Post-nasal drip and allergic asthma a... - Asthma Community ...

Asthma Community Forum

19,518 members23,429 posts

Post-nasal drip and allergic asthma at night.

Jamesd1986 profile image
30 Replies

Hello, over the last 5 years my allergic asthma has worsened and especially during summer and at night. I am taking the following medication - top dose of symbicort, ventolin, montelukast, dymista nasal spray, loratadine or cetirizine morining and night and extra priton if needed. I feel like I am maxed out on medication. Tried showering my nasal passage and vaseline in my nostrils too.

During the day, my asthma tends to be ok and no problems at work. As soon as I go to bed and lay down I have issues. Waking up suddenly every night at around 1am and sometimes 3am, struggling to breathe, and trying to cough up phlegm / clear my throat. After a few puffs of ventolin and lots of throat clearing, I can eventually get back to sleep.

I know this is due to current changes in weather and pollens, I've had many tests and tried various different inhalers, but this seems to be as good as it gets. Sitting upright and caffeine seems to help a bit, but then stops me sleeping.

This is getting very frustrating and seriously affecting my quality of life. Does anyone have any advice for allergic asthma, post-nasal drip and how to sleep with this issue?

Thanks

30 Replies
Bevvy profile image
Bevvy

How do you lay in bed? I use a foam wedge because I am unable to lie flat. It can take a little time to become used to a wedge - only a few days though. I kept rolling off when I first purchased it! Now I wouldn’t be without it.Something worth considering?

Jamesd1986 profile image
Jamesd1986 in reply to Bevvy

Hi Bevvy, thanks so much for your suggestion. I currently lay on my side and sometimes almost on my front with my neck twisted as it somehow helps my asthma. I might try a foam wedge and higher pillows, but also feel that the constant nasal drip might still be an issue. I have now arranged a doctor appointment next week to test for nasal polyps as I have never tested for that. Many thanks

Poobah profile image
Poobah in reply to Jamesd1986

If you are being tested for nasal polyps then be aware of aspirin induced asthma (asthma and nasal polyps are symptoms). It's not unusual for doctors to be unaware of the disease which is actually called aspirin exacerbated respiratory disease (AERD). You may not even take aspirin or other NSAIDs in order to experience symptoms as a diet high in omega 6, preservatives, sulphites and colourings will exacerbate the condition. Brigham Women's Hospital in Boston has become a centre of excellence for this widely misunderstood condition and you can find out more here: samterssociety.org/about-aerd

There's a very useful video by an ENT consultant (NHS) on using nasal sprays. I conquered my nasal problems once I learnt how to perfect the nzsal spray technique and cut out triggers from my diet. youtu.be/LOhmsn4gQMM

Poobah profile image
Poobah in reply to Poobah

I should have also stressed that dry powder inhalers will be more effective if there's any question of AERD, no matter how weak the condition. The propellant in the aerosol inhalers can be irritants to some asthmatics.

Jamesd1986 profile image
Jamesd1986 in reply to Poobah

Thanks very much for the info. As far as I’m aware I’ve had asthma since a child and for the last 5 years my symptoms are much worse in summer and high pollen times, so it’s highly likely that I have allergic asthma. I’ve also tried many different medications over the years and also find that my steroid nasal spray and anti histamines do help. I’m also affected by the usual triggers of smoke, perfumes and stress, but otherwise quite healthy and luckily no excercise induced asthma. I’m aware that we shouldn’t take aspirin , but I’ll do some research on AERD if I can’t get any further solutions to my allergies. I should probably try to eliminate one thing at a time but thanks for your info and help. Much appreciated

LilsM profile image
LilsM in reply to Poobah

A really informative video, thanks for posting it. I knew some of the tips but not all. So helpful.

Troilus profile image
Troilus

I’m not sure whether to post this or not, but I am doing it, as you can see.I had a nose that just wouldn’t blow for ages and had really bad post nasal drip. Montelukast helped - I could occasionally blow my nose, but still had post nasal drip, although perhaps not as bad.

My consultant suggested doubling up my antihistamine, which helped, but I was still using the steroid nasal spray all year round.

Recently I began experimenting with Quertecin. While I wouldn’t say I am cured, it certainly helps. I am back down to one antihistamine a day and no longer use the steroid nasal spray.

