What is the best position to sleep in if you have asthma? Night attacks of suffocation. Nocturnal asthma attacks in children

Some people experience unpleasant attacks of suffocation at night, which are expressed in an acute feeling of lack of oxygen. In most cases, attacks develop in a dream, unexpectedly, without any warning signs, therefore, a disoriented person who has just woken up, who is suffocating and cannot wake up, perceives them quite hard. Choking at night is a serious signal of problems in the body. What should be the first aid for apnea?

Nocturnal suffocation can be caused by various reasons.

Causes of asthma attacks during sleep

In order to correctly provide first aid to a person who is suffocating in his sleep, you should know about the possible causes of this unpleasant symptom - treatment tactics directly depend on the provoking disease.

Numerous studies have identified several main diseases associated with suffocation at night:

• Increased blood pressure in the venous system - in this case, attacks are accompanied by swelling of the neck veins.
• Left ventricular failure - night suffocation is accompanied by coughing; in severe cases, there is a serious danger to the patient’s life.
• Sleep apnea syndrome in severe cases is accompanied by shortness of breath and suffocation as a result of complete occlusion of the airways and the development of laryngospasm - a condition in which the walls of the larynx collapse as a result of compression of the muscles of its walls.
• Spasm of the bronchial tree often occurs with bronchial asthma, while experts have long established that bronchospasm often develops at night. During an attack, the patient takes a characteristic position - sitting, leaning on his hands; a person's breathing is noisy, accompanied by wheezing and whistling. As a rule, an attack of suffocation ends safely, with the release of viscous sputum.

• Diseases of the nervous system – neuroses, panic attacks. In people with an unstable nervous system, attacks of suffocation at night may develop after a nightmare or as a result of severe stress suffered the day before.

Differential diagnosis of the causes of attacks

In many ways, first aid for sleep apnea at night depends on the cause of the asthma attack, so it is important to correctly assess the situation. It is advisable to have a specialist handle the diagnosis, so it is important to seek help immediately after the first incident.

An attack of suffocation during sleep is in many ways similar to an exacerbation of chronic obstructive bronchitis, however, this disease is characterized by a long course with a gradual increase in symptoms, while bronchial asthma is characterized by the reversibility of bronchial obstruction and the production of large amounts of sputum.

Pulmonary embolism is also accompanied by a sharp increase in symptoms; the patient, gasping for breath, complains of a feeling of chest pressure. The main difference is dry wheezing when listening.

Patients with neuroses often complain of a feeling of lack of oxygen, and attacks always occur after stressful situations as a result of a violation of the nervous regulation of respiratory function. Choking in this case is not accompanied by wheezing in the lungs.

First aid during an attack

During an attack of bronchial asthma, the patient must be seated and given a special anti-asthmatic aerosol

What to do if an attack of suffocation suddenly develops, how to provide first aid? Most often, an acute lack of oxygen during sleep occurs outside the hospital, so it is important not to get confused and properly help the sick person.

In an upright position of the body with support on the hands, the discharge of sputum improves by facilitating the work of the muscles involved in breathing.

First of all, you should calm a panicking person, try to help him get out of bed - it will be easier for the patient if he leans his hands on something and breathes shallowly, lengthening the exhalation. Call an ambulance immediately. It is advisable to organize a supply of oxygen or fresh air; for this you can open a window and bring a suffocating person to it. In most cases, the patient's hands and feet are cold during an attack of suffocation, so it is important to try to warm them with warm water or a heating pad. It is recommended to do distracting procedures - mustard plasters on the back or chest will help with this. A light massage has a good effect - stroking the back and chest from top to bottom will help remove mucus. Before the ambulance arrives, it is recommended to give the patient a bronchodilator drug, for example, Eufillin tablet. It is also advisable to take a Prednisolone tablet in the appropriate dosage.

People who periodically suffocate in their sleep should always have a thermos with hot water in their bedroom at night - a hot drink in combination with expectorant bronchodilators helps speed up the end of an attack of suffocation. In severe situations, when such measures are ineffective, it is necessary to use aerosols with special agents from the group of sympathomimetics (Salbutamol, Fenoterol). If you do not have the necessary medications, you can give the patient ammonia to sniff or press on the root of the tongue.

