Ask Dr. Miriam Anand

Preventing Nighttime Asthma

Q: I’ve noticed that asthma bothers me the most at night. What can I do to control my symptoms so I can sleep better?

A: First, it’s important to identify the triggers for your nighttime asthma symptoms. For example, you may be exposed to certain allergic triggers at night, such as dust mites that can live in mattresses, pillows, and bedding. Similarly, if you are allergic to feathers and have feather bedding or pillows, you could be experiencing allergic asthma.

Acid reflux is another factor that can worsen or trigger asthma, and it’s more common at night when your body is horizontal in bed. It’s important to note that acid reflux doesn’t always cause overt symptoms like heartburn or the taste of stomach acid. If acid reflux is an issue for you, try raising the head of your bed 6 to 8 inches, and make sure you that you do not eat or drink large amounts for at least three hours before lying down.

You may also want to talk to your doctor about other sleep issues. While it may not be associated specifically with nighttime asthma, untreated sleep apnea (a condition in which breathing stops for brief periods during sleep) can lead to more poorly controlled asthma in general. Loud snoring and daytime sleepiness are the most common symptoms of sleep apnea.

Seeing an asthma specialist, such as an allergist/immunologist, can help in identifying triggers or aggravating factors for asthma. However, patients who have nighttime asthma symptoms more than twice per month should be on daily medication to control asthma. Inhaled steroids are commonly used to control inflammation in the airways, but some patients may require a combination of these and long-acting bronchodilators, which help relax the muscles around the airways. Alternative medications known as leukotriene inhibitors may also be appropriate for some people.

Last Updated: 07/31/2013