Why is asthma worse in the night?

[Pinkyboo28]

can get really bad in the night and early morning

[Photog24]

Yes, am finding mine is worse at night. Have you done the usual things such as vacuum your mattress regularly, checking for other possible issues such as ventilation, are there any damp issues or potential mould spores? This time of year can be worse as it gets cooler and I find when humidity is high my asthma is worse in general but feel it more so at night.

[Pinkyboo28 in reply to Photog24]

This property has alot of mould issues so definitely not helping im also allergic to a lot of things such as dust mites I have a dehumidifier which I will need to use more regularly now that temperature is dropping

Thanks

[Photog24 in reply to Pinkyboo28]

Do you rent the property? Mould will be making your asthma a lot worse so try to address that. I too am allergic to dust mites so have to make sure I vacuum my mattress regularly. An anti allergy mattress protector will help too.

[Pinkyboo28 in reply to Photog24]

I do rent. Landlord is saying can’t do much else as it’s because it’s old building apparently but the mould issues are quite bad so I am looking to rent elsewhere but just so hard rent so high everywhere. I also use dehumidifier not sure if this is even helping

[strongmouse in reply to Pinkyboo28]

You might want to think about buying a Hepa air filter for your bedroom. It cleans the air of allergens and some you can leave on during the night - they have a quiet sleep mode. We have one in our bedroom and I put it on a few hours before going to bed then leave it on sleep mode overnight. It might be worth asking your GP for a test for allergy. There should be a clinic in your area for doing this, as I have found it helps to know what I am allergic to.

Mould and dust mites are well known allergens, but there are others. I am allergic to certain pollens and brushing my hair well at night is important for me - not to put pollens onto pillow and then sleep on it!

[Photog24 in reply to Pinkyboo28]

That’s awful. There are things you can do to get rid of mould. I live in an old house and it’s all about making sure the correct breathable materials are used when decorating, etc. Usually there is a source /reason for the mould such as leaking gutters but it sounds as though your landlord can’t be bothered. Look up Ecover Mould Remover. It kills the mould without it releasing spores and prevents it coming back (but it will come back if the root cause is not treated). If you can, try to keep the affected rooms ventilated. If your landlord won’t help it sounds as though a move would be the best option for you. It doesn’t sound legal to me though. Or it shouldn’t be! Mould is more than an allergen, it’s toxic and harmful.

[peege]

I think it may be to do with the type of asthma we have. (I'm not a doctor so no idea really).I'm not allergic to dust or dust mite so I think it's praps change in humidity or temperature. Mine's just changed at night and it's been much colder last two nights. I absolutely cannot sleep with a window open even in summer, it triggers my airways.

I await interesting replies. P

[Pinkyboo28 in reply to peege]

Looks like another call to the gp is needed for me this is an ongoing cycle

[peege in reply to Pinkyboo28]

Yes, I think that's wise Pinkyboo, certainly because the season is changing. I'm on a MART inhaler (Maintenance And Reliever Therapy ) so I can take more or less when the need changes. IE in summer one puff am and pm is sufficient with perhaps the odd extra puff before exercise & when certain pollens abound in parks. The last three nights I've definitely needed two puffs at night (it was 4° here in Gloucestershire last night). Although I'm not allergic to dust mite I do take precautions - damp dust my bedroom, vacuum & wash bedding regularly...I've 4 pillow cases on my pillows and two duvet covers....never use biological cleaning products, joss sticks or smelly candles. Cover my nose & mouth when out in the very cold &/or damp air. Steam relieves my airways however for some people steam exacerbates theirs. Shows we're all different. Good luck. P

[Pinkyboo28 in reply to peege]

Wow thanks I need to also try this and yes steam exacerbates my asthma but defo will try rest

[Poobah]

It could be several different things at play, or just one. Keeping dust mites at bay is important, regular laundering and hoovering, including pillows and mattress. Could be post nasal drip, where nasal phlegm is dripping down your throat while you lie asleep. Or reflux from the stomach that irritates your breathing.

It may help to discuss your concerns with your asthma nurse and explore ways to address what's going on. They may wish to give you a nighttime treatment to help. But discovering what your nighttime triggers are is key to solving the problem.

[Pinkyboo28 in reply to Poobah]

Definitely will be doing another consultation to discuss with asthma nurse nights are the worst for me and it’s just disrupting sleep so much

[Lysistrata Administrator Community Ambassador]

Hi, I agree with others it may be that you have triggers at night, so check that - is your bedroom too cold/warm/dusty etc for you? (Dust can be a trigger even if you aren't allergic to dust mites as it can be an irritant for your lungs).

This is for you and your triggers - a good sleeping environment for one person with asthma might be terrible for someone else, so be wary of any advice that's absolute such as 'always open a window' or 'turn off the heating'.

