What parents can do about nighttime asthma

Asthma happens when an airway is constricted or inflamed. Wheezing and coughing can be tiring, especially when these symptoms disrupt sleep. For children with asthma, dealing with symptoms at night can be difficult.

When asthma symptoms happen at night, it's called nocturnal asthma (NA). NA can refer to any type of asthma someone has at night, including:

• Allergic
• Nonallergic
• Occupational
• Exercise-induced

Not everyone who has asthma has NA. Children often have NA, but don't always tell their parents when they have symptoms. Sometimes parents don't know their child has NA. 

If a child has trouble sleeping at night, it can affect their focus, attention and energy during the day. It can also cause chronic fatigue. Sometimes undiagnosed nocturnal asthma is the cause of sleep issues in children. 

Why is my child's asthma worse at night?

There are no proven reasons why asthma may be worse at night. Possibilities may include: 

Allergen exposure. If you’re around items that trigger or cause you to have symptoms, that’s allergen exposure. Common triggers include:

• Dust mites
• Allergens and mold that can build up in bedding, pillows and mattresses

Sleeping position. If you’re leaning back or lying down, this can cause drainage or postnasal drip, less lung capacity and more resistance in your airways.

Gastroesophageal disease (GERD). GERD involves the stomach and esophagus or the part of the body that connects the throat and stomach. GERD symptoms 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, your child can aspirate or fluid can get in their lungs. This can cause coughing and difficulty breathing. 

Air conditioning. AC cools down the air in a building. If your body's airways are cooled by AC while you sleep, this can trigger asthma. Many homes in Seattle don't have AC. Remember when you travel, your hotel may have AC. 

How should I handle my child's NA?

Each person is different. If you lessen the amount of time your child spends around triggers, that will help with their asthma symptoms and NA. It's also important to keep the sleeping area clean. 

Change sheets regularly. Wash bedding in hot water. Wipe down shelves, ledges and nearby furniture to lessen the amount of dust in the room. Don't let your child sleep in the same room with pets. 

Try to use allergy-free sheets. Make sure pillows have a cover and look for allergy-free material. 

Try to have your child sleep at a slight incline. If you lift your child's head four to six inches by adding blocks under the bed post, this can help with GERD symptoms. 

Using a humidifier also helps to keep the air moist in your child's room. 

When should I call my doctor?

If your child suffers from NA regularly, call your child's doctor to talk about making changes to their treatment plan. 

Sometimes medications used to take care of asthma can cause sleep problems. Talk to your child's doctor if your child can't sleep because of their asthma medication. 

The information provided is for general informational purposes only and is not intended to be medical advice or a substitute for professional health care. You should consult an appropriate health care professional for your specific needs.