Nocturnal Asthma: Facts, Causes, Symptoms, Triggers, and FAQs

Nocturnal Asthma Facts

  • A type of asthma that gets worse at night is called nocturnal asthma.
  • Environmental allergens, stress, hormonal factors, obesity, sinusitis, and more contribute to the worsening of asthma at night.
  • People with nocturnal asthma develop symptoms such as wheezing, chest tightness, breathing difficulty, and coughing.
  • Nocturnal asthma symptoms are common regardless of which type of asthma you have – including allergic and non-allergic asthma, exercise-induced asthma, or occupational asthma.
  • The average sleep quality score for nocturnal asthma patients are lower. For children, it gets as low as 51.
  • In Orange County alone, 15.9% of asthma cases were reported in 2015-2017.

Image of a Boy with Inhaler and Nocturnal Asthma Text

What is Nocturnal Asthma?

Asthma is a long-term, chronic respiratory disease, caused by the inflammation of the airways. When this condition worsens overnight, we call it nocturnal asthma or nighttime asthma. Regardless of the type of asthma you have, including allergic, non-allergic, occupational, and exercise-induced asthma, nocturnal asthma can occur more than once a month.

Over the past decade, the prevalence of asthma in adults and children has increased in the United States. The California Health Interview Survey states that 15.9% of asthma cases were reported in Orange County in 2015-2017. Although there is no cure for asthma, the symptoms (whether worse during daytime or nighttime) can be managed through long-term medications and short-term quick-relief inhalers. A few home remedies and other tips (we"ll look into those later in this blog) can also help patients with nocturnal asthma sleep better.

What Factors Contribute to Night Time Asthma Attack?

The factors that contribute to nocturnal asthma include:

  • Environmental allergens
  • Cold air
  • Hormonal factors
  • Stress
  • GERD (Gastroesophageal Reflux Disease)
  • The supine sleeping position
  • Obstructive sleep apnea
  • Sinusitis
  • Obesity
  • Increased mucus production

What Are the Symptoms of Nocturnal Asthma?

The symptoms of nocturnal asthma and regular asthma are the same, but a few may get worse at night, which include:

  • Shortness of breath
  • Wheezing
  • Chest tightness
  • Coughing

In addition, people and especially children may develop other sleep issues, including:

  • Excessive daytime sleepiness
  • Sleep-maintenance insomnia
  • Sleep-disordered breathing like sleep apnea
  • Parasomnias like sleepwalking

What to Do During an Asthma Attack Without an Inhaler at Night?

Follow these tips to survive a night-time asthma attack without an inhaler:

  • Sit straight to keep your airways open
  • Stay calm, as stress or panic can worsen your symptoms
  • Take long, deep breaths to reduce symptoms
  • Asthma can be triggered by dust, cigarette smoke, and other allergens. Stay away from triggers and go to any area with clean air.
  • A cup of coffee can open up your airways and provide you some relief
  • Seek emergency medical attention if symptoms persist

Tips to Sleep Better with Severe Asthma At Night

Nocturnal asthma is associated with poor sleep quality. This condition of sleeplessness and its effects are worse for children. The average total sleep quality score of children affected by asthma is 51, which is above the clinical cut off of 41, but it indicates the pervasive sleep disturbances among this population.

Here are a few tips that can help you sleep better with asthma at night:

Pet dander, dust mites, and other indoor allergens can trigger or worsen asthma symptoms. Clean your bedroom regularly to improve the indoor air quality and keep these factors out.

Related Blog: 4 Ways How Poor Air Quality Can Negatively Affect Your Health

Wash your bedding in hot water every week. The water should be at least 130 degrees Fahrenheit so that it can kill dust mites and other allergens in your bedding.

Zippered pillow covers are tightly woven to keep allergens and dust mites out of your bed covers.

Cold air can trigger or worsen asthma symptoms at night. During winter, you can use a humidifier to increase your bedroom’s air quality. Dust mites usually develop in low humidity. By increasing humidity, you can keep the dust mites out of your room.

Pet dander can trigger asthma symptoms, so don’t sleep with pets. Make sure to close your bedroom door to keep your pet and their dander out.

If you have acid reflux, cold or sinus infection, lying flat can trigger an asthma attack. You can sleep keeping your head propped slightly up with a pillow to avoid a night-time asthma attack.

People with asthma may experience sleep apnea, which are frequent pauses in breathing during sleep. Sleep apnea can worsen asthma symptoms. Undergo a test to diagnose sleep apnea and take treatments if required.

  • Keep Your Bedroom Clean

  • Wash Your Bed Covers and Blankets

  • Use Dust-Proof Pillow Covers and Mattress

  • Use Humidifier

  • Avoid Sleeping with Pets

  • Consider Your Sleeping Position

  • Undergo Sleep Apnea Test

Nocturnal Asthma FAQs

Can You Die in Your Sleep From Severe Asthma?

Asthma causes sleep disturbances and usually wakes up people from sleep, so it is unusual to die because of asthma during sleeping, unless heavily sedated for some other reason. However, asthma can be fatal if you are not seeking proper medical attention to treat worsening symptoms.

Does Steam or Vaporizer Reduce Chances of an Asthma Attack at Night?

Generally, steam or vaporizer can liquefy mucus when breathing problems are caused by an allergy or cold. This can help a person feel better. On the other hand, asthma is caused by chronic inflammation of the airways, making it difficult to breathe. Steam or vaporizer can cause irritations and worsen breathing problems.

Does Melatonin Improve Sleep in Asthma?

Researchers have revealed that the hormone melatonin plays a vital role in improving the sleep cycle in asthma patients. Melatonin helps in regulating human circadian rhythms and is believed to have sleep-inducing activity. Additionally, melatonin studies suggest that it affects smooth muscle tone and inflammation too. Both of which helps in improving the sleep cycle for asthma patients at night.

Does Honey Treatment Help in Improving Sleep with Asthma?

Coughing is one of the symptoms of nocturnal asthma, which can be reduced by taking two teaspoons of honey with warm water or cinnamon before you go to bed. Honey can increase saliva production, which can ease your cough by lubricating your airways and reduce inflammation in the bronchial tubes that causes breathing difficulty.

Does a CPAP Help in Asthma Attack at Night?

If there is an issue of carbon dioxide retention during an asthma attack, your doctor is more likely to recommend a BiPAP (Bilevel Positive Airway Pressure), as opposed to a CPAP (Continuous Positive Air Pressure). However, many patients with mild asthma have reported of using a CPAP machine without any problems.

Visit your doctor as soon as you suspect that you have asthma or asthma-like symptoms. Seeking immediate medical attention from an urgent care near you can also help you control an asthma attack and manage the symptoms.

Also Read: Signs of Acute Bronchitis and How to Heal It




Gina Nguyen, MD

Dr. Nguyen is a medical director at Family Care Center Costa Mesa. She has implemented standards of care for underserved population and helped the clinic achieve NCQA (National Committee of Quality Assurance) Level 2 recognition and FQHC (Federally Qualified Health Care Center) status. Now, her focus is on providing the highest quality care to patients and improving lifestyle choices to reduce or eliminate health problems.

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