To relieve a severe attack of bronchial asthma during the provision of medical care, intravenous administration of aminophylline and glucocorticoids is indicated

In a hospital, treatment methods largely depend on the cause of suffocation. The main goals of drug therapy are to restore normal airway patency, eliminate spasm and swelling of the larynx, and facilitate the discharge of sputum. The main medications for suffocation are:

• Glucocorticosterols: Pulmicort, Dexamethasone, Prednisolone in tablets, ampoules and aerosols for attacks of bronchial asthma.
• Antihistamines - Suprastin, Tavegil, Diphenhydramine, Diazolin in tablets or solutions.
• Inhalations with various solutions - mineral water, expectorants, bronchodilators, antibiotics.

Attacks of suffocation at night can be very dangerous, and therefore require detailed diagnostics to identify the causes of their development.

Bronchial asthma (BA) is one of the most common diseases in the world. This pathology affects 5% of the world's population, and two thirds of patients with asthma have nocturnal bronchospasm attacks, which significantly worsens the quality of sleep and, as a result, aggravates the course of the disease. These nocturnal attacks are commonly called nocturnal asthma. It is characterized by a significant decrease in the daily rhythm of bronchial patency during the period of night sleep. Naturally, providing effective assistance at night presents great difficulties.

The first mention of nocturnal asthma dates back to the 17th century. As early as 1698, Dr. John Floyer, himself an asthmatic, wrote: “I have observed that the attack always comes at night... On first awakening, about one or two in the morning, the attack of asthma becomes more pronounced, the breathing is slow..., diaphragm it seems stiff and constricted... She can go down with great difficulty.” Despite such a clear description, at least two and a half centuries passed before nocturnal asthma began to receive more attention. At one time, there was a debate among specialists about whether the number of deaths among patients with asthma increases at night or not. The published results of the four studies combined showed that 93 of the 219 deaths occurred between midnight and 8 a.m., which itself still indicates a significant (P< 0,01) учащение смертельных случаев именно в ночное время . Показатель смертности, конечно, выше именно ночью, а не днем и у всего остального населения, но здесь речь идет только о 5%-ном учащении смертельных случаев, приходящемся на период между полночью и 8 часами утра — в отличие от 28%-ного увеличения этого же показателя среди астматических больных . Восемь из десяти случаев остановки дыхания у астматических больных — уже в условиях больницы — также происходили ранним утром .

The forced volume of exhaled air (forced expiratory volume) in 1 second (FEO) and peak flow measurements in patients with asthma drop sharply during the night, and in most patients by more than 50%. Among patients in remission, in approximately one third, bronchospasm occurs only at night, and in another third, it occurs before bedtime and continues throughout the night. Thus, in two thirds of such patients, the lowest bronchial obstruction rates occur between 10 pm and 8 am.

Most healthy people also experience diurnal changes in bronchial caliber with nocturnal bronchospasm. A significant number of studies that compared daily changes in bronchial patency in healthy subjects and in unstable asthmatic patients showed that, although changes in asthmatics and healthy subjects are indeed synchronous, the amplitude of the decrease in bronchial patency in patients suffering from bronchial asthma asthma, significantly higher (50%) compared to healthy subjects (8%).

Lack of sleep during the night reduces the degree of nocturnal narrowing of the airways. The fact that some narrowing of the airways during the night persists, even if the patient is awake all night (for example, during shift work), may be a consequence of changes in the circadian rhythms of each individual person.

Thus, nocturnal bronchospasm in asthma appears to exceed the normal level of diurnal variation in bronchial caliber. It is a consequence of increased sensitivity to factors that cause mild nocturnal bronchospasm in healthy subjects.