I hesitated about mentioning it, because it is not an “official” treatment.

Jamesd1986 profile image
Jamesd1986 in reply to Troilus

Thanks so much, I’ll look into that. Keeping an open mind to anything. Querticin looks like a good idea and a good supplement to my medication as well. My asthma nurse has actually encouraged me to look at diet options and even pro biotics to help allergies. I’m glad this worked for you.

Carus profile image
Carus in reply to Troilus

Hi Troilus, can I ask you how much quertecin you take on a daily basis? And what brand? Thanks for the info!

Troilus profile image
Troilus in reply to Carus

Hi Carus. I started slowly to make sure there were no adverse reactions with 250 a day increasing to twice a day. I increased again to 500 once a day and increased again to 500 twice a day.I haven’t had any adverse reactions to that but I am now reducing down to 250 twice a day to see if I have the same results with that.

I don’t pay much attention to brands. I buy from Amazon and read the blurb and the reviews.

Sorry this isn’t a very clear or concise answer, but as you can see I am still experimenting with it.😁

Carus profile image
Carus in reply to Troilus

Thanks for the info Trolius! I’m going to give it a try.

Jamesd1986 profile image
Jamesd1986 in reply to Troilus

Thanks very much for this info. As I already have and over reactive immune system with allergies, is it likely that taking something like this could make my immune system even more over the top and cause bad side effects? however, I can see that people do take this for help with allergies as well. Many thanks

Troilus profile image
Troilus in reply to Jamesd1986

It is reckoned to act as a natural antihistamine. It is present in apples and onions. If I have a little bit of time later on, I will see if I can find some info.You are very wise to be cautious

aacijournal.biomedcentral.c...

medicalnewstoday.com/articl...

Jamesd1986 profile image
Jamesd1986 in reply to Troilus

Thanks so much for taking the time to send me this info. The first link is a little bit scientific to get my head around but from the sounds of it this is very good for allergic asthma and inflammation. The only thing that might be an issue is interference with other asthma medication, but hopefully unlikely

Troilus profile image
Troilus

Hi James. There are quite a lot of research articles on it. Here is one which is a bit of a round up of several different studies.ncbi.nlm.nih.gov/pmc/articl...

Gwalltarian profile image
Gwalltarian

Hi James, The fact that your asthma is noticeably worse at night suggests that your night time environment and possibly evening diet could be the cause.

Do you avoid food and drink that you’re allergic to - I’m allergic to sulphites in wine and to yeast extract among others.

You’re a long term asthmatic and I would therefore expect you to be fully aware of the necessity of a dust free, clean environment. Hard floors rather than carpet etc,washing your bedding weekly, being aware of what you are allergic to - including animals., perfumes etc.

You might find an air purifier, or dehumidifier with hepa filter would help.

LilsM profile image
LilsM

Have you ever been prescribed Carbocisteine capsules ?

I also often wake up with similar symptoms to you and have to sit up or walk around and cough up phlegm, often for 20 minutes or more. I sometimes take 2 puffs of ventolin which helps.

I take Fostair next, and Dymista nasal spray both twice a day, and Cetirizine before bedtime. I have been prescribed Montelukast in the past but it didn't help and upset my stomach.

A few days ago I had a medication review with a pharmacist from my GP practice. She was so helpful and got a prescription for Carbocistein capsules 375mg, 4 times daily.

It is early days, but I have now had the best two nights sleep for a long time, with no phlegm in my throat on waking up, and not waking at 2/3 am needing to cough some out. I can also breathe more easily all day and don't have the aching ribs from prolonged coughing.

I really hope it continues, I have no side effects so far although the main one listed is upset stomach.

It may be worth you asking for this extra medication if you haven't tried it before.

I really hope you find a solution soon. I have found GPS not very helpful with this in the past. They just say its post nasal drip and prescribe nasal sprays.

Best wishes Mary

LilsM profile image
LilsM in reply to LilsM

PS I've just taken my peak flow and it is up from 330 a few days ago to 390 - the highest I have recorded for a long time. Also I didnt cough while taking the peak flow.

