Why asthma is worse in the evening and what to do about it

Many asthmatics have worse symptoms in the evening and night than in the day. Find out here why the respiratory disease is often worse in the evening and night and how to get through the night.

3 reasons why asthma is worse in the evening than during the day

There are several potential reasons why asthma symptoms may be more severe in the evening and night. Please note that many of these factors may vary from person to person and you should speak to your doctor if your asthma symptoms are regularly worse at night.

1. Circadian rhythm (day and night rhythm)

The main reason asthma symptoms become worse in the evening and night is the circadian rhythm (= day-night rhythm) of the human body. Our bodies follow this rhythm. “Cortisol and histamine release is especially affected by circadian fluctuations. In the evening, the body naturally produces less cortisol and histamine. This means inflammation is more likely to develop in the evening and at night, which in turn causes the lining of the bronchial tubes to swell”, explains Prof Dr Fischer, a lung specialist, in an interview about why asthma symptoms are worse in the evening. This means that asthma symptoms are more pronounced in the evening.

2. Physical reactions when we lie down

When we lie down, secretions from the nose and sinuses flow towards the airways, which can trigger a cough as a protective reflex. The horizontal position can also limit the lungs from expanding, which makes it harder to breathe.

3. Allergens in the bedroom

Being close to allergens such as household dust and pollen can also make asthma symptoms worse. If there are allergens on the pillow or duvet, they are automatically very close to us when we are in bed.

4 tips on how to get asthma under control in the evening

Things you can do to make sure your asthma symptoms do not get worse in the evening:

1. The right medication schedule

It is very important to take your prescribed medicine properly. If your asthma is worse in the evening despite taking your medication properly and consistently, the therapy may need to be adjusted. Ask your doctor for advice.

2. Nasal douche before bed

Take a nasal douche before going to bed to clear any secretions out of your nose. This means that no secretions or very little will trickle into your throat from your nose when you lie down, and you will not have to cough as much. This is especially important if you have a cold or hay fever. If you have hay fever, a nasal rinse also flushes pollen (allergens) out of your nose.

3. Clean bedroom

If a dust or pollen allergy triggers your asthma, it is very important that your bedroom and bedding are clean. Change your bedding once a week and clean your bedroom regularly.

Eliminate any pollen in the bedroom

If you have a pollen allergy it is very important that no pollen, or as little as possible, makes its way into the bedroom. This is why nobody should enter the bedroom in their day clothes because pollen may attach to them. You and your partner should get changed before going to bed. Wash your hair before you go to bed to remove any pollen from your hair.

Open the windows when the pollen count is at its lowest

To prevent pollen getting into the bedroom when you open the window, keep the windows closed during the day. Only open them when the pollen count is at its lowest.

4. Keep an asthma diary to identify triggers

Keep an asthma diary to identify any asthma triggers you may not be aware of. Note your observations and discuss them with your doctor.

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Note: The information in this blog post is not a treatment recommendation. The needs of patients vary greatly from person to person. The treatment approaches presented should be viewed only as examples. PARI recommends that patients always consult with their physician or physiotherapist first.

An article written by the PARI BLOG editorial team.

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