Nighttime asthma

[jivemonkey]

Hi, only recently diagnosed after 5 years of on off symptoms where my GP said was anxiety. Got fed up and paid for private assessment.

Had dye injected CT, full lung function tests and examined by specialist. Had lung function tests about 8 weeks after starting beclamecasone. Exceeded average on it all including peak flow regularly over 700, this can move around a bit and best 750 (5'10" mid 40's guy) but peak flow and symptoms seem unrelated.

Onlly test that came out close was my nitric oxide was 25 on a scale of 0 to 25 even when on daily 2 x 2 puffs of Fobumix. Before that beclamecasone did not really work. Specialist asthma consultant at hospital said certain its asthma.

My asthma is classed as mild and comes and goes, worse early Jan to May ish then reduced or dissapears through summer and autumn sometimes.

My issue is that whilst daytime symptoms seem to be gone about 90% of the time since using inhaler, nighttime is still an issue. Comes and goes but been waking with shortness of breath nearly nightly for last few weeks (and not slept well for last 5years or so now). Sincd using inhaler my peak flow has increased nearly 100 but still struggle at night. Often 5 am ish wake with shortness of breath. Goes a few mins after sitting up but regularly up at 5 am with shortness of breath so sleep is 6 ish to 7 hours a night.

Any advice on what I should do about nighttime issues. Tried better bedding,. room dust extractor etc but still struggling.

Fairly fit... excercise most days (cycling, cross trainer, weights, long walks etc) but could do with losing weight and wondering if that can help. Currently 15 stone 4..

Any advice appreciated

[twinkly29]

Symptoms at night even when it's ok in the day can be a sign that asthma is not controlled so it would be worth asking for things to be reviewed. Things like silent reflux can also cause problems at night which can occur alongside asthma as a separate issue or can occur and trigger asthma symptoms. Either way it's generally easy to sort with gaviscon or ppi medication.

The nitric oxide bit is odd though. It doesn't have a range of up to 25. It goes much much higher and above 40 is meant to be indicative of likely asthma.

That's not to say it's not asthma as FENO is only useful in some types of asthma (and to be honest sometimes not even then!) - it's just odd what you were told about it.

That's by the by though as your symptoms now would suggest a review is sensible. I presume your GP is more receptive now?

[ChrissieMons]

Losing a bit of weight would help, of course, and try having more pillows so you're sitting up at night. You'll slide down in the night, but it might help. A pillow under your knees will stop a bit of the slide. Worth a try, anyway!

[jivemonkey in reply to ChrissieMons]

thanks, thinking of trying one of those wedge pillows, not sure if any good but willing to try anything that helps stop the almost daily 5am waking with sob... consultant just advised to increase inhaler so will see if that helps. always bad around March April time so hopefully will improve in the next few weeks as summer and autumn usually much better