Possible, although less likely, causes of nocturnal narrowing of the airways include body position during sleep, interruption of treatment, and the presence of allergens in bedding. On the other hand, body position probably does not affect the width of the bronchial lumen, if only because patients who are in bed around the clock continue to experience bronchospasm attacks mainly at night. The length of the intervals between taking medications is also not important; Regular use of bronchodilators throughout the day does not lead to the disappearance of nocturnal bronchospasm, and nighttime difficulty breathing is still the subject of complaints of many asthma patients who have not yet undergone treatment. It also seems unlikely that the presence of allergens in bedding is the primary cause of nocturnal asthma, since their removal, contrary to expectations, does not relieve nocturnal bronchospasm. However, it is likely that exposure to household allergens increases the degree of bronchial reactivity in patients with a corresponding predisposition and may thus lead to the onset of nocturnal bronchospasm.

In patients with asthma, bronchospasm can also be caused by cold and dry air. Nocturnal asthma is believed to be associated with inhalation of cooler air at night or with cooling of the bronchial wall as a result of a decrease in body surface temperature during the night. It is unlikely that the temperature and level of humidity of the inhaled air play a fundamental role in this case, since bronchospasm is persistent during the night even in healthy subjects - in cases where the temperature and humidity of the air are maintained at a constant level during the day. However, one study showed that inhaling warmer and more humid air (36-37°C, 100% humidity) during the night compared to room air (23°C, 17-24% humidity) led to the disappearance of nocturnal bronchospasm in six of the seven asthma patients who took part in the study. However, this study was, firstly, small in number, and secondly, it was conducted without polysomnographic control, so it remains unclear how well these patients slept.

The main complaint of patients with nocturnal asthma attacks is that their sleep is disturbed and they often feel tired and drowsy during the day. The fact of this kind of sleep disturbances was confirmed by studies conducted in the EEC countries. Nocturnal bronchospasm attacks are an indicator of the severity of asthma, so diagnosis of such conditions is necessary, for which it is recommended to clarify the daily rhythm of the occurrence of asthma attacks, the number of awakenings during the night, the nature and quality of sleep. For this purpose, patients with asthma, especially with signs of nocturnal asthma, undergo a polysomnographic study. During this study, in real time, during the patient’s night sleep, a simultaneous recording of EEG channels (leads C3/A2 and C4/A1) is carried out; EOG of the left and right eyes; EMG from the mental muscles; breathing air flow sensor; thoracic and abdominal respiratory force sensors; taking readings from the microphone (registering snoring) and the body position sensor; ECG (precordial leads); registration of pulse and arterial blood oxygen saturation (SaO2). In addition, during a polysomnographic study, patients can detect obstructive sleep apnea syndrome (breathing cessation with a complete cessation of air flow in the respiratory tract for at least 10 seconds), which further aggravates the course of bronchial asthma.

Several groups of researchers recorded the electroencephalogram (EEG) of asthma patients while they slept, paying attention to the stage of sleep during which the patients woke up with asthma attacks. The largest of these studies found that asthma attacks occur during all sleep stages, with a frequency proportional to the amount of time spent in each sleep stage. In this sleep laboratory study, patients with asthma were awakened during two nights during dreaming sleep (REM sleep) or slow wave sleep (NREM sleep), followed by peak flow measurements. The results showed that peak flow measurements were lower during awakening from REM sleep than from NREM sleep. However, the difference between these indicators averaged only 200 ml, while the drop in FEO throughout the night was about 800 ml. Expiratory time would increase during bronchospasm and was originally thought to increase during REM sleep in asthmatic patients. Further studies showed that between the individual stages of sleep, in general, there are no changes in the average peak flow measurements, but at the same time, the duration of exhalation becomes noticeably more variable during REM sleep, which corresponds to the general irregularity of the frequency and depth of breathing at this stage . As in healthy subjects, asthma patients experience a reduction in ventilation as they progress from wakefulness to various stages of sleep; However, ventilation levels become lower during NREM sleep compared to the waking state, and the lowest levels are recorded during REM sleep. In addition, recent studies have shown that nocturnal asthma leads to oxygen desaturation during sleep and, accordingly, to chronic hypoxemia.

