Advise on a symptom

Hi,

I'm new here but have had asthma since contracting another condition, dermatomyositis 2 years ago (DM causes muscle problems and various systemic issues). I have had a lot of investigation into my asthma as it was a bit odd as the disease (DM) can cause interstitial lung disease so it may have been that, but it wasn't. I am on a drug called methotrexate for my condition and nothing for the asthma, but notably I was on high dose prednisolone (50 mg per day tapering over 18 months) and that didn't help my asthma symptoms whatsoever, nor did a steroid base inhaler. It's all been a bit of a mystery.

Most recently, I have been having a sort of sleep apnoea, I say sort of because I don't fit the typical profile. I am going to bed and waking up gasping for air. I wheeze a lot in bed and cough a lot too.

The question is - can asthma cause sleep apnoea? And has anyone else had symptoms like this and did anything help as I find it quite distressing and frankly, frightening too.

I'm having a chest x-ray today to see if the methotrexate is the underlying cause, but I suspect not as I've had the asthma symptoms since before I started on the methotrexate.

thanks for any help and advise

11 Replies

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  • asthma and sleep apnoea have very different physiological mechanisms, thus asthma is not causative of sleep apnoea. If you are concerned about sleep apnoea, your GP can refer you to a sleep clinic for polysomnography. It sounds more like you asthma symptoms are uncontrolled at night as you describe wheezing, coughing and gasping for air. Thats what I experience when my asthma is out of control. (I have had polysomnogram done to check for sleep apnoea).

    Have you tried taking your bronchodilator before bed? (Usually salbutamol). Have you tried taking it if you wake up with coughing/wheezing to see if it resolves? I find having my nebuliser before bed sorts out these issues. Its horrid when you wake in that situation. Hope the CXR doenst show anything up x

  • Thanks so much for coming back - just today I was given salbutamol and im going to try it for the first time tonight, so I'm hopeful. It's good (I use the word good in the loosest sense) to hear that you have similar symptoms, it's very frightening when you don't know what it is - thank you so much for sharing that with me.

  • You're welcome :) do you have a spacer? Like an aerochamber or similar? Its more effective if you use the salbutamol through a spacer as more gets into your lungs, rather than your mouth and throat, and you don't have to hold your breath, can just breathe in and out normally through the spacer mouthpiece.

    Hopefully it will make a difference to you, don't be afraid of using it, you can't really overdose on it, as one puff is 100 micrograms, whereas a nebuliser is anything from 2500micrograms (2.5mg) to 5000 micrograms (5mg).

  • I think I just lost my reply, so here goes again.

    I'm not sure what a spacer is - the thing I have is a blue mouthpiece which you suck. I've just tried it and nothing seemed to happen - my peak flow both before I took it and after is 320 and I'm still coughing, does it take a while to take effect?

    Its very odd as I know a lot about the main disease I have but very little about asthma, even though I've had it for 2 years - it has taken a back seat while I fought the other illness. Now I'm in remission with the other disease the asthma is playing centre stage and I know nothing about it.

  • Salbutamol isn't instant, it can take anything up to 15 minutes to be effective, though is often less than this. How many puffs did you have? It might be that you need more puffs. This is an aerochamber spacer: hcp.gsk.co.uk/products/aero...

  • Oh brilliant, I've found one on Amazon, I'll get that. THANK YOU!

    I only took one puff. Ill try more, I'm still coughing and its been about 15 minutes.

    I'm seeing an asthma nurse in a couple of weeks - I'm sure she'll go over things better than the doctor can as they don't really seem to specialise (although believe it or not I was under the care of a pulmonologist for 18 months, but it was confusing with the other illness to be fair)

    Again, thank you for all your advise and help, it is MUCH appreciated!

  • lol one puff won't do anything, the standard minimum dose is two puffs. If my lungs are pants but I don't need my nebuliser, I will have up to 10 puffs through my spacer over a few minutes. Have another couple of puffs, wait five mins and see how you feel then, repeat if necessary. Never thought of looking on amazon for a spacer! ;)

  • That did the job, multi puffs is the key, my PF is at 420!

    :-) Thanks!!!

  • Nice one, thats a good increase! :)

  • Methotrexate can cause a dry cough but I've heard that DM can also attack the lungs in some cases... maybe you should see if the DM is more active? How is your ESR and CRP? If they are elevated that is an indication that the DM is active and you have active inflammation in your body...

    A spirometry would be able to show if it is asthma that is causing the issues or if it is the DM... maybe ask for a spirometry?

    Hope you work everything out soon!

  • Hi,

    I'm new here but have had asthma since contracting another condition, dermatomyositis 2 years ago (DM causes muscle problems and various systemic issues). I have had a lot of investigation into my asthma as it was a bit odd as the disease (DM) can cause interstitial lung disease so it may have been that, but it wasn't. I am on a drug called methotrexate for my condition and nothing for the asthma, but notably I was on high dose prednisolone (50 mg per day tapering over 18 months) and that didn't help my asthma symptoms whatsoever, nor did a steroid base inhaler. It's all been a bit of a mystery.

    Most recently, I have been having a sort of sleep apnoea, I say sort of because I don't fit the typical profile. I am going to bed and waking up gasping for air. I wheeze a lot in bed and cough a lot too.

    The question is - can asthma cause sleep apnoea? And has anyone else had symptoms like this and did anything help as I find it quite distressing and frankly, frightening too.

    I'm having a chest x-ray today to see if the methotrexate is the underlying cause, but I suspect not as I've had the asthma symptoms since before I started on the methotrexate.

    thanks for any help and advise

    Asthma is a chronic condition of lung in which your airways become narrowed and inflamed with extra production of mucus. Asthma is also known as bronchial asthma. This can lead to difficulty in breathing, chest pain, coughing, wheezing and shortness of breath which in turn causes sleep apnoea sometime.

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