How to sleep with asthma positions (A brief guide)

How to sleep with asthma positions

In this guide, we will discuss “How to sleep with asthma positions”, the association between a particular sleeping position, symptoms and medication, tips on how to prevent asthma long-term, symptoms of night-time asthma and treatment options.

How to sleep with asthma positions

To answer the question How to sleep with asthma and the recommended sleeping positions, we could take the advice from the Cleveland Clinic where they recommend lying on your side with a pillow in between your legs and your head elevated with pillows. Make sure you keep your back straight. 

However, asthma can become a big problem since it can have a detrimental effect by keeping you wide awake at night. You may be coughing, feeling a shortness of breath or a tight chest at night (or all of them),  know that there are some simple steps that can make your life easier and especially improve the quality of your sleep.

How to sleep with asthma positions (A brief guide)

Moreover, according to Beth Orenstein from Everyday Health, there are some key factors that may be contributing to your night-time asthma attacks:

  • Your body’s internal clock. Your circadian rhythm causes some of your hormone levels to fall at night. Lower levels of hormones can cause your airways to narrow slightly. These narrowed airways can exacerbate your asthma symptoms, according to the Asthma Society of Canada (ASC).
  • Dust mites. Your pillows, blankets, and mattress can all be a haven for these microscopic insect-like pests and their waste. Allergies to dust mites can worsen asthma, and you could be wallowing in them as you sleep, according to the ASC.
  • Gravity. When you lie down, your chest and lungs naturally experience extra pressure, the ASC says.

Association between sleeping position, asthma symptoms and medication

In terms of the sleeping position and night-time asthma symptoms and medication, a study from 2016 found that symptoms started to get reduced just 30 mins after supine sleep position that relieved difficulties in breathing and shortness of breath. Moreover, after one-hour coughing and tightness of chest improved as well.

Even more surprising was the monthly follow up, during the first week the patient reported relief from chest pain, chest tightness, difficulty in breathing, shortness of breath and wheezing. However, the patient got awakened at night due to several symptoms which were relieved with salbutamol tablets, inhaler and prednisolone tablets. Day 2 reported similar results and on day 3 only coughing was reported and so on with the following weeks. 

How to sleep with asthma positions (A brief guide)

They determined how supine sleeping position for the asthma patient demonstrated persistent use of this natural body position plus anti-asthma medicine when symptoms were present, to ensure an improvement in the quality of sleep.

What can I do to prevent asthma from letting me sleep?

Here are some useful tips from asthma.org.uk:

  • If you have asthma symptoms, sit up and take your reliever inhaler (usually blue) as prescribed. 
  • Always make sure your inhaler is beside your bed before you go to sleep, so you don’t have to search for it in the middle of the night.
  • “Give yourself a bit of time to check your reliever medicine has dealt with your symptoms before you go back to sleep,” says Dr. Andy Whittamore. “This is better than falling asleep straight away only to wake up soon after with asthma symptoms because your reliever didn’t help enough.”
  • Some people find propping themselves up with extra pillows helps as it keeps the airways open.

*Dr. Andy Whittamore recommends paying a visit to your GP if your asthma keeps you awake at night. 

How to sleep with asthma positions (A brief guide)

Remember that there are many existing types of asthma that can be triggered by different things and under different situations. For instance, there is Adult-Onset Asthma, Allergic asthma, asthma-COPD Overlap, Exercise-Induced Bronchoconstriction (EIB), Nonallergic Asthma, among others. Each may require different approaches but we will talk specifically about night-time asthma or nocturnal asthma.

What are the symptoms of Night-time asthma?

According to WebMD, the si¡ymptoms include chest tightness, shortness of breath, cough, and wheezing at night, making it impossible to sleep and leave you feeling tired and irritable during your day. This can affect your overall quality of life and make your daytime asthma symptoms harder to control.

What causes nocturnal asthma?

There is not a specific reason that triggers asthma attacks during your sleep but we could mention reasons such as (Asthma.org.uk):

  • It is believed that during the night your body produces fewer natural steroid hormones that can affect your symptoms and more of the cells that cause the inflammation in your airways.
  • When you lie on your back, gravity places extra pressure on your chest and your lungs which makes it harder to breathe, triggering cough, mucus in your nose, etc.
  • Triggers such as dusty pillows or mattresses, making your asthma get worse.
  • Sleeping with your pet may trigger your asthma where it is recommended to keep them out of the room while you are sleeping.
  • Mould can also worsen the symptoms so make sure you check your room searching for damp patches on walls and mould growing around your windows.
  • Pollen triggers asthma when it is higher than normal. Try to use a fan to keep your bedroom cool.
How to sleep with asthma positions (A brief guide)

How to stop your asthma waking you long-term?