Thus, nocturnal asthma is primarily a circadian rhythm of changes in the caliber of the bronchi synchronized with sleep.

A study of 30 young people suffering from clinically resistant bronchial asthma was conducted at the University of Delhi to determine the nature of sleep disturbances in this group of patients. The control group was formed from 30 healthy people. The study was conducted using a sleep diary, which subjects had to fill out over the course of a week. The results of the study showed that 90% of patients suffering from bronchial asthma, compared with 27% in the control group, have sleep disturbances. This difference is statistically significant. Another similar study conducted in the United States also found that asthma attacks, especially at night, lead to sleep disturbances and negatively affect mental and physical performance.

Nocturnal asthma continues to be a serious problem for most patients and physicians. Nocturnal bronchospasm is a sign of inadequate asthma treatment; its development requires special monitoring and urgent treatment. Additional treatment of nocturnal bronchospasm should be carried out only in cases where, with the help of optimally selected daytime therapy, nocturnal symptoms cannot be achieved. For the treatment and prevention of nocturnal asthma, the use of inhaled β-agonists is currently recommended. For example, the drug Serevent (salmeterol), the effect of which lasts more than 12 hours from the moment of inhalation. There is already evidence that salmeterol improves symptoms, nocturnal peak flow measurements, and sleep quality in nocturnal asthma. Formoterol, another long-acting inhaled agent, has been shown to improve overnight lung function and the patient's subjective impression of sleep quality.

As for the treatment of sleep disorders that occur in patients with nocturnal asthma, most researchers are inclined to believe that adequate treatment of asthma itself in most cases leads to the disappearance of sleep disorders. In cases where this does not happen, that is, sleep disorders begin to be chronic, it is necessary to select adequate therapy for sleep disorders, which should not affect respiratory function. In particular, such therapy can use the non-benzodiazepine hypnotic drug ivadal (zolpidem), the effectiveness and good compatibility with bronchodilators was shown in a study conducted recently in St. Petersburg.

In cases where nocturnal bronchial asthma is accompanied by sleep apnea syndrome, patients need special therapy with continuous positive pressure in the upper respiratory tract, the so-called CPAP therapy, carried out using special equipment.

Our study was carried out on the basis of City Clinical Hospital No. 50 and City Clinical Hospital No. 81 using a computer diagnostic system for polygraphic sleep research - the SAGURA sleep laboratory - SCHLAFLABOR-II.

The study involved 14 patients with asthma—11 women and three men, with an average age of 57.4 years. The vast majority of patients had concomitant pathology: 10 had chronic bronchitis, 8 had arterial hypertension, 4 had coronary artery disease, 2 had diabetes mellitus. The severity of the condition was assessed according to clinical data, peak flow measurements, pulmonary function and the results of a polysomnographic study. An exacerbation of moderate severity of asthma was detected in 3 patients, a severe exacerbation was observed in 11 patients, and 6 of them were admitted to the intensive care unit upon admission to the hospital. 9 patients had frequent (more than once a week) nocturnal bronchospasm attacks, 3 patients - more than twice a month, 2 patients - less than twice a month. Among the main complaints, 9 patients noted a feeling of suffocation, 8 - coughing attacks, 7 - daytime sleepiness, 7 - a feeling of tension, 6 - frequent awakenings at night. All patients underwent a polysomnographic study in the first 7 days after admission to the hospital.

According to our data, in patients with AD, a decrease in sleep efficiency was revealed to 71.2% (with the norm being 93%), an increase in EEG activation reactions to 84.1 events per hour (with the norm being up to 21) and a decrease in the REM stage of sleep to 13. 24% (with the norm being 20%). In addition, data was obtained that the average SaO2 value in the subjects was equal to 90.6% (with the norm being at least 93%), and saturation decreased to a maximum of 45%, which confirms the data obtained in Western Europe on the presence of chronic hypoxia in this category of patients .

