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Causes and tips for sleep problems with asthma

In this article, we discuss some tips to improve sleep quality with asthma.
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- Reading time: 5 min
Published: 07-08-2023
Updated: 08-04-2025 2025-04-08T20:58:10Z

Asthma can lead to sleep disturbances, causing people to feel less well during the day. Fortunately, there are various measures that can be taken to improve sleep quality and reduce the impact of asthma on nighttime rest. Additionally, it appears that lack of sleep can exacerbate asthma symptoms, making it even more important to pay attention to a good night's rest.

Why do I sleep poorly with asthma?

Asthma patients are not only more likely to experience sleep problems. There may be more antibodies active in the lungs at night, leading to more complaints. However, lack of sleep often also increases the severity of asthma symptoms. This is because breathing is affected by rest during sleep. This phenomenon is known as nocturnal asthma.

Symptoms of nocturnal asthma

Typical symptoms of nocturnal asthma include coughing fits, chest tightness, wheezing, and shortness of breath just before and during sleep. Additionally, repeatedly waking up during the night can lead to fatigue, concentration problems, and difficulty controlling asthma symptoms during the day, both in adults and children. This can have significant consequences for quality of life.

Common symptoms of nocturnal asthma include:

  • Shortness of breath
  • Wheezing
  • Chest tightness
  • Coughing

Effects of nocturnal asthma

Nocturnal asthma can also have other effects on both adults and children, including:

  • Lack of concentration during the day
  • Excessive daytime sleepiness
  • Difficulty controlling asthma symptoms during the day

Triggers of Nocturnal asthma

Although the exact reasons why asthma worsens at night are not yet fully understood, there are certain factors that increase the likelihood of nocturnal asthma attacks. Some triggers for asthma attacks during the night include:

  • Sleeping position: Certain sleeping positions, such as lying on the side or stomach, can narrow the airways and thereby worsen the symptoms of nocturnal asthma. Lying on the back can cause mucus from the nose to drip to the back of the throat, which can lead to nighttime coughing.
  • Inhaling cold air: While a cool bedroom is conducive to sleep, nocturnal asthma can worsen in winter or in air-conditioned rooms. Cold air is dry, and the loss of moisture and warmth in the airways can trigger an asthma attack.
  • Exposure to allergens during the night: Dust mites in bedding or mattresses, pet dander, dust particles, and mold in the bedroom can irritate the airways and increase susceptibility to nocturnal asthma.
  • Exposure to allergens in the evening: Exposure to allergens in the evening, such as pollen or pet dander, can cause a delayed or 'late phase' reaction. This can lead to airway obstruction a few hours later, increasing the risk of an asthma attack at night.
  • Insufficient control of asthma during the day: If the asthma treatment plan is not followed properly during the day, the risk of nocturnal asthma attacks increases.
  • Changes in lung function: During sleep, the body undergoes natural processes that can increase sensitivity to nocturnal asthma. Lung function is naturally lower at night. As the muscles relax, the upper airway narrows, resulting in increased resistance in the lungs. This increases the likelihood of breathing difficulties and coughing fits during the night.
  • Hormonal changes: Hormonal changes during sleep can exacerbate asthma. Studies have shown that reduced cortisol levels during sleep contribute to airway obstruction.

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Prevention of nocturnal asthma

Since poor sleep can worsen asthma and asthma can in turn cause sleep problems, a vicious cycle arises. Therefore, it is important to take measures to improve sleep quality as much as possible. Here are some tips that may help:

  • Ensure a clean sleeping environment free from allergens. Do not allow pets in the bedroom, wash bedding regularly at high temperatures to remove dust mites, ventilate the bedroom, and treat any mold on walls. Avoid using down comforters and pillows.
  • Regulate the room temperature in the bedroom. Close windows during the night, avoid air conditioning, and consider using an air purifier to improve the air quality in the bedroom.
  • Treat underlying conditions: If there are underlying conditions such as gastroesophageal reflux disease (GERD), allergic rhinitis, or obstructive sleep apnea, make sure these conditions are treated and kept under control.
  • Keep your rescue inhaler next to your bed. This way, you have it within reach if you start coughing at night.
  • Keep a glass of water next to your bed. Take a sip of water if your symptoms worsen. Moisture helps to soothe the airways and can relieve nighttime coughing.
  • Do breathing exercises. Various breathing techniques are used to relieve asthma symptoms and can help stop an asthmatic cough at night. If you wake up coughing at night, you can try applying a breathing exercise to control your cough.
  • Undergo an asthma evaluation with your general practitioner or practice nurse. They can check if you are using your inhalers correctly and discuss possible triggers for your nighttime asthma.
  • Follow an asthma treatment plan. Keep your asthma under control by taking your medication correctly, monitoring your symptoms, following an effective asthma treatment plan, and adjusting your medication as needed according to your doctor's advice.
  • Maintain a healthy weight. Follow a balanced diet and stay active to keep your weight under control.
  • Quit smoking. Smoking can worsen asthma and exacerbate the symptoms of nighttime asthma.

It is important to note that these tips may not work for everyone and that it is advisable to consult a doctor for personal advice and treatment. A doctor can assess the specific situation and make additional recommendations to reduce sleep problems with asthma.

Is a weighted blanket recommended for asthma?

Although weighted blankets can offer many benefits for certain people, it is important to note that they are not suitable for everyone. People with chronic health conditions, such as severe asthma, COPD, sleep apnea or other respiratory disorders, should be cautious when using a weighted blanket at night, as it may worsen the symptoms of these conditions. Would you still like to try it? Then first contact your doctor to discuss this.

In this case, a weighted blanket can be effective in the period before you go to bed. For example, use the weighted blanket on the couch to calm down. You will then go to bed with a calmed body and fall asleep more easily.

We hope that after reading this article you have enough information about sleep problems with asthma. If you have any questions about using a weighted blanket for asthma, we are happy to help.

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