Waking at night

[Gymbearo]

Recently I’ve been waking up coughing at night at least 3-4 times a week, but mostly during the day I feel fine - ie not generally using my blue inhaler more than once a day. I’ve tried sleeping on two pillows, cleaning my room thoroughly and I’ve even put an air purifier in the room. Any other ideas or thoughts please?

[Bevvy]

I use a wedge pillow to prop myself up at night because that seems to help.

Because the issue seems to be when lying down have you been tested or treated for reflux? This is often found in asthmatics and maybe causing the issues.

Also does your gp/asthma nurse know you use your blue inhaler every day? Even though you tend to use only once, the use of blue inhaler often indicates your asthma isn’t as well controlled during the day as you think. It might be the preventative medication is not working as well as it could and a different preventative could be tried.

[Homely2 Administrator]

Change your duvet and pillows for new ones. If you have a childhood teddy bear, remove him to your lounge. Declutter, particularly any books.

If all fails, try sleeping somewhere else and see if the cough improves, to prove if your bedroom is the issue.

Do antihistamines help.

[Scrofulous]

I agree with Bevvy. If you're using your blue inhaler each day, then your preventer may not be working as well as it should, which only becomes apparent when you lie down at night. A review would be a good idea.

[Emaych61]

As others have stated you need to have your asthma reviewed. In properly controlled asthma reliever inhalers such as Ventolin rarely need to be used. Your post seems to suggest you are using yours almost daily which may well be because your asthma is not adequately controlled by the medication you are currently on.

[peege]

Bevvy is right to mention reflux, many people with lung issues have it (there's something called silent reflux too). If it does turn out to be reflux it really helps to sleep on the left side because of the way the entrance to stomach lays, the adid is less likely to spill over when settling on left side. Perhaps avoid mid evening snacks - cheese on cream crackers is a no-no for me, the fat in cheese & palm oil in the crackers would deffo cause later coughing & discomfort. I also agree with others that a review would be in order in case asthma is uncontrolled - especially if your asthma is of the type for night-time symptoms. Not everyone is allergic to dust or dust-mite but there's plenty of pollen about at the moment to consider. A good vacuum cleaner helps, personally I damp-dust so I'm not just stirring it up to go elsewhere.

Good luck.

[Gymbearo]

Thanks everyone. I hadn’t really considered that my asthma wasn’t under proper control but I’ll have a chat with my asthma nurse as I’m definitely relying on ventolin to get me through a day. What symptoms might I expect with reflux, as I don’t feel like I have any but don’t want to rule it out. Thank you

[RABS1957 in reply to Gymbearo]

Drinking alcohol late in the day is not helpful, I use a white turbo with a red twist bottom 200 symbicort I do 2 blasts on morning 2 at night I had same symptoms as you but I smoke 6aday and drink it took about a week then I was ok but I must take it until doctor says reduce then stop been on it 2 months now and no more waking up in the night no more blue inhaler feel great and can breath deeply without a wheeze or pain had chest scan and reflux scan , nothing so alls well for me so far, hope you find out your triggers and get the right medication that suits you. Ps you must rinse you mouth regularly after taking any inhalers or you might get mouth infection )

[runcyclexcski]

What Homely2 says, plus try an acid-reflux proton-blocker.

I do not know how bad your coughing is, but if one wants to fully control the dust mite/allergen during sleep, an air purifier by itself won't do much (there are scientific studies on this, with particle counts etc). The mattress/pillows are infinite sources of dust, and this source is right next to your nose, mobilized when you roll around in your sleep, whereas the purifier is further away. I got the dust mite under control only after fully sealing the pillows and the mattress in airproof bags, and getting CoolMax sheets and pillow cases. These are washed at least once a week at 60C. There is nothing in the bedroom except for the bed (no carpet, too). The purifier is still there in case there are external irritants (pollen, smoke, pollution etc).

Here is one of many reviews on the general ineffectiveness of common air purifiers, common mattress covers etc.

sciencedirect.com/science/a...

I believe my sleeping arrangements work, but I am yet to see another person (other than my wife, god bless her) willing to sleep in a non-cuddly plasticky bed and a plasticky pillow.

Abstract: Fifty-nine randomized and 8 nonrandomized trials addressed 8 interventions: acaricide, air purification, carpet removal, high-efficiency particulate air filtration (HEPA) vacuums, mattress covers, mold removal, pest control, and pet removal. Thirty-seven studies evaluated single-component interventions, and 30 studies assessed multicomponent interventions. Heterogeneity precluded meta-analysis. For most interventions and outcomes, the evidence base was inconclusive or showed no effect. No interventions were associated with improvement in validated asthma control measures or pulmonary physiology. Exacerbations were diminished in multicomponent studies that included HEPA vacuums or pest control (moderate strength of evidence [SOE] for both). Quality of life improved in studies of air purifiers (SOE: low) and in multicomponent studies that included HEPA vacuums (SOE: moderate) or pest control (SOE: low).