After the first polysomnographic study, conducted during an exacerbation of asthma, patients were prescribed adequate therapy for the underlying disease. Initially, they were administered prednisolone once, intravenously, in a bolus, then for one week the patients took Berodual 15-20 drops four times a day using a nebulizer. In most cases, when the patient's condition normalized, sleep disturbances disappeared. Under the influence of treatment, in 9 patients the feeling of tension disappeared, night awakenings became less frequent, and daytime sleepiness decreased. According to a polysomnographic study, the duration of the REM stage of sleep increased by an average of 18.5%. In addition, in 7 patients, nighttime O2 saturation increased to an average of 92.5%, that is, almost to the normal level. The remaining 5 patients, who continued to have complaints of sleep disturbances despite normalization of their general condition, were prescribed the drug Melaxen (melatonin), which is a synthetic analogue of the pineal gland hormone melatonin. The drug was prescribed at a dose of 3 mg once at night for 30 days. After a course of taking the drug, in all patients the period of falling asleep decreased to an average of 15.4 minutes, sleep efficiency increased to 78-85% and the presence of the REM stage of sleep increased to 17.9%. Thus, the drug Melaxen can be considered a safe and quite effective means of combating sleep disorders in patients with bronchial asthma.

Nocturnal bronchial asthma is a fairly serious problem from both a medical and socio-economic point of view. The search for new methods of diagnosis and treatment of this condition should lead to an improvement in the prognosis of the disease and the quality of life of a large number of patients suffering from this pathology.

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There have been relatively few studies comparing the effectiveness of long-acting inhaled β-agonists with other nocturnal asthma control agents. One such study found no significant difference in effectiveness between salmeterol and oral theophylline, although there were some marginal benefits of salmeterol in terms of frequency of awakenings from sleep and improved quality of life. Another study found that salmeterol, compared with theophylline, caused less deterioration in nighttime lung function and improved subjective sleep quality. Salmeterol also has advantages over oral slow-release terbutaline in terms of the number of nights in which patients sleep well until the morning without awakening, as well as morning peak flow rates and the degree of clinical effectiveness. Salmeterol at a dose of 50 mg twice a day daily was no less effective in improving the well-being of patients with nocturnal asthma than fluticasone, used at a dose of 250 mg twice a day daily. It seems likely that inhaled long-acting bronchodilators will gradually replace long-acting bronchodilators taken orally, which have more side effects.

* CPAP (short for continuous positive airway pressure) is continuous positive air pressure in the upper respiratory tract, preventing airway obstruction.

During an attack of bronchial asthma, the patient experiences a very sharp compression of the bronchial tissues, and a large amount of secretion begins to be produced, as a result of which the required amount of oxygen does not enter the lungs.

That's why it is important to take such measures of assistance, which will help suppress secretion production, relieve severe tension in the bronchial muscles and remove inflammatory processes along with an allergic reaction.

Asthma attack: features

What to do if you don't have an inhaler?

If for some reason you do not have an inhaler, you need to breathe over the steam and water in which jacket potatoes are boiled. To do this, you need to bend over the pan, after covering your head with a terry towel. This method will promote the opening of the bronchi and.

Cupping massage helps very well. To do this, you need to moisten a cotton wool wrapped around a pencil in alcohol and set it on fire. Burn the can with fire and secure it on your back. Do this until the cans cover the entire area between the shoulder blades. Before the massage, lubricate your back with Vaseline or any nourishing cream. Keep the jars for 1-2 minutes.

You can grate 2 onions on a fine grater and put this mixture on your back.

First aid

1. Be sure to free your neck and chest from constricting clothing.
2. Open the window for fresh air.
3. Use an inhaler. If there is no effect, apply it again after 10 minutes.
4. To relieve suffocation, you can take a tablet called Eufillin.
5. It is also necessary to take any antihistamine.
6. Make a hot bath with mustard. To do this, dilute a tablespoon of powder in hot water and place your feet in the water. Keep them for 5-7 minutes.
7. You can also add a spoonful of soda to a glass of hot milk and drink this mixture. This will expand the bronchi and facilitate the release of sputum.

Algorithm for providing assistance

Anyone who witnesses a person suffocating on the street should call an ambulance. But before her arrival, the person needs to provide first aid. It is divided into the following stages.