Jamesd1986 profile image
Jamesd1986 in reply to LilsM

Thanks very much LilsM, I really glad you found something that worked. I will look into Carbocisteine, but perhaps this might be something a doctor or my asthma nurse may need to prescribe. Hoping I can get something that works. Thank you

LilsM profile image
LilsM in reply to Jamesd1986

Yes I think it is prescription only but worth asking for.

Itswonderful profile image
Itswonderful

Hi Jamesd. Sorry to hear of your problems. I can empathise. I had similar struggles. I was referred to a respiratory physiotherapist and she gave me various techniques to get rid of the mucus. Like you, I would wake in the night struggling to breathe. At first glance, I wondered how the techniques could help, but they did! She also advised Neil Med Nasal Rinse which clears the sinuses in a way that showering your nostrils and other methods do not. Do you have your bed head raised a little ? It’s better than a wedge because you don’t slide down in the same way. The other thing the physio (and the speech and language therapist ) advised was to drink at least 3 litres of water every day. The mucus needs to be thinned so it’s easier to shift. But coughing isn’t a good way of shifting it. You have to be gentle because lots of coughing means that your vocal cords are bashing together and this irritates them and causes swelling and more coughing. So ask for a referral to a respiratory physio from your GP. If they won’t refer you, perhaps you can pay for a private session ? You probably only need one or two. Good luck. 👍

fraid profile image
fraid

Just to be pedantic but if you only get it at night could it be your bed,mattress,pillows,duvet etc? Mite counts increase with warmth & damp.New anti allergen stuff? Good luck.

Jamesd1986 profile image
Jamesd1986 in reply to fraid

Thanks Fraid. You're right this could be a contributing factor. I do wash bedding and hoover often, but maybe im not thorough enough and I will try doing more. I feel that there must be more too it with the way these symptms increase seasonally.

fraid profile image
fraid

I meant perhaps new bedding,esp. duvets etc,mites breed according to conditions.Hope things improve for you.x

Jamesd1986 profile image
Jamesd1986 in reply to fraid

Thank you. I've done all these things several times, and whilst they do help, the issue is still on going. Its usually much worse in the summer and especially during grass pollen season. I've had many doctor and nurse appointments, blood test for allergies and tried several different medications. I had a particularly rough night's sleep last night coughing up at 1am and again at 3am. Yet all day long I am absolutely fine. It seems to be a combination of night time pollen dropping , my own sleep cycle and laying down with post-nasal drip. I'm getting the end of patience with all this and frustrated that I can't find any proper solution.

fraid profile image
fraid

My asthma & coughing up is much worse when I try & lie flatter,I live on a reclining sofa as bad back,so am propped up,also helps with Gerd.I got a wedge pillow but can’t use my bed so have lots of pillows & cushions to get comfy- you do get used to it eventually though I never have slept well anyway.Perhaps you could try propping yourself up as much as you can bear till comfy?I do hope you find a solution.I take Cetirizine as Piriton stopped working for me & made me fall asleep!Good luck.x

ZeilaJee profile image
ZeilaJee

My own experience with allergic asthma has benefited from Intal sodium cromoglicate. GPs say it doesn’t work for adults. I can give the lie to that - it’s been controlling my allergic lungs for 40 years and I would be frightened without it. I have other support too (terbutaline) if I get a sudden attack and I haven’t been taking Intal regularly. Sodium cromoglicate eye drops can be bought over the counter and I find those effective too. We are not supposed to promote what we use but you could check this out and it would be remiss not to mention it as it’s been fantastic for me.

Jamesd1986 profile image
Jamesd1986 in reply to ZeilaJee

Amazing, thanks so much for sharing your experience. Do you buy these as tablets to go alongside anti histamines? Weirdly my asthma has slightly improved due to all the dry grass with this weather! But I know it could flare up any moment. Much appreciated

ZeilaJee profile image
ZeilaJee

Intal is a sodium cromoglicate inhaler. It doesn’t come in tabs as far as I know. I was told it works on certain T cells which is why it may work for allergy. It works for me. It’s only on prescription and you would have to persuade your GP to prescribe - they don’t believe in it.

Jamesd1986 profile image
Jamesd1986 in reply to ZeilaJee

Thanks very much for that. I have a very supportive asthma nurse who may be willing to let me give this a try! My asthma isn’t too bad right now, but worth trying soon when the pollen season changes. Thanks for the suggestion

You may also like...