Nocturnal Asthma.

Nocturnal Asthma

Last updated: July 2022

Are your asthma symptoms worse at night? Many asthmatics find themselves dreading the time of day when the sun goes down, because you know that's the witching hour when your asthma will start to kick up.

Nocturnal asthma symptoms

It is estimated that as many as 70% of asthmatics have worsening symptoms at least one night a week. More than half of asthmatics have asthma flare-ups at least 3 nights per week.
The symptoms of nocturnal asthma are essentially the same as regular asthma and can include:

These symptoms tend to get worse when laying down and often times can wake you up in the middle of the night which is super frustrating!

Many (but not all) people with nocturnal asthma symptoms generally only have mild asthma symptoms during the day or no symptoms at all, but the symptoms increase significantly at night time.

Possible explanations


Our hormones in our bodies change throughout the day. At night, they can cause the muscles to contract which in turn can lead to the airways narrowing, thus causing asthma symptoms to worsen.


The bedroom can be a highly allergic place to be at night. Pet dander, dust mites and even dusty heaters and fans can cause an allergic response which can also cause asthma flare-ups.

Late phase response

Usually when an asthmatic is exposed to an asthma trigger or allergen you can expect to have asthma symptoms pretty quickly. Sometimes asthmatics will experience a late phase response. This happens when a second bout of asthma symptoms occurs several hours later related to the same trigger/allergen you were exposed to earlier.

Acid reflux (GERD)

Acid reflux can definitely worsen asthma symptoms. When the stomach acid comes up through the esophagus, it can cause airway construction. This is usually worse when lying down or after eating a large meal.

Tips to help cope with nocturnal asthma symptoms

Keep an asthma journal to record symptoms

I always recommend to every asthmatic I take care of in the hospital or educate in a clinic setting. Additionally, I keep one myself to write down when I'm having bad asthma days. I note the time the flare-up began and what steps I took according to my asthma action plan. This comes in handy when I have doctor visits and can exactly pinpoint when and the time of day the flare-up occurred.

Track your peak flow

If your asthma tends to be worse at night start being diligent about tracking your peak flows. You'll notice that your peak flow numbers will be lower at night than they are in the morning. Always make sure to do your peak flows BEFORE you take your asthma medication.

Sleep with your head elevated

Either elevate the head of your mattress or use more than one pillow to prop your head up a bit while sleeping.

Reduce bedroom allergens/triggers

If you have pets, try to not have them sleep in the same room (if pets are the source of triggers/allergies for you), vacuum regularly if you have carpet, encase your mattress and pillows to protect against dust mites.

If you are experiencing nocturnal asthma symptoms, definitely talk to your doctor about it. Extra precautions and steps can be added to your asthma action plan to help cope with night time flare-ups. As always, if you have any tips that have helped you cope with nocturnal asthma symptoms I would love to hear them! Drop a comment below!

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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