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 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. Reference from Annals of Allergy, Asthma, & Immunology, November, 1998
Treating nighttime asthma
Medicine to relax muscles around airways
Medicine to decrease or prevent inflammation
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.
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.
Treat nighttime GERD if it is present.
Treat sleep apnea if it coexists with asthma.
Reduce indoor allergens, especially in the bedroom.
