MD4Lungs.com - Yatin J. Patel, MD MBA

Sneeze & Snooze Clinic

Yatin J. Patel, MD MBA
Barb Chupp-Grove, NP-C
2417 S. Berkshire Drive
Goshen, IN 46526

Phone 574.534.9911 Fax 574.534.6915

Nighttime Asthma

Nocturnal (nighttime) asthma, which can be severe, is often brought on by allergens in the bedroom, heartburn, a drop in body temperature, or even by delayed reactions to triggers that you were exposed to during the day.

The circadian rhythm -your body's internal clock- may also affect your asthma, making you more susceptible to episodes in the early morning hours.

A combination of causes Like all types of asthma, nocturnal asthma has its own "triggers" that cause symptoms. Recognizing your own personal triggers is the first step in helping your doctor develop an effective treatment plan.

One or a combination of these factors can contribute to nocturnal asthma symptoms:

Allergic factors. Exposure to allergens such as pet dander, dust, or pollen can lead to an asthma episode. a Inflammation. Causes airway blockage and occurs when your bronchi come in contact with irritants or triggers.

Airway cooling. Exposure to cold is a common trigger for asthma symptoms. Your body temperature drops-often quite rapidly-when you steep, and this increases the chance of an asthma episode at night.

Airwaysecretions. People who have chronic sinus problems (swollen or infected sinus passages) or who have postnasal drip may also experience nocturnal asthma symptoms.

Sleep apnea. This is a condition in which your breathing actually stops for short periods during steep. Steep apnea occurs in the upper airways, and may bring about an asthma episode. a Circulatory factors. Throughout the day, hormones and other chemicals circulate through your bloodstream. Studies show that the levels of these chemicals vary according to the time of day or night, and may have an effect on lung function.

Gostroesophageal reflux (heartburn). Lying down sometimes causes gastric (stomach) acids to seep back into the esophagus (the muscular tube leading from your throat to your stomach), causing irritation and coughing, which can cause asthma symptoms.

Responding to a daily cycle.

Several of the triggers described above are related to the changes in lung function that occur in a regular pattern or rhythm over a 24-hour period. This pattern is called the circadian rhythm, or diurnal variation. Studies have revealed that the airways of people with asthma are more sensitive in the early morning hours (around 4 AM) than in the late afternoon (around 4 P.M.). Therefore, swelling of these airways often increases while sleeping. Interestingly, however, this circadian rhythm relates to the time of day that a person regularly sleeps. For example, if you work at night and steep during the day you may experience symptoms while sleeping during daytime hours.

Controlling nocturnal asthma

The goal of treatment for nocturnal asthma is the prevention of symptoms that can interfere with your normal cycle of sleeping and waking. You and your doctor can work together to identify your triggers and develop a treatment plan.

The first things that your doctor will consider before prescribing medication will be how often you experience nighttime asthma episodes, and how severe the symptoms are. Certain medicines last longer than others, or give peak levels at desired times, allowing more accurate control of the disease. Other medicines are most effective when taken just before going to bed. This is why it is so important to follow your treatment regimen exactly-so that you get the most benefit.

Other ways to control nocturnal asthma include: a Sinus relief. If you have a chronic sinus infection or postnasal drip, take steps to improve this condition. When your sinuses are clear, nocturnal asthma symptoms often improve significantly.

Temperature control. If a fall in body temperature is your main problem, try breathing warm, humidified air while you sleep. Most drugstores carry humidifiers or vaporizers that can help. Make sure to clean these units regularly, as dust, mold, and other allergens may collect, thereby defeating the units' purpose. Also, warm, damp areas can be a breeding ground for bacteria and mold, so make sure surfaces are clean and dry.

Improved air flow. If you experience steep apnea, ask your doctor for ways to control it. Changes in sleeping position, medication, or a device that helps keep the throat open are possible solutions. o Allergen removal If you know that exposure to pets, dust, feathers, carpeting, or other allergens is a trigger, take preventive steps-especially in the evening hours. Try to make your sleeping area as free of potential triggers as possible.

The important thing to remember is that like any other type of asthma, nocturnal asthma can be controlled. By working with your doctor and by following your treatment plan, you'll be able to take effective steps toward a restful night's sleep.