4am Question

Why is it that 4am is the worst time of the day fofr asthmatics lungs. Was told this in a and e last night and have read it but don't know why.

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Its probably something to do with the high levels of dust or pet allergen that build up in your bedroom. Pillows and mattresses get very dusty and many people unconsciously breathe through their mouthes at night - several hours of this would help to explain why so many asthmatics have horrible trouble sleeping, but are much better in hospital thanks to a minimal amount of soft furnishings / cuddly toys / animals.

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Hi Katharine,

I've been told that early hours of the morning are the worst time for asthmatics as between 2am and 5am the body's natural cortisol (similar to pred) is at it's lowest then. Makes sense to me but maybe a med-type person can explain it better.

Becky.

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Its at a time where your bodies own steriod is at its lowest. Infact pretty much everything in your body is at its lowest at that point. Hence the classic dirurnal (early morning dip).

Bex

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You body has diurnal rhythms, which help to tell you when to sleep, to get up etc. Part of this is that you have a diurnal variation in your hormone levels - 4-6am is typically when your cortisol levels are at their lowest, meaning that your natural anti-inflammatory system is at its lowest - hence why many folk do report more symptoms around this time of day.

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thanks cathbear that explains it. I had noticed that if i am stuggling it does mean i tend to wake between those hrs for my inhaler but never associated it with any particular time just that i was in a lighter sleep maybe nice to know there is a medical explanation for it. Am only sorry that it took me a trip to a and e to qestion it further.

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As a night shift worker ,I can confirm that almost without fail,I need a couple of relief blasts between 4 & 5 am-even if I have had my Seretide as late as possible before going to work.

Bluejam.

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Yeah, when I used to work nights I noticed the same difficulty. OK if things weren't busy at the time, but more difficult if things were hectic.

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4am Question

Early morning waking is generally thought to be a sign of poorly controlled asthma, it is related to the body's natural sleep/wake cycle or diurnal variation however it is not usual in well controlled asthma - I suggest that you make a trip to the GP and review things. It concerns me that so many of you are commenting about having experienced this - please take note and speak to your GPs or asthma nurses about it.

I have also experienced this many times over the years as an asthma sufferer and in my patient populations - it has always signalled a worsening of my own or a patients asthma. It is not something to be ignored or deemed 'normal'. (I am a respiratory nurse specialist now working in research.)

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For alot of us 'brittle-asthmatics' being awake early hrs isnt neccessarily a sign of worsening but just one of those things we have to put up with regularly.

In many milder asthmatics it can help to indicate a deteriation in control but as I said many of us brittles do have this more as a constant symptom than a worsening signal.