian Rhythm

At night, the body’s natural clock changes. This can cause a rise in airway inflammation and a fall in lung function, making asthma symptoms worse at night.

2. Posture

Lying in a reclining position can lead to an accumulation of mucus in the airways. This in turn aggravates asthma symptoms and makes breathing more difficult at night.

3. Acid reflux

Stomach acid refluxes into the esophagus and airways during the night. So, gastroesophageal reflux disease (GERD) often gets worse at night and aggravates asthma symptoms.

4. Allergens

At night, indoor allergens like mold, pet dander, and dust mites tend to be more concentrated. These can exacerbate asthma symptoms during nighttime, says Dr Dawar.

5. Changes in air quality

Drop in temperature, reduced humidity, and pollution during the night can all aggravate the airways. Once that happens, it can cause asthma attacks while sleeping.

How to diagnose?

You can find out if you have nocturnal asthma by getting checked by a doctor, who can look at the changes in your lung function. There is a device called peak expiratory flow meter, which is used to take measurements of airflow during the day and at night. It is done in the morning after waking up and again before going to bed.

How to treat nocturnal asthma?

Identifying and avoiding asthma triggers is an important part of managing nighttime asthma, says the expert. As for the treatment for nocturnal asthma, it typically involves a combination of long-term control medications to manage underlying inflammation and prevent symptoms, as well as quick-relief medications for acute symptom relief. Inhaled steroids can help in reducing inflammation and preventing nocturnal asthma symptoms.

It is important to see a doctor if you experience frequent nocturnal asthma symptoms or if your current treatment plan is not effectively managing your condition.