Why is My Asthma Worse at Night? [1] 

Asthma symptoms can get worse at night. This is known as “nocturnal asthma”.  

Nocturnal asthma is like regular asthma. You’ll have symptoms such as chest tightness, shortness of breath, coughing, and wheezing. But the intensity is greater at night and makes it difficult to sleep. Making you tired and irritable during the day. 

These issues affect your overall quality of life and left untreated, can be fatal.  

You should talk to your doctor about it.  

Causes of nocturnal asthma [1] [2] 

The exact cause of nocturnal asthma is not known. But several causes can be pinpointed:   

- Not following your asthma treatment plan- your asthma treatment plan plays a key role in preventing disease progression. This means it helps reduce the underlying airway inflammation that leads to more damage.  

- Exposure to allergens at night – from bed dust mites to pet hair, can result in a delayed or 'late phase' response. Airway obstruction may occur several hours later, increasing your risk of an asthma attack during the night. 

- Air Conditioning- breathing colder air at night or sleeping in an air-conditioned room may also result in heat loss from the airways. They have also been linked to night-time asthma  

- Sleeping Position- sleeping on your side or on your stomach can constrict your lungs, potentially exacerbating nocturnal asthma symptoms. Meanwhile, sleeping on your back reclined can cause mucus accumulation. Try sleeping with your shoulders and neck elevated by a few pillows.  

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Treatment [1] [2] 

Nighttime asthma has no cure, but daily asthma medications, such as inhaled steroids, are very effective at reducing inflammation and preventing nocturnal symptoms. 

It is always good to speak to your doctor to evaluate your symptoms and potentially adjust your treatment plan to suit you better.  

Other non-medication treatments include: 

-Stop smoking 

-Reduce obesity 

-Reduce allergen exposure 

-Change sleeping position  

References 

1. WedMD. (2022). Nocturnal Asthma (Nighttime Asthma). Retrieved 26 September 2022, from https://www.webmd.com/asthma/guide/nocturnal-asthma-nighttime-asthma#:~:text=Treatments%20for%20Allergies-,Nocturnal%20Asthma%20Causes,that%20follow%20a%20circadian%20pattern. 
2. Malaysian Health Technology Assessment Section (MaHTAS). (2017). Management of Asthma in Adults [Ebook] . Retrieved from https://www.moh.gov.my/moh/resources/Penerbitan/CPG/Respiratory/CPG%20Management%20of%20Asthma%20in%20Adults.pdf