1. Be sure to sit the patient on a hard surface or hold him by tilting him forward. This will allow the asthmatic to breathe easier.
2. If the asthmatic has an inhaler with him, spray the medicine into the mouth.
3. If the effect does not occur after 10 minutes, repeat the steps again.
4. Rub the patient's back so that due to rubbing, a rush of blood to the bronchi begins.
5. It is recommended to give validol, corvalol or any other sedative.
6. Rub the asthmatic's hands vigorously so that proper blood flow begins.

The patient must study the symptoms of the onset of an attack in order to reduce suffocation. It is better to use the inhaler in advance to avoid complications. You also need to remember an important rule: always have all the necessary medications with you.

Does nighttime asthma keep you from sleeping? Symptoms such as chest tightness, shortness of breath, coughing and wheezing lead to sleep disturbances, leaving you feeling groggy and tired the entire next day. Nocturnal asthma is a serious disease that requires an accurate diagnosis and the use of effective treatment methods.

Nocturnal asthma and sleep disorders

Asthma symptoms worsen during sleep. Many doctors underestimate nocturnal asthma, but when common symptoms such as coughing and breathing problems occur at night, they pose a potential threat to the patient's life. Studies have shown that most asthma-related deaths occur at night. Nocturnal asthma attacks can cause serious sleep problems, resulting in sleep deprivation and daytime fatigue. They also negatively affect overall quality of life and make it more difficult to control symptoms during the day.

Causes of nocturnal asthma

The reasons why asthma symptoms worsen during sleep are not fully understood. There are many hypotheses on this topic, such as more intense exposure at night, hypothermia of the respiratory tract, horizontal body position or changes in hormonal levels due to the circadian rhythm. Even the process of sleep itself can cause changes in the functioning of the bronchi. In addition, the following factors may influence the development of nocturnal asthma:

Increased mucus production or sinusitis

Air conditioner

Cold air from an air conditioner in the bedroom can cause hypothermia and dry airways, leading to exacerbation of symptoms of exercise asthma, as well as nocturnal asthma.

GERD (Gastroesophageal reflux disease)

If you often suffer from heartburn, the backflow of stomach acid from the stomach into the esophagus and larynx can cause bronchospasm. worsens when lying down or while taking certain asthma medications, as these relax the valve between the stomach and esophagus. Sometimes stomach acid irritates the lower part of the esophagus and activates the vagus nerve, which sends signals to the bronchioles, thereby causing bronchoconstriction (narrowing of the bronchial tube). If gastric juice gets into the trachea, bronchi and lungs, then the body’s reaction will be very serious: respiratory tract, increased mucus production and bronchoconstriction. If GERD and asthma are treated, nighttime asthma attacks can be eliminated.

Most studies have shown that if exposure occurs in the evening rather than in the morning, a late asthmatic reaction is more likely to develop and the asthma attack may be more severe.

Hormones

Both patients suffering from asthma and healthy people experience circadian fluctuations in hormone concentrations. One of these hormones - adrenaline - has a significant effect on the bronchioles, helping to maintain the muscular bronchi in a relaxed state (thus, the lumen remains wide enough). In addition, it suppresses histamine, which causes the formation of mucus and the development of bronchospasms. Body levels and maximum expiratory flow rate are lowest around 4 a.m., while histamine levels are at their highest at this time. It is this decrease that leads to an exacerbation of the symptoms of nocturnal asthma during sleep.

How is nocturnal asthma treated?

A way to completely cure nocturnal asthma has not yet been found. However, daily use of medications such as inhaled medications is very effective in reducing inflammation and preventing the onset of nocturnal asthma symptoms.

Because these asthma symptoms can worsen at any time during sleep, treatment should be aimed at protecting the body during these hours. A long-acting bronchodilator in inhaler form is quite effective in preventing bronchospasm and reducing asthma symptoms. If you suffer from nocturnal asthma, you may benefit from a long-acting inhaled corticosteroid. If you suffer from GERD in addition to asthma, you should seek advice about medications that reduce stomach acid production.