[Gymbearo in reply to runcyclexcski]

Thank you. You somewhat blew my mind but I think I got the gist

[hilary39]

As others have said, nighttime asthma is a hint from our bodies that our asthma is uncontrolled as that is when cortisol drops lowest and inflammation is highest. I find when I'm in a flare but can fall asleep, my eyes fly open between 1:20-1:30 am like clockwork and then I'm up for at least a half hour if not longer.

Do you take controller inhalers?

Getting a review is a great idea. These control test questions point to other hints your asthma may be less controlled than normal. Maybe helpful to review before your appointment: asthmacontroltest.com/en-gb...

Keep us posted!

[Gymbearo in reply to hilary39]

I find it’s always between 3-3:30am. I’ve often wondered what on earth is going on in my body to make it that predictable timewise!

[Lysistrata Administrator Community Ambassador in reply to hilary39]

Oh, the witching hour! A lot of asthmatics seem to have one but it varies. Mine is usually 3.30ish - if I wake up fully it'll be then. However I have a habit of not fully waking but still experiencing the asthma, which is annoying because then I don't address it. My body can deal with a disturbing amount of asthma before it thinks that waking up would be sensible - it tends to put it into my dreams.

I agree with others here that it sounds like your asthma isn't well controlled. Your bedroom may be the issue but as Hilary says, it may also just be that night is often worst for asthma.

You can take some steps to see what helps but I would address the wider asthma control to start with, don't feel like you have to spend loads or make drastic changes right away (though if you think bedding could be the issue it's definitely worth changing if you can, especially if nothing has been changed for a while.) I personally find the temperature of a bedroom (too cold) is my biggest trigger but then my asthma isn't allergic.

[Gymbearo in reply to Lysistrata]

I’m exactly the same in terms of often not waking up or being vaguely aware I’m coughing but not really waking up enough to do bother doing anything about it. I sometimes drive my husband crazy as a result. I also find it becomes part of my dreams - mostly I tend to dream I’m running out of air in someway - most often running away from something/someone but can’t escape. I’ve dreamt I’m stuck under water and in caves and all sorts of weird things. Sometimes it’s pretty funky!!

[Lysistrata Administrator Community Ambassador in reply to Gymbearo]

Oh yes I've had many diving dreams in particular - it's amazed how unbothered I am by those! Just oh well I'm underwater so I can't breathe, let's chase the sharks... ok then brain 😅 I've always wanted to scuba dive or freedive but can't now. Much better than the dreams where I'm in hospital and they won't treat me which is why it won't go away.

I also find even if I am sort of awake I can be really stupid sometimes and don't always connect the feeling to asthma. Like oh what is this I don't like it? But doesn't occur to me when half awake to actually just take inhaler. I have been known to think there's a random extra person in the bed with me who has asthma and is feeling it!!

Would add to anyone else reading that this happens only when my asthma is really poorly controlled and is NOT normal or something to put up with. I mentioned my experiences in case anyone didn't realise this was asthma or had been told, like I was many times, that it wasn't asthma because you 'can't sleep through it'. You can and if you have asthma and are getting this even if you don't wake up, it's a sign of poor control. This page may help: asthmaandlung.org.uk/living... - though sadly they seem to have removed the bit where Dr Andy says not to fall asleep again without treating your asthma if you wake up, which is a reminder I need.

[Gymbearo in reply to Lysistrata]

I genuinely thought it was just me that the dream thing happened to but the first 2 paragraphs are basically identical to what I experience (apart from the extra person bit!!). However, I have just got used to it and accept it as part of the package, and I hadn’t particularly thought until I posted that it was because my asthma is poorly controlled, more just that sometimes it seems to be an issue and other times not so much. I have booked a review now, as everyone seems to be saying this is the case. Incidentally, I did have to stop on the side of the motorway for a good 20 mins yesterday as I couldn’t breathe properly, so even I can concede that’s not optimal control!

[Lysistrata Administrator Community Ambassador in reply to Gymbearo]

Ugh yeah that doesn't sound good re the motorway I hope they're helpful at your review - definitely make sure you tell them about all these issues, maybe do a journal or something showing them? As you may be ok when you go and they can have trouble understanding it's not that you're bad all the time.

It is really easy to slip into 'oh this is fine as it's my normal' and not do anything! I have to say I'm glad someone else has the weird dreams element as I haven't come across anyone else who has it this way. The extra person is really quite trippy - thankfully last time I somehow managed to work out that 'random bed Intruder' could do with a neb.

[Jamesd1234]

Hello. I'm very sorry to hear you're having these troubles and I completely relate. I've been waking up every night once or twice coughing since october, and every summer to autumn for the last 8 years.

All of the advice given here is spot on. Do you have any pets or known allergies?

my issues mainly come from post nasal drip and coughing up a lot of phlegm at night. ive yet to find a proper solution, but reccomend investigating allergies with your asthma nurse, and looking into steroid nasal sprays and strong anti histamines, as that might help.

[Gymbearo in reply to Jamesd1234]

I have a cat and also hayfever, so I take antihistamines every day anyway. I’m also anaphylactic to a few things. I’m not sure it’s allergy related though, as it happens wherever I sleep (I often work away from home)

[Gymbearo]

I had a review and have been given an Elipta inhaler alongside my regular fostair. Im hoping this might make a difference. Has anyone got any experience of taking it please?