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Asthma At Night – A True Nocturnal Menace

What Is Nocturnal Asthma?

Nocturnal asthma is no uncommon occurrence.

Studies have shown that even healthy lungs function best from 12 P.M. to 4 P.M. and worst between 3 A.M. and 4 A.M.

Doctors often underestimate the severity of nocturnal asthma as most deaths related to asthma symptoms occur during the night.

Nocturnal asthma needs a proper asthma diagnosis and an effective asthma treatment.

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Asthma Symptoms At Night

  • Wheezing
  • Coughing
  • Tightness in the chest
  • Shortness of breath, also known as dyspnea

Does Asthma Get Worse At Night?

The short answer is: yes, asthma usually worsens during sleep, and especially so during the night.

While the exact reasons are unknown, there are many possible reasons why asthma gets worse at night.

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Why Does Asthma Get Worse At Night?

Here are the most likely culprits for asthma symptoms at night:

  • Increased exposure to allergens
  • Cooling of airways
  • Sleeping in a reclining position
  • Hormone secretions
  • Sleep itself

Toddler Asthma Cough At Night

Just as with adults, toddlers and children may also experience heavier asthma symptoms during the night.

That is because lying down can trigger a cough, and especially so if your toddler also has blocked sinuses.

In addition, hay fever is also often a cause. That is because of the post-nasal drip which may occur.

Post nasal drip is the mucus that drips from the back of your nose down to your throat.

Causes for Asthma at Night

Causes For Asthma Cough At Night

Sleeping In A Reclining Position

Doing so can increase the volume of blood in the lungs.

In addition, sleeping in a reclining position can increase airway resistance, the buildup of secretions in the airways and decrease lung your volume.

Increased Sinusitis or Mucus

Your airways tend to narrow down during sleep and build up mucus in the swollen airways. This may trigger wheezing and coughing at night, which in turn may lead to your airways tightening up even more.

Additional drainage from your sinuses can also trigger asthma for those who have highly sensitive airways.

Internal Triggers

Most research indicates that breathing is most difficult for us about 4 to 6 hours after we fall asleep.

It also suggests that there may be some internal triggers for sleep-related asthma. This can include heavy emotions, such as intense anger, sadness, or even happiness.

Air Conditioning

Sleeping with the air conditioning on or breathing colder air at night can cause nighttime asthma. Your airways may lose heat and the colder the air, the dryer the air will also be.

This triggers asthma - especially exercise-induced asthma and nocturnal asthma.

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Increased exposure to pollution or other indoor allergens can trigger asthma. The most common culprits are pets or dust mites in your living or bedroom.

Also, if you have a traditional wood burning stove or a kerosene heater, be aware. Both are known to cause asthma attacks at night.

Gastro-Esophageal Reflux Disease

If you frequently experience heartburn, then the reflux of your stomach acid tends to rise through the esophagus to your larynx. This may stimulate a bronchial spasm, and it’s even worse when you’re lying down.

Certain medications for asthma which relax the valve between the stomach and the esophagus may also worsen the situation. In some cases, the acid from the stomach may even irritate the lower esophagus.

In turn, the vagus nerve that sends signals to the bronchial tubes may be activated, resulting in bronchoconstriction.

The good news is: taking care of Gastro-Esophageal Reflux Disease and asthma with the right medications can often cure wheezing and coughing at night.

Late Asthmatic Response

The chances are high that airway obstruction or allergic asthma will occur shortly after being exposed to an allergen.

Generally speaking, an acute asthma attack at night should usually last no more than an hour.

Approximately 50% of people who get an immediate reaction to an allergen will have a second response to it within 3 to 8 hours. It is also known as the late asthmatic response, characterized by the development of bronchial inflammation, an increase in airway responsiveness and a prolonged period of airway obstruction.

Researchers have shown that exposure to an allergen in the evening increases the chances of having a more severe late phase response than one during the day.


The hormone levels in your body change according to your circadian rhythm.

Epinephrine is a hormone that keeps the bronchi muscles relaxed, so that the airways remain fully open. It also suppresses the release of other substances like histamine, which can cause bronchospasm and mucus secretion.

The epinephrine levels are the lowest around 4 A.M., while the histamine levels tend to peak at the same time. This results in the narrowing and inflammation of the bronchi, which explains nocturnal asthma during sleep.

In addition, estrogen is also known to be a possible trigger for asthma.

How to Stop an Asthma Cough at Night

How To Stop An Asthma Cough At Night

If you are having problems with your breathing – during the night or day – we highly urge you to visit your local doctor.

While there is no cure yet for asthma at night, there are some medications that can help control the symptoms.

One of the most important things to keep in mind is that the better you take care of your asthma during the day, the better it will also be during the night. Also, make sure to minimize all possible allergens in your bedroom.

Here are some medications that you may encounter when looking to treat your asthma:

  • Anti-inflammatory
  • Antihistamines
  • Bronchodilators
  • Corticosteroids
  • Inhaled glucocorticoids
  • Inhaled/oral B2 adrenergic agonists
  • Leukotriene modifiers
  • Steroids
  • Theophylline

Home Remedies For Asthma Cough At Night

After you have visited the doctor, these tips below are home remedies which will help take control of your asthma.

  • Keep your pets away from bedroom
  • Install an air humidifier in your bedroom, especially during winter
  • Take your medicines on time so they continue to work throughout the night
  • Look into hypoallergenic mattresses, toppers and pillows such as those with Vita Talalay latex inside.
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