Nocturnal Asthma Health
Lung function declining at night
Some patients have worsening of asthma at night even when a daytime exam by their physician or a breathing test is normal.
Tests show that lung function declines at night for all individuals with maximum lung function around 4:00 p.m. and is the lowest at 4:00 a.m. Normal and asthmatic individuals, who do not have nocturnal symptoms, decrease about 8% while those suffering with nocturnal asthma show larger declines on breathing tests.
Treating night-time asthma
Medicine to relax muscles around airways
Bronchodilators relax muscles around airways and taking a long-acting inhaled bronchodilator (Serevent®) may keep symptoms under control throughout the night. There are also oral bronchodilators that may be prescribed.
Medicine to decrease or prevent inflammation
Airway inflammation is thought to be the underlying reason for asthma symptoms. Worsening of asthma at night can indicate asthma “controller medicines” need to be added or the dose adjusted. Inhaled corticosteroid medicines or oral leukotriene modifiers (i.e., Singulair®,) are most often used.
It is also important to do the following if indicated:
- Treat night-time GERD if it is present.
- Treat sleep apnea if it coexists with asthma.
- Reduce indoor allergens, especially in the bedroom.