You should also avoid contact with potentially dangerous ones, such as dust mites, animal hair or bird feathers, this will help prevent

Nocturnal vomiting, with symptoms such as tightness in the chest and wheezing at night, can make sleep impossible and leave you tired and irritable during the day. These problems can affect your overall quality of life and make it difficult to control daytime asthma symptoms.

Nocturnal asthma is very serious. She needs a correct asthma diagnosis and effective asthma treatment.

Nocturnal asthma and sleep disorders

Nighttime wheezing, coughing and difficulty breathing are common but potentially dangerous. Many doctors often underestimate nocturnal asthma.

Research shows that most deaths associated with asthma symptoms such as wheezing occur at night.

Causes of nocturnal asthma

The exact reason why asthma is worse during sleep is unknown, but explanations include increased exposure to allergens; cooling of the respiratory tract; staying in a lying position for a long time; and hormonal secretions that follow a circadian pattern. Sleep itself can even cause changes in bronchial function.

Increased mucus or sinusitis

During sleep, the airways tend to narrow, which can cause increased resistance to airflow. This can cause coughing, which can cause the airways to become more constricted. Increased drainage from your sinuses can also trigger asthma in your highly sensitive airways. Sinusitis with asthma is quite common.

Internal triggers

Asthma problems can occur during sleep, even though you are asleep. People with asthma who work night shifts may have breathing attacks during the day while they sleep. Most studies show that breath tests are worse around four to six hours after you fall asleep. This suggests that there may be some internal trigger for asthma related to sleep.

Lying position

Lying in a supine position may also predispose you to nighttime asthma problems. This can cause many factors, such as accumulation in the airway (sinus drainage or postnasal drip), increased blood volume in the lungs, decreased lung capacity, and increased resistance to the airway.

Air conditioner

Breathing cold air at night or sleeping in an air-conditioned bedroom can also cause heat loss from the respiratory tract. Airway cooling and moisture loss are important triggers for asthma. They are also involved in nocturnal asthma.

GERD

If you frequently experience heartburn, reflux of stomach acid through the esophagus into the larynx may stimulate bronchial spasms. It is worse when you lie down or take asthma medications, which relax the valve between the stomach and esophagus. Sometimes stomach acid irritates the lower esophagus and narrows the airways. Stomach acid can drain into the airways and lungs, causing a serious reaction. This can cause irritation of the airways, increased mucus production, and tightening of the airways. Treating GERD and asthma with appropriate medications can often stop nocturnal asthma.

Hormones

The hormones circulating in the blood are well characterized by the circadian rhythms that everyone experiences. Epinephrine is one such hormone that has an important effect on the bronchial tubes. This hormone helps keep the muscles in the walls of the bronchi relaxed so the airways remain wide. Epinephrine also inhibits the release of other substances such as histamines, which cause mucus secretion and bronchospasm. Epinephrine levels and peak expiratory flow rates are lowest around 4:00 am, while histamine levels tend to peak around this time. This decrease in epinephrine levels may predispose you to nocturnal asthma while you sleep.

How is nocturnal asthma treated?

There is no cure for nighttime asthma, but daily asthma medications, such as inhaled steroids, are very effective in reducing inflammation and preventing nighttime symptoms. Because nocturnal asthma can occur at any time during sleep. A long-acting bronchodilator supplied for asthma may be effective in preventing bronchospasm and asthma symptoms. If you suffer from nocturnal asthma, you can also use a long-acting inhaled corticosteroid. If you suffer from GERD and asthma, ask your doctor about medications that reduce stomach acid production. Avoid potential triggers and allergens such as dust mites, pet dander or feathers in bedding...

Additionally, by using your peak flow meter, you can monitor how your lung function changes throughout the day and night. As soon as you notice changes in your lung function, talk to your doctor about a plan to manage your nighttime asthma symptoms. Depending on your type of asthma and the severity of your asthma (mild, moderate, or severe), your doctor may prescribe treatment to help you resolve your nighttime asthma symptoms so you can sleep like a baby.

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