If you wake up in the middle of the night gasping and coughing for air you may be a victim of a pattern known as “nocturnal asthma”. The definition of nocturnal asthma is: an asthma cough that becomes more severe and less responsive to control at night.
Nocturnal asthma usually involves more coughing, wheezing and breathlessness at about midnight and gets you tired in the morning.
So, why does asthma act up at night? Airways narrow during sleep. Hormonal changes reduce their ability to stay relaxed. Sleeping in a lying flat position can also result in mucus accumulating and acid reflux which are both irritants to the airways.
Finally, whilst they may be relatively tiny, dust mites and other allergens in your bedding may also be exacerbating your night-time asthma.
The good news: there are concrete actions you can take to control an asthma cough at night and improve the quality of your sleep. Learn more in this blog.
How to Stop Asthma Cough at Night? Practical Relief Strategies
Controlling your nocturnal asthma is a two-part process: Taking quick action when an episode occurs and practicing long-term preventive measures to prevent future episodes. Discover how to do both.
However, if you are worried that your asthma symptoms are becoming more frequent or severe, searching for the best pulmonologist near me in your city is your first step.
Our team of pulmonologists at Big Apollo Spectra Hospital are highly trained and dedicated to provide you with a comprehensive evaluation, review of your medications, and develop an individualized asthma action plan to help manage your condition.
A. Immediate Relief During a Night Cough Episode
As with any asthma cough, you want to stay as calm as possible and take quick action to minimize symptoms. Follow these four steps:
1. Use Your Rescue Inhaler as Prescribed
Your short-acting bronchodilator inhaler is your first line of defense. Keep it and an extra inhaler near your bed in case of emergency. Take it as directed by your healthcare provider, usually one to two puffs (inhalations).
Take a few minutes to see how your airways respond to it. DO NOT OVER-USE IT! If you are using it regularly (i.e. frequently on more than half of your nights a week), you need to see your healthcare provider right away.
2. Sit Upright Instead of Lying Flat
When you lie down in a flat position, your airways can be compressed and mucus accumulates.
Sitting up, perhaps at the edge of the bed, or with the aid of additional pillows, can improve respiratory function and aid better lung expansion. Raising your head by an angle of at least 30 degrees may also reduce chest pressure and may also act as a deterrent to further coughing.
3. Practice Slow Breathing Exercises
Breathe with slow, controlled breathing to stop an asthma cough at night without an inhaler. This method of breathing is more useful in milder episodes.
Try this technique: Breathe in through your nose for a count of 4, hold your breath for a count of 2, and breathe out for a count of 6. It’s also worth trying to do some pursed lip breathing. This will not only slow your rate of breathing but it will also reduce irritation in your airways and may even help to calm out your nervous system.
4. Sip Warm Water
A small amount (1-2 drinks) of warm water may help to soothe an irritated throat and encourage some movement of mucus. However, cold water is not recommended as it can cause further airway constriction.
A warm drink of water may also help to stop asthmatic cough in the milder episodes. The throat can become dry from the force of repeated coughing, and warm water can help with that as well.
B. Bedtime Routine to Prevent Night Cough
You hear it time and again: “Prevention is the best medicine.” We know that a pre-sleep routine can be an effective way to prevent asthma cough at night from ever occurring.
But the idea of having a pre-sleep routine can be shockingly simple and – yet – very, very hard to do. Follow our steps to help your child have a pre-sleep routine to potentially curb and prevent an asthma cough at night.
1. Take Prescribed Controller Medication Before Sleep
Take your controller medications at the same time as prescribed. They work best when taken consistently, especially in the evening. For example, your inhaled corticosteroids work to stop inflammation in your airways. Even if you feel better, you still need to take your controller medications as the doctor has suggested.
2. Avoid Heavy Meals 2-3 Hours Before Sleep
This happens to be a really uncommon food trigger to talk about, but eating a heavy meal at night can result in acid reflux, one of the asthma triggers mentioned quite often.
Actually, the stomach acid that escapes into the oesophagus can irritate the adjacent airways; it also appears as one of the main factors of cough variant asthma episodes. That said, having an early dinner, eating light meals or foods causing no irritation can help minimize the symptoms of the night.
3. Take a Warm Shower or Steam Inhalation
Breathing in warm, humid air right before sleeping can help you loosen the mucus in your respiratory system, relieve the chest congestion, and relax the muscles of your bronchial tubes.
In addition to that, a warm shower can make your body realize that it is time to sleep. You can take this opportunity to remove any pollen and other allergens that have collected on your skin and hair over the day.