Sometimes also, triggers from the daytime can make themselves known later. It's very typical for asthma to be worse at night, especially when it's uncontrolled. It's one of the standard questions on the asthma control questionnaires.

It does sound like your asthma isn't well controlled and that means you need to see your asthma nurse or GP and discuss your treatment, as it's not safe to leave it like this. You could also talk to the nurses at ALUK 0300 2225800 or WhatsApp on 07999 377 775 Monday-Friday 0915-5pm. They can't treat you, but can listen and make suggestions.

I have seen some research suggesting that the night time issues with asthma may be partly due to the fact we have our lowest levels of natural cortisol during the night, and cortisol can have an anti-inflammatory effect. So it may be in part because we're not suppressing inflammation in the airways as well at that time as at others -which is less of an issue when the inflammation is already being suppressed by the correct treatment and asthma is under control.

I know there's also research going on into the relationship between our body clock and asthma - not sure of the results.

[Pinkyboo28 in reply to Lysistrata]

Thank you for all the information and my asthma is definitely in poor control the nights are terrible seems like I need another asthma review. Will be contacting gp again all they seem to be doing is checking my chest and sending me on my way. At this point I believe I need a referral to the hospital respiratory team

[Photog24 in reply to Pinkyboo28]

Let us know how you get on.

[peege in reply to Lysistrata]

So interesting re lowest levels of natural cortisol at night. Would this be the same in children do you know Lysistrata? Thank you for all the great information you share. P

[Lysistrata Administrator Community Ambassador in reply to peege]

Hi Peege, honestly I don't know for sure but I would guess yes? Since night time asthma when uncontrolled is also a feature for children - especially coughing at night. That's what I did before I was diagnosed at 7 and the GP said it was absolutely classic.

[peege in reply to Lysistrata]

I remember incessant coughing as a child & lots of coughing up green gunk (never taken to the doc) miraculously got better about 8 yrs old but it has returned in my early 50s.In mid 1970s I spent endless nights sitting upright & holding 3 yr old son coughing through the night. Luckily we found a British doctor (in Libya) who immediately dx asthma and px Becotide & Ventolin. When we returned to UK our new gp said the Becotide was like using a sledgehammer to crack a nut but that's all that was available there at that time. I was so naive, only wish I'd known then what I know now (& that'snot much)! Always grateful for more info 🙏

[runcyclexcski]

As others already mentioned, dust mite allergy is usually the first suspect. I diagnosed this for myself by sleeping in a room with no furniture at all (just bare hardwood floor, a closed-cell camping mat, and a drybag-encased pillow), and found that I sleep just fine. Then return back pieces one by one, until symptoms return. Then remove the last problematic item. Washing bedding on high temp at least weekly, no upholstery in the bedroom, no carpets, 24/7 HEPA filtration. All of my pillows are encased in sealed dry bags, so is the mattress.

Another thing that helped for me were anti-acid-reflux tablets. I stopped waking up with closed airways.

With the measures above, for me the night is the "safe heaven" time which allows me to recover from challenges allergens bring during the day. During sleep, one is immobile, so it's relatively easy to control the sleep environment and the air.

[Pinkyboo28 in reply to runcyclexcski]

Wow thanks I definitely need to try this

[Jamesd1234]

I wish I knew the magic answer to this , but as someone with allergies to everything , I can relate and have woken up with asthma almost every night since last October. I’ve finally started having the occasional solid nights sleep and just had 2 in a row! Making 8 in total this year! I suspect this is due to reduction in pollens and exposure in the day and trying to manage stress during a week off work. But I have also read that our circadian rhythum can leave us more vulnerable to allergies at night (assuming you have allergic asthma). I’m also researching the link to stress and how this can inflame allergies and asthma , however, if we’re struggling with asthma at night and poor sleep, it’s a vicious cycle. . As others have mentioned, hepa filter hoovers, air purifiers and washing bedding at 60 helps.

I also try to have a healthy diet and supplements which may help allergies , like omega 3, vitamin d , quercetin, and tumeric / circumin and I am yet to try magnesium (but unsure how useful that one is). All of this in addition to medication .

I’m also on lansoprazole for acid reflux but I hope I can get off this in the future if possible.

Montelukast, steroid nasal spray and antihistamines also useful but weren’t strong enough for me this summer. About to try sole new meds and maybe get biologics eventually.

I would say keep researching and hope you find some solutions.

[djbctla]

hi Pinkyboo

Poobah and others on the forum suggested Reflux which in my case caused nasal drip, I coughed all night, after insisting on having a endoscopy, a camera placed into the stomach, I was diagnosed as having severe reflux.

Tablet medication has almost made the reflux disappear. Minimal cough on occasion. I now have no coughing in bed at all.

Best of luck. BERNARDINE