Nocturnal asthma symptoms can ruin sleep, leaving you feeling tired and run down the next day. Nocturnal asthma attacks are very serious and needs proper diagnosis and effective treatment.

The chance of asthma symptoms are 100 times higher during sleep. Nocturnal wheezing, coughing, and trouble breathing are common yet potentially dangerous. Nocturnal asthma attacks can cause significant problems sleeping, resulting in sleep deprivation and daytime sleepiness, fatigue, and irritability. These problems may affect your overall quality of life and may make it more difficult to control your daytime asthma symptoms.

9 Possible Causes of Night Asthma

There’s usually not one specific trigger that causes nocturnal asthma attacks. Rather, a number of possible factors can make you more susceptible to having a night asthma attack. Read on to find out what they are and what you can do about them.

1. Internal Triggers

Asthma problems may occur during sleep despite when the sleep period is taking place. People with asthma who work on the night shift may have breathing attacks during the day when they are sleeping. Most research suggests that breathing tests are worse about four to six hours after you fall asleep. This suggests there may be some internal trigger for sleep-related asthma.

2. Air Conditioning

Breathing colder air at night or sleeping in an air‑conditioned bedroom may also cause loss of heat from the airways.  Airway cooling and moisture loss are important triggers of exercise‑induced asthma. They are also implicated in nighttime asthma, too.

3. Gerd

If you are frequently bothered with heartburn, the reflux of stomach acid up through the esophagus to the larynx may stimulate a reflex associated with a bronchial spasm. This reflux is worse when you lie down and if you take certain medicines for asthma, which relax the valve between the stomach and the esophagus. Sometimes, acid from the stomach will irritate the lower esophagus and may activate the vagus nerve, which sends signals to the bronchial tubes that result in bronchoconstriction. If acidic gastric juice regurgitates all the way up the esophagus to the back of the throat and some of it drips down into the trachea, bronchi, and lungs, a severe reaction may take place. This can involve airway irritation, increased mucus production, and bronchoconstriction. Taking care of GERD and asthma with appropriate medications can often stop nighttime asthma.

4. Allergies

Allergy triggers that exist in your bedroom can lead to a nocturnal asthma attacks. These include dust mites, mold, pet dander, and seasonal allergens that become trapped in your clothing, bedding, and hair. Studies also show that if you’re exposed to an allergen before bed, there’s a good chance that you could experience a delayed second response at the night. So do what you can to allergy-proof your home and avoid triggers throughout the day.

5. Positioning

Lying down flat in bed can bring on an asthma attack because your airways become tighter, making it more difficult for air to flow in and out. This leads to coughing, which prompts your airways to tighten further and can cause an asthma attack. Try using extra pillows to lift your head or putting your mattress at an incline to minimize this risk, or talk to your doctor about other strategies that can make a difference.

6. Sinus Issues

While you sleep, your sinuses can drain into the airways and cause an attack if you suffer from allergies, have a cold, or have another illness. Therefore, to treat your nasal symptoms with an antihistamine, decongestant, or nasal spray before you go to bed.

7. Reflux

You may find that a bout of gastroesophageal reflux while you sleep can lead to a nocturnal asthma attacks. Some asthma medications can put you at an increased risk for reflux because they relax the valve that prevents acid from leaving the stomach and traveling back up the esophagus. Left unchecked, the acid can irritate the airways and lead to a full-blown asthma attack. If this is a concern for you, be sure to ask your doctor about using reflux medications.

8. Hormonal Changes

Hormonal changes that commonly occur while you sleep can increase your risk of experiencing nocturnal asthma. Epinephrine keeps your airways open and prevents airway spasms and excessive mucus reproduction. So if this hormone drops at night, you could be more vulnerable to having an attack. Take your asthma medications before bedtime to help prevent this effect.

9. Sleep Apnea

Sleep apnea is a serious condition that causes a brief lapse in breathing and sometimes occurs in conjunction with asthma. If your doctor suspects you have this problem, it’s important to undergo testing to confirm the diagnosis so you can get proper treatment.

Prevention is the best medicine

No matter what drug therapy your doctor recommends, addressing the causes of nocturnal asthma can help alleviate symptoms. Thus, it’s important to take steps to eliminate allergens from the bedroom and to avoid daytime exposure to triggers as much as possible. For more information, read these asthma trigger articles about air irritants and animals.