4. Keep Your Inhaler Near Your Bedside
Can you imagine how scary it would be to not find your inhaler when the asthma attack symptoms start to show up and it is already dark? Equally scary can be the situation when you are trying to calm down your little one who coughs, cannot breathe, and does not have an inhaler at hand.
Not being able to find the child’s inhaler would turn the situation not only into a panic attack for the child but also the whole family members. Besides, an emergency visit to the hospital due to an asthma crisis might be the scariest part for everyone involved.
To avoid such situations, make sure your child’s inhaler is within reach 24/7. This is especially true if there is a chance of the inhaler being dropped on the floor. Perhaps the best place to keep the inhaler is somewhere safe right next to the bed.
C. Bedroom Optimisation for Asthma
How much thought do you really give to your bedroom environment and how it may be affecting your health? Typically the answer is “not much”. While we often think of indoor air quality as a problem, exposure to a host of pollutants can easily trigger an asthma attack.
Common indoor air pollutants in the bedroom include dust mites, humidity, and fragrances, and eliminating these irritants can help you get rid of asthma cough at night, once and for all.
1. Wash Bedding Weekly in Hot Water
Dust mites love to live in your mattress, pillow and sheets. Washing your bedding in warm water (above 60°C) once a week will kill them and remove their waste products which are the real allergen. Get rid of dust mites to help calm asthma at night. Also, remember to wash your pillowcase and duvet cover.
2. Use Allergen-Proof Pillow Covers
Using an allergen-proof or dust mite barrier cover on your pillow and mattress can be an effective barrier between you and the allergens. The tight weave of these materials prevents dust mites and other allergens from entering the material.
The covers are washable, very inexpensive, and can be easily found at home improvement stores. In addition to using the barrier covers on your pillow and mattress, we recommend washing your bedding (including your comforter, sheets, and blankets) in hot water one time per week to also help control the amount of dust mites and allergens you have on your bedding.
3. Maintain Moderate Humidity
High humidity above 50% promotes the growth of dust mites and mould – two of the common asthma triggers. Controlling the humidity level in a room by using a dehumidifier or air conditioner and keeping humidity within the optimal range of 30-50% is one way to help control asthma symptoms at night.
Learning to manage the many different environmental stressors that build up in the bedroom and trigger excess nighttime coughing is an important aspect to stop uncontrollable coughing at night in asthma.
4. Avoid Strong Fragrances or Room Sprays
Use air fresheners, candles or aerosol sprays, and they pour volatile gases and particles into the air that you can easily breathe in and that can cause irritation to the sensitive airways in your lungs.
Try to switch to non-scented options, or at least avoid using them in your bedroom. Some laundry detergents can cause similar irritation too, so you may need to switch to fragrance-free/hypoallergenic laundry products, at least for washing your bedding and nightclothes.
7-Minute Bedtime Routine for Asthma Patients
Even though it takes only a couple of minutes to apply your bedtime asthma routine, it can make a huge difference for your asthma symptoms. Find out more in this 7 minute mini guide.
Minutes 1-2: Take your prescribed controller medication with a full glass of water and at the same time every day.
Minute 3: Take 1-minute to breathe through your nose slowly. Inhale for 4 counts, exhale for 6 counts to calm your airways.
Minute 4: Take a quick look in your bedroom to make sure that all of your windows are closed, your humidifier is on and you haven’t used any sprays or candles.
Minute 5: Now, drink a few sips of warm water. Prop your pillows to support a slight upward lean.
Minute 6: Put your rescue inhaler in plain sight on your nightstand in case of an emergency.
Minute 7: Take one last deep, slow breath in through your nose, hold it for a few seconds and then breathe it out. You are now ready for sleep.
For the rest of your life, no matter how tired you are, follow these steps and you’ll sleep better and your body will begin to associate these actions with calm, controlled breathing.
Control Nighttime Asthma Cough Starting Today
Asthma shouldn’t be an insomnia trigger. Immediate relief strategies in addition to maintaining a regular bedtime routine and a sleep environment that is asthma-friendly will allow you to control nocturnal symptoms, thus improving sleep and reducing the frequency and severity of nocturnal attacks.
If your symptoms are getting worse or have an impact on your daily life, an appointment is due. Big Apollo Spectra Hospital, the best hospital in Patna, is equipped with the latest advancements in pulmonology and offers expertise in managing asthma in children, adults, and elders. You will get a tailor-made treatment plan, evaluation of lung function tests, and a host of other services to manage your asthma in the long-term.
There is no excuse for another restless night’s sleep. Book an appointment today. Improve your lifestyle and start to breathe easier.