You may have been getting used to your usual night-time asthma symptoms but you don’t have to. Here are some simple tips you can follow:

  • Using your inhaler every day and as prescribed by your doctor. This can help to build up protection in your airways and to keep your symptoms under control reducing your chances of waking up at night.
  • As mentioned before, if you notice your asthma symptoms get worse at night or when you wake up, consider getting an appointment to see your GP or Nurse to discuss it.

Treatment options

Even though there is no cure, daily asthma medications such as inhaled steroids can help reduce inflammation and nocturnal symptoms. Nocturnal symptoms can happen at any time during the sleep period, a long-acting bronchodilator in an asthma inhaler can be effective in preventing bronchospasms, and control the symptoms of asthma. 

Here are some of the prescribed medications indicated for long-term use by asthmatics (sleepfoundation.org):

  • Inhaled steroids (e.g. Flovent, Pulmicort)
  • Inhaled cromolyn sodium (e.g. Intal)
  • Inhaled nedocromil sodium (e.g. Tilade)
  • Leukotriene modifier (e.g. Accolate, Singulair, Zyflo)
  • Long-lasting Beta2-Agonist (e.g. Foradil, Serevent)

In addition to the inhaler, you could also benefit from a long-acting inhaled corticosteroid. Moreover, WebMD recommends GERD sufferers to ask their doctor about medication that is able to reduce acid production in the stomach. It also adds “Avoidance of potential allergy triggers such as dust mites, animal dander, or feathers in a down comforter may also be very helpful in preventing allergies and asthma and nocturnal asthma attacks.”

Why is this blog about How to sleep with asthma positions important?

As we have discussed, it seems that the position you sleep on can help you reduce asthma symptoms along with the use of asthma medication. Moreover, we talked about several tips, such as changing your bedding at least once a week, that you can follow to prevent having an asthma attack during the night that can affect your quality of sleep. 

Also, we talked about how there is no definite treatment so make sure you go to your GP and get the appropriate treatment for your case, also if you feel symptoms get worse set up an appointment to keep the situation controlled.

Please feel free to leave any comments or thoughts about the content of this article!

Frequently Asked Questions (FAQs) about How to sleep with asthma positions

How do you sleep with asthma?

You can sleep better with asthma if you:

  • Make sure to clean your room regularly, especially your bedding.
  • Wash your bedding in hot water at least once a week.
  • Use a dust-proof mattress and pillow protectors.
  • Invest in a humidifier.
  • Avoid sleeping with pets even if you feel compelled to or think nothing will happen if you sleep just one night with them. It is recommended to keep them outside during the night.
  • Keep your head up, this will help you breathe better and relieve your lungs from the pressure of the gravity.
  • Make sure you get tested by a professional to rule out sleep apnea.

Can you die in your sleep from asthma?

Some professionals would agree on how unusual it is for someone to die because of asthma while they are sleeping. Usually, because asthma wakes people from their sleep unless they are heavily sedated for other reasons and due to certain substances.

Why is my asthma worse when I lay down?

Your asthma may get worse when you lay down since there may be accumulations of secretions in your airways, increased blood volume in your lungs, decreased lung volume, and increased airway resistance (WebMD). This is due to the effect gravity has on your lungs.

What sleeping position is best for breathing?

The best sleeping position to breathe better is sleeping on the side. Some studies have shown that people with sleep apnea breathe much better when they are not on their back due to gravity. According to beddrsleep.com “Side-sleeping has long been known as the best sleeping position for breathing and to protect the airway from collapse.” 

Are hot showers good for asthma?

Some people with asthma find hot showers very soothing since warm air is said to help clear the mucus in your airways, making it easier to breathe. However, some others find heat makes asthma get worse so it is important to know that what works for some may not work for others. So, if you try it and your symptoms get worse then try looking for another way to get some relief from the symptoms.

References 

My.clevelandclinic.org: “Positions to Reduce Shortness of Breath”

Orenstein, B.W. (2017, May.) 7 Tips to Prevent Nighttime Asthma Attacks. Retrieved from Everydayhealth.com.

WebMD.com: “Nocturnal Asthma (Nighttime Asthma)”

Asthma.org.uk: “Asthma keeping you awake at night? Here’s how to deal with night-time symptoms”

Kalolella A. B. (2016). Sleeping position and reported night-time asthma symptoms and medication. The Pan African medical journal, 24, 59. https://doi.org/10.11604/pamj.2016.24.59.9159

Sleepfoundation.org: “Asthma and Sleep”

How to sleep with asthma positions (A brief guide)

Daniela Paez

Daniela Paez is a Clinical Psychologist with an MSc. In Clinical Neuropsychology from Bangor University. She has vast experience in working with children with disabilities, adolescents and their families, in extreme conditions of poverty and vulnerability. Additionally, she owns a private practice where she provides neuropsychological evaluation for children and adults, and treatment for mood disorders, anxiety, couple therapy, among other conditions.

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