Many people with asthma find that their symptoms are worse at night. What’s called nocturnal asthma is common, with a large percentage of people reporting that their asthma symptoms, including their asthma cough, wake them up at night at least once per week.
If you have asthma, many factors play a role in your nighttime symptoms and, as a result, the quality of your sleep.
Why Does My Asthma Get Worse at Night?
It’s not clear exactly why asthma symptoms commonly are worse at night. One possible explanation is that cooler temperatures cause the airways to contract. Another is that there may be increased exposure to allergens in the bedroom.
Other possible causes of nighttime asthma symptoms include the secretion of hormones related to the natural patterns of wakefulness and sleep (what’s called circadian rhythm) or changes in bronchial function brought on by sleep itself.
And finally, sleep position can directly affect how well you sleep, especially if you have asthma.
What Is the Best Sleeping Position for Asthma?
If you’re thinking about sleeping positions and how to sleep when you have asthma, here are three positions that can help:
Sleep on your left side with a pillow between your legs
Many people are side sleepers. If that’s you, sleeping on your left side specifically can help keep your airways open. And the addition of a pillow between your legs stabilizes your spine and may help keep you in better sleep posture.
Sleeping on your left side is especially helpful for people who suffer from both asthma and heartburn, as heartburn can trigger asthma symptoms. Left-side sleeping takes advantage of gravity, the shape of the stomach, and the angle of the connection between the esophagus and the stomach to reduce acid reflux.
Sleep on your back with your neck and shoulders elevated
If you prefer to sleep on your back, use pillows to prop yourself up somewhat. This can help open your airways while you sleep. A slightly elevated position also takes advantage of gravity to help your sinuses drain, which makes it easier to breathe.
Sleep on your back with your head elevated and a pillow under your bent knees
Another option for back sleepers who have asthma is to sleep on your back with your head slightly elevated and a pillow under your knees. This position can improve circulation while also keeping your body stable throughout the night, which can help you breathe easier and sleep better.
The key to finding the right sleep position for you is to experiment with what are considered the best sleeping positions for asthma patients and make notes. Pick a position, stick with it for a week or so, and record your observations about your asthma symptoms and sleep quality. Then try another position and do the same.
Using the same sleep position for multiple nights is helpful, as it allows your body to get comfortable with that position so that the newness of it isn’t a factor in your sleep quality.
A note about right-side sleeping: Research has determined that sleeping on your right side increases resistance in the airways within the lungs. A possible cause of this difference between left-side and right-side sleep positions is that sleeping on your right side may increase what’s called vagal tone, which activates the nervous system in a way that causes airway constriction. Not everyone experiences this effect, but you should keep it in mind as you experiment with sleep positions.
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What Other Steps Help with Asthma at Night?
In addition to finding your best sleeping position for asthma symptom relief, there are other steps you can take to reduce the risk of an asthma attack at night. They include that you should:
- Sleep in a bed that’s elevated off the floor. While some people like to have their mattress directly on the floor, the closer you are to ground level, the more allergens you’ll breathe in overnight. Sleeping on an elevated mattress lowers your exposure to irritants that can trigger asthma symptoms.
- Clean your bedroom regularly. Dust, dust mites, and other asthma triggers are frequently found in the bedroom. Dusting and vacuuming your bedroom regularly reduces the number of irritants you inhale overnight.
- Wash your bedding weekly. Washing your bedding every week in water that’s at least 130 degrees Fahrenheit helps kill bacteria and other allergens. And drying it on high heat helps, as well. Be sure your bedding is completely dry before putting it on your bed. Damp bedding can develop mold, which is a common asthma trigger.
- Buy dust-proof pillow and mattress covers. Pillows and mattresses can be breeding grounds for dust mites. Dust-proof covers keep them out.
- Keep pets out of the bedroom. Pet dander triggers asthma symptoms. Ideally, pets should be kept out of the bedroom at all times, since dander can stick to bedding, clothes, and other soft surfaces. At a minimum, they should be kept out of your bedroom at night if possible.
- Keep bedroom windows closed. Outside air can bring pollen, dust mites, and other irritants into your bedroom. Closing your windows eliminates that source of asthma triggers.
- Use an air purifier and a humidifier. Air purification systems help reduce the number of allergens in the air, and using a humidifier keeps the air from getting too dry. Dry air can irritate the nasal passages and throat, worsening asthma symptoms.
- Talk with your doctor about sleep apnea. It’s common for people with asthma to have sleep apnea, in which breathing stops for a few seconds at a time and then resumes. This can leave you feeling groggy and tired in the morning and throughout your day. Your doctor can talk with you about your sleep quality and recommend sleep apnea testing and treatment if appropriate.
Can I Use My Inhaler Before Bedtime?
Yes, you can use your inhaler before you go to bed to help control asthma at night. You should also keep it near your bed in case you have an asthma attack during the night. If that occurs, sit up before using your inhaler, as that helps the medication get into your throat and lungs more easily.
Learn More About Asthma and Sleep from Baptist Health
Getting plenty of restful sleep is crucial to overall health and happiness. If your asthma symptoms are affecting your sleep quality, talk with your Baptist Health doctor about how to sleep better with asthma. If you don’t yet have one, you can find a provider using our online directory.
Next Steps and Useful Resources