Asthma, known as reactive airway disease, is a chronic lung condition that affects approximately 20 million Americans, according to the National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health. Symptoms of asthma occur when the airway becomes inflamed and constricts to make breathing difficult. What causes asthma or why incidences of asthma are on the rise is not known, but some have suggested that it could be the result of environmental factors such as an increase in exposure to pollution or indoor allergens. There are new studies showing that oilfield fracking triggers asthma episodes. Its increase may also be related to the increase in obesity that is simultaneously also occurring in the US. Researchers are looking for a genetic factor for asthma based on the fact that a person has a higher risk of developing asthma if a member of his or her family also suffers from Asthma.

Asthma patients may also suffer from nighttime coughing, wheezing and breathlessness that disturb their sleep. It is not clear whether there is a circadian rhythm factor (a circadian rhythm is a rhythm of biological functions occurring in a 24-hour periodic cycle) responsible for these nighttime disturbances or whether sleep in some way contributes to disturbances.  Many researchers believe that asthmatic symptoms are at least partly due to circadian rhythms and use the term “nocturnal asthma” to describe the asthma symptoms worsening at night. Not all asthma sufferers experience nocturnal asthma. People with asthma should also be aware that nocturnal asthma is associated with a more severe disease and increased mortality.

There are several reasons that may explain why nighttime seems to exacerbate asthma symptoms. Airway resistance increases throughout the night, whether or not a person is sleeping; the increase is much greater if the person is asleep. The airway functions best just before the onset of sleep and decreases as sleep progresses.  In other words, the more a person with asthma sleeps, the greater the impairment of his or her lungs. People with asthma frequently show the first symptoms of their disease during sleep.

Asthma often starts in childhood and is more common in children than adults, according to the NHLBI. It is extremely important for children with asthma to get adequate sleep.  HARRIS POLL that was conducted  in April, 2005 for the Asthma and Allergy Foundation of America reported that 48% of child asthma sufferers experienced disturbed sleep as a result of asthma. Asthma is one of the leading causes of children missing school, according to NHLBI .

In Archives of Diseases in Children, sleep disturbances were analyzed in children with nocturnal asthma. Researchers discovered that children who suffered from sleep disturbance caused by nocturnal asthma also exhibited signs of psychological problems and impaired performance in school. The children improved their mental function if treatment were given to treat the nocturnal symptoms and thus reduced their sleep disturbance.

It is important for a person with asthma to know the triggers for their asthmatic attacks. The following are some common triggers:

  • Colds
  • Flu and viruses
  • Dust (and/or dust mites)
  • Allergens
  • Mold
  • Animal dander
  • Smoke
  • Strong odors
  • Exercise
  • Reflux disease
  • Weather
  • Food
  • Emotions
  • Laughter

Symptoms of asthma occur when the airway becomes inflamed and constricts to make breathing difficult. People with asthma often suffer from nighttime coughing, wheezing and breathlessness that disturb their sleep.  Be sure to discuss any sleep problems that you or your child might be experiencing with your doctor, it may be the medications taken or an asthma induced sleep disorder.

The goal of any asthma treatment plan is to maintain normal breathing and to participate in a full range of activities such as exercise and childhood play. In addition to modifications to lifestyle, most people with asthma use a combination of quick-fix and long-term medicinal remedies. Effective long-term therapies for asthma are those that reduce swelling in the airway. The following medications are indicated for long term use to reduce airway swelling:

  • Inhaled steroids (e.g. Flovent, Pulmicort)
  • Inhaled cromolyn sodium (e.g. Intal)
  • Inhaled nedocromil sodium (e.g. Tilade)
  • Leukotriene modifier (e.g. Accolate, Singulair, Zyflo)
  • Long-lasting Beta2-Agonist (e.g. Foradil, Serevent)
  • Inhaled short-acting Beta2-Agonists (e.g. Albuterol, Alupent, Maxair, Xopenex)
  • Anticholinergic (e.g. Atrovent, Combivent)
  • Steroid (e.g. Deltasone, Medrol, Orapred, Prelone, Pediapred)

People with asthma are mostly able to live a normal life and participate in most activities. In order to do this, however, asthma patients must take their medications as prescribed, recognize and avoid things that trigger an attack and act quickly when symptoms appear to be getting worse.  Take medication at the prescribed time.  This is very important in managing asthma symptoms. Patients should work with their doctors to develop a medication regime that works best.  Use a peak flow meter, asthma patients should constantly monitor their symptoms.

There is evidence that people with asthma are at risk of developing sleep apnea, which is a when your breathing is briefly and repeatedly interrupted during sleep. A visit to a sleep center is required to determine whether a person with asthma also suffers from sleep apnea.  People with asthma may discuss the sleep study with their OOA physician.

According to the National Sleep Foundation’s 2004 Sleep in America poll, about 10% of parents or caregivers say their children have trouble breathing (including heavy or loud breathing) while sleeping at least a few times per week.

Source:  www.sleepfoundation.org, Reviewed by Barbara Phillips, M.D., M.S.P.H.