What is Asthma?

Asthma is a condition that affects your breathing.  It currently affects approximately 8 million people in the UK (approximately 12% of the population), and over 300 million people worldwide. Asthma can vary in severity, from a mild wheeze to a severe breathing difficulty. It can be fatal and it’s important to get a formal diagnosis from a doctor or asthma nurse.

Who can get asthma?

Asthma can affect both adults and children. People with a history of allergies are more predisposed to asthma. Asthma is commonly diagnosed in at a young age and many children often find that symptoms significantly improve as they get older.

What are the causes and causes and symptoms of asthma?

Asthma is a condition that affects your lungs. The lungs and airways become inflamed and obstructed, this narrowing of the airways results in wheezing and tightness of the chest. In some cases, asthma is triggered in response to a stimulus.

Asthma Triggers :

·         Bacterial or viral infections, such as colds and flu.

·         Pollen

·         Dust mites

·         Smoking

·         Pollution

·         Stress

The symptoms of asthma can be mild or severe and vary from person to person. Symptoms of asthma can include the following.

·         Wheezing

·         Tightness of the chest

·         Breathlessness

·         Coughing (especially at night).

You GP or nurse will probably use a peak flow meter to monitor how fast you breathe out. This will help them diagnose asthma.

How is asthma treated?

Asthma has no cure, however there are many treatments available to manage the condition. Treatments vary depending on multiple factors including frequency and severity of the condition. Most patients who require treatment will be prescribed inhalers and in some cases tablets.

Why does asthma get worse at night?

Many asthma sufferers will find their symptoms are worse at night. In some cases asthma only presents itself at night. This is especially true in children who often present with a night time cough.

There is no conclusive evidence to explain why asthma is worse at night, however there are some theories which could explain it.

·         Narrowing airways when sleeping

When sleeping your airways tend to narrow naturally. A process known as circadian rhythm regulates your sleep and awake cycle. It involves a changing hormonal levels and this natural body clock effects your breathing patterns.

·         Asthma Triggers that occur at night.

Night time and sleep can present asthma triggers that you would not normally be exposed to. This includes allergens such as dust mites which may be present on your linen or your pillow cases.

·         Gravity.

The effect of gravity on your body and lungs is considered to exacerbate symptoms of asthma at night. When lying on your back your chest and lungs naturally feel the force of gravity which is though to result in narrowing of the airways. This makes it harder to breathe than usual and can result in worsening of asthma at night.

What can you do about asthma that is worsening at night?

Use your Inhalers correctly.

It is important to follow the treatment regime your doctor or nurse has recommended. This can be either using a reliever inhaler (often called blue inhaler) such as Salbutamol, Ventolin,  Airomir, or Bricanyl. These inhalers are designed to give instant and immediate relief of asthma symptoms.

Some patients will also be prescribed a preventer inhaler which doesn’t provide immediate relief, but reduces asthma if used on regular basis. These types of preventer inhalers include Clenil, Flixotide, Qvar, Pulmicort, Kelhale, and Soprobec.

Some patients are prescribed a combination product which includes a preventer and a long acting reliever. This includes inhalers such as Seretide, Flutiform, Fostair, Relvar Ellipta, and Symbicort Turbohaler.

Sleeping position.

Lying flat can exacerbate the symptoms of asthma. You should try sleeping with pillows propped up to prevent gravity pressing down on you chest and lungs, and to help with post nasal drip as you sleep.


Regular cleaning of your bedroom and washing your linen can prevent build up of triggers such as dust mites, pet hair and mould.

Room Temperature

Hot or cold air can affect your airways and breathing patterns. Symptoms of asthma can worsen if you are breathing in air which is too hot or too cold. Using a fan or opening a window can help regulate the temperature to help night time asthma. Be careful not to direct the fan directly at yourself, as this can also worsen your asthma or breathing patterns.

Want to know more? Don’t forget to check out our YouTube video about night time asthma.


Author: Boo Dhaliwal. The author is one of the clinical pharmacists working for Pharmacy Planet.