Tools To Control Your Asthma & Allergies
93% of asthma patients have disturbed sleep. Most physicians agree neither asthma patients nor their caregivers have to suffer from disturbed sleep. The major reason an asthma patient might have a poor night’s sleep is uncontrolled or poorly controlled asthma. Many asthma flare-ups or symptoms occur at night, robbing patients of the rest they need in order to withstand and recuperate from these same flare-ups. Asthma symptoms like wheezing & coughing disturb sleep and are usually at their worst at 4 am and are referred to as the “morning dip”. Steps can be taken to change and improve this situation to get a better night’s sleep for patients.
- Optimize drug therapy with regular use of anti-inflammatory control medications, typically using an inhaled corticosteroid and a long acting beta-agonist
- Time the medication is used (Chronotheraphy) is critical: Take the evening bronchodilator just before sleep, which minimizes the “morning dip”
- Provide a comfortable and healthy bed: Buy the best & most comfortable mattress you can afford; eliminate dust mites by using bedding encasements; keep bedding free of other organic matter like feathers & animal dander
- The bedroom should be a quiet, clean, appropriately dark and environmentally comfortable sanctuary
- Use a Peak Flow Meter to ensure better asthma control. Peak Flow Meters accurately assess the degree of airway narrowing even before symptoms begin to show or an episode starts. Using a PFM allows adjustments in asthma medications before symptoms begin, meaning better disease control, and better disease control means better sleep.
- Control other ailments that affect sleep quality such as nasal drainage, acid reflux, sleep apnea, chronic pain and stress
- If the patient is an adult, Stop smoking, limit caffeine and alcohol intake late at night
- Exercise is a good way to improve sleep quality but timing is important. Don’t exercise before bedtime, and if you have EIA (Exercise Induced Asthma) ask a physician about using a bronchodilator prior to exercise
- Drink less fluids after 6 pm and do relaxing things before bedtime like bathing, grooming, reading. Don’t watch action movies, TV news, start a stressful project or play computer games before bed
- Go to sleep and arise at the same hours every day, setting a pattern that works for you, and above all, keep animals out of the bedroom
Many asthma patients suffer from Acid Reflex or GERD (gastrointestinal reflux disorder) and this is related to nocturnal asthma episodes. GERD occurs when the valve separating the esophagus from the stomach malfunctions and allows stomach content (acid and digestive enzymes) to leave the stomach and enter the esophagus. (Think of a door that won’t shut properly). When this happens, the lining of the esophagus gets damaged causing heartburn, chest pains and belching. Symptoms are often worse at night because we sleep in a reclining position and the valve opens more easily. The same vagus nerve that controls this valve action supplies sensory fibers to the airway passages, so GERD could cause asthma symptoms – coughing, wheezing, hoarseness or even stomach acids spilling into the lungs. Many asthma medications relax this same vagus nerve, but then this aggravates GERD (opens the valve) and thus provokes more asthma symptoms.
Milk at bedtime encourages relaxation or settles a nervous stomach, which may be fine for some people, but because of the relationship of allergies and asthma, may have a detrimental effect on some asthma patients.
In 80% of asthmatics, emotions or stress can cause an asthma attack; racing thoughts & stress don’t allow a person to fall asleep or get back to sleep once awake, again creating a vicious cycle of symptoms for asthmatics. Many people treat insomnia or sleeplessness with either OTC (over-the-counter) or prescriptive medications without first finding the reasons for the insomnia and treating those. Accurate diagnosis leads to appropriate treatment and restful sleep. If insomnia lasts more than a week, see a doctor instead of self-medicating.
Nighttime asthma symptoms keep parents & caregivers awake, too. To sleep better, caregivers should:
- Educate themselves about the disease. Be in control through knowledge
- Learn when to ask for professional help for their children’s symptoms
- Maintain the best asthma control plan for the patient: regular use of PFM, using control meds, environmental controls, avoiding triggers, plus regular doctor visits
- Recognize the stresses of being the caregiver for an asthma patient.: every week, set time to do something fun for yourself, whatever relaxes you
- Make the adult bedroom a private sanctuary – buy a good bed, maintain proper darkness, and keep pets out of the bedroom
- Avoid caffeine and alcohol in the evenings & stop smoking
- Take their own regular medications
- Have someone to talk with regularly to share thoughts & fears
- Avoid TV news or violent movies before bedtime and exercise either in the morning or daytime rather than right before bedtime
- See their doctor for professional help if insomnia lasts more than a week.