Can Asthma Get Worse At Night?

A picture of a boy using home nebulizer machine for treating asthma, bronchitis and illness related to respiratory at bed.

Asthma at night is a nightmare. It is bad enough when your child is awake, but why does it feel worse while they are sleeping?

In sleep mode, you don’t have control over your body. So, when your child gets an attack, they can be awoken by shortness of breath and wheezing.

Even more concerning, what if they do not have your inhaler nearby? Will they be able to breathe at all?

The good news is that, even though nighttime asthma attacks are unpleasant, you can prevent or alleviate them.

What is Nocturnal Asthma?

This type of asthma happens at night between the patient’s bedtime and awakening. It’s a chronic condition wherein inflammation in the airways causes wheezing, coughing, and shortness of breath.

For patients with asthma, it’s an uncomfortable yet common occurrence. One study reports that up to 75% of asthmatics are woken up by asthma attacks once a week, while 40% of them suffer from it every night.

Symptoms of Nocturnal Asthma

Signs of nighttime asthma are the same as its daytime counterpart:

  • coughing
  • tightness in the chest
  • dizziness
  • shortness of breath, wheezing, or both

Factors that Trigger Nighttime Asthma Attacks

The following can contribute to nocturnal asthma:


According to the Asthma and Allergy Foundation of America (AAFA), strong emotions can trigger asthma. When stressed, the body swings into a fight or flight response which causes faster breathing and muscular tension, leading to an asthma attack.

GERD (Gastroesophageal Reflux Disease)

Patients with GERD often experience acid reflux while sleeping. It occurs at the lower end of the esophagus which is connected to nerves in the lungs. As stomach acid goes up the esophagus, small particles may get into the airways, triggering asthma symptoms like chest tightness.

Internal Body Clock

Some hormone levels drop at night and cause airways to contract slightly. This can aggravate asthma symptoms.

Ways to Sleep Better with Asthma

Here are a few tips to help you get more than 40 winks even with nocturnal asthma:

Use a Humidifier

Cold air makes it difficult for asthmatics to breathe because it irritates the bronchial tubes. A humidifier can add moisture to your bedroom when the weather is cold. It also helps prevent dust mites, another asthma trigger.

Maintain a Clean Bedroom

Unkempt rooms accumulate dust and other allergens which can stimulate asthma while you sleep. Make sure to vacuum, change bed sheets regularly, and wash bedding thoroughly to kill off any dust mites.

Keep Pets Out of the Bedroom

Pet dander, the material shed from animals with fur or feathers, can set off asthma symptoms. Unfortunately, if you’re asthmatic, sleeping with your furry pals and keeping them in your room are discouraged.

Change Your Sleeping Position

If you have GERD or acid reflux, sleeping on your left side reduces esophageal acid exposure. Reflux and asthma can be triggered by lying flat on one’s back.

Additionally, elevating your head slightly helps avoid nocturnal asthma attacks since it better aligns your spine, making it easier to breathe.

How to Stop Night Asthma Attack Without an Inhaler

Try these methods for relief:

Stay Calm

Even if it’s challenging, try to keep as relaxed as possible. Stress aggravates symptoms so take a few deep breaths to calm down.

Sit Up Straight

If you’re lying down when the attack starts, sit up and perform breathing exercises to keep your airways open.

Go to an Area with Clean Air

Allergens in your bedroom might be the culprits. Try to go outside or to a room without dust.

Have a Cup of Coffee

According to some studies, caffeine may help asthmatics by reducing respiratory muscle fatigue and temporarily improving lung function.

Newport Children’s Medical Group

Nighttime asthma episodes are a reality for many children, so it’s important to understand its triggers and the different ways to manage them. While there’s no cure for asthma, you can prevent it from happening in your sleep by following our tips.

If your child’s symptoms are not improving, or are getting worse, contact one of our pediatricians at one of our four office locations in Southern California.