Nocturnal exacerbations may be a major problem for some patients with asthma. A number of factors may contribute to these distressing events.


Asthma-related factors:

(1) exposure to allergens in the bedroom

(2) drying out of mucus in the airways

(3) diurnal variation in lung function with minimal levels in early morning

(4) inadequate asthma control

(5) minimal levels of short-acting asthma medications in the blood


Other factors that may contribute:

(1) gastroesophageal reflux (GERD)

(2) obstructive sleep apnea


Interventions to reduce nocturnal exacerbations:

(1) Identify and treat obstructive sleep apnea.

(2) Identify and treat GERD.

(3) Optimize asthma management.

(4) Provide long-acting medications for asthma control if needed.

(5) Reduce allergens in the bedroom.

(6) Keep well-hydrated. Humidification in the bedroom may help, but excess humidity may promote mold or other allergens.


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