Child sleeping.

Wheezing and coughing can be exhausting, especially when these symptoms disrupt your sleep. For children who suffer from asthma, it can be especially challenging to manage symptoms at night.

Asthma occurs when airways become constricted or inflamed. When asthma symptoms occur at night, it is often called nocturnal asthma (NA). Nocturnal asthma can refer to any type of asthma experienced at night including allergic, non-allergic, occupational, and exercise-induced.

Not everyone who has asthma will have symptoms at night. Children can often experience nocturnal asthma but underreport their symptoms, leaving parents without the whole story of their child’s condition. Trouble sleeping at night because of nocturnal asthma can significantly impact a child’s focus, attention and energy the next day, and cause chronic fatigue. Sometimes undiagnosed nocturnal asthma is the cause of sleep issues in children.

Why is asthma worse at night?

There are no proven reasons why asthma can be worse at night but several factors may include:

  • Exposure to allergens. Dust mites, allergens, and mold can easily accumulate in bedding, pillows, and mattresses. For asthmatics, these tiny triggers can wreak havoc on their lungs.
  • Reclining position. Lying down can cause accumulations of drainage or postnasal drip, decreased lung capacity and increased resistance in the airways.
  • Gastroesophageal disease (GERD). Symptoms of acid reflux disease can make asthma worse. After lying down to sleep, stomach contents or acid can come back up into the esophagus. If your child wakes up from the discomfort, he or she may aspirate the acid into their airways, causing coughing and difficulty breathing.
  • Air conditioning. Cooled airways can trigger asthma as airways lose heat. While many homes in Seattle do not have air conditioning, it’s important to remember when traveling and staying in hotels.


Each patient is different. Minimizing your child’s triggers can help avoid exposure and prevent symptoms from happening at all.

What can you do to help control asthma at night?

  • Keep a clean bedroom environment.
  • Make sure to change sheets regularly, wash bedding in hot water, and wipe down shelves, ledges or nearby furniture to minimize dust. Don’t let your child sleep in the same room with pets.
  • Choose allergy-free linens. Make sure pillows have a cover and look for allergy-free materials.
  • Sleep on a slight incline. Elevating the head 4-6 inches by adding blocks under the bed post can help with GERD symptoms. Sleeping on an incline can reduce acid regurgitation.
  • Use a humidifier. Keep the air moist in your child’s room with a humidifier.

When to Call Your Doctor About Nighttime Asthma

If your child suffers from asthma symptoms at night regularly, call your child’s doctor to discuss adjusting their treatment plan. Sometimes medications used to manage asthma may also cause sleep disturbances. Be sure to discuss with your child’s doctor if your child experiences bouts of insomnia while taking an asthma medication.


May 25, 2016 | by The Polyclinic