Asthma accounted for 13.9 million outpatient visits, 1.9 million emergency department visits, and 484,000 hospitalizations. About 20 million people in 2002 were diagnosed with asthma, and 11.9 million had experienced an asthma episode/attack in the previous year (2001).

According to the CDC, in 2002 there were an estimated 30.8 million people in the United States who had diagnoses of asthma during their lifetime. Serious asthma attacks require hospitalization and may be critical situations involving intubation and mechanical ventilation. In an acute attack, the patient may exhibit wheezing, shortness of breath, coughing, and chest tightness. Airflow obstruction is a result of the inflammation and bronchospasm. 2 When an asthma attack occurs, a flood of cellular mediators is released that causes the inflammatory response (vascular congestion and leakage, release of histamine and leukotrienes, airway swelling, and an influx of mast cells, eosinophils, and lymphocytes) and bronchospasm or sudden contraction of the smooth muscles that surround the airways. 1 The main underlying problem with asthma is tied to the inflammatory process, with acute attacks involving bronchospasm of the airways.Īsthma is often referred to as allergic, where the problem is linked to an allergen such as pollen or pet dander, and nonallergic, where the problem is linked to exposure to an irritant such as smoke, fresh paint, or air pollution. Asthma is partially or fully reversible, either with treatment or spontaneously. Asthma is described as an obstructive airway disease that involves inflammation and airway hyperresponsiveness (sometimes referred to as twitchy airways). “I’m sleeping through the night without wheezing and coughing, as long as I take my medicine as you ordered.”Īs we have seen with this case, asthma can play havoc with a good night’s sleep, but with the right management, it can be minimized and good sleep restored. “I feel much better now,” Mark told his doctor. Upon confirmation of the asthma diagnosis, Mark’s doctor prescribed bronchodilators and steroids, added an antacid medication, a leukotriene modifier, and recommended that Mark elevate the head of his bed to help relieve the nighttime gastric reflux.

In addition, you are allergic to cat hair and dust mites, plus you suffer from heartburn.” You complain of wheezing and frequent cough, and say that every year you have trouble with pollen. After a thorough examination and a series of questions about his symptoms, his doctor finally concluded, “Mark, I think you have asthma. Every night he woke up coughing and wheezing, so he finally went to his doctor. Available at.Mark had not had a good night’s sleep in 2 weeks. The Asthma UK and British Lung Foundation Partnership.American Journal of Respiratory and Critical Care Medicine. Nocturnal Asthma and the Importance of Race/Ethnicity and Genetic Ancestry. Asthma treatment, which typically involves a long-term daily controller/s plus another rescue inhaler for asthma attacks, may need to be adjusted to control nighttime asthma symptoms. Keeping a rescue medication in easy reach at night, taking steps to control bedroom asthma triggers and discussing nighttime symptoms with a doctor can help improve sleep and stave off nighttime asthma flare-ups. Researchers continue to explore other risk factors that may give rise to nocturnal asthma symptoms. Nocturnal asthma tends to be associated with more severe disease. More than 75 percent of individuals with asthma report nighttime symptoms. Nighttime flares may also be due to poorly controlled asthma by day.Īlone or together, all of these factors can set the stage for nighttime asthma symptoms, including coughing, wheezing and chest tightness that can disrupt sleep.Back sleeping puts extra pressure on the chest and lungs. Some people may also be triggered by mold, pollen or cold air. Exposure to triggers at night such as dust mites in the bedding or mattress, or animal dander if pets sleep in the bed, may trigger nighttime symptoms.Higher levels of blood cells known to promote inflammation, including eosinophils and neutrophils, are present in the blood of individuals with nighttime asthma symptoms.This is known as reduced forced expiratory volume (FEV) rate. Airway function tends to decrease during sleep (and daytime) in people with nocturnal asthma. The tubes that carry air into your lungs and back out again (airways) grow more resistant to air flow during the night due to normal hormonal fluctuations.

“Nocturnal asthma” may be due to one or more factors that interact: Exactly why asthma tends to get worse at night is not fully understood, but several theories exist.

Nocturnal asthma causes