If you’re one of the millions of people with asthma, you know how frightening it can be to experience an asthma attack. What’s even more difficult is waking up with an attack at midnight, where seeking help can be more challenging.

An asthma attack can be life-threatening. It can also leave you feeling exhausted and unable to function the next day.

Whether you have long-time asthma or have recently been diagnosed, understanding what causes these attacks and how to manage them is critical to living a healthy, comfortable life.

This article explores the triggering factors of asthma attacks at night and what you can do to prevent its dangerous complications.

What is Nocturnal Asthma in Medical Terms?

Nocturnal asthma is a type of asthma where symptoms worsen at night. Medically, it’s also known as nocturnal or nighttime asthma. It’s a common form of asthma, affecting up to 75% of people with asthma.

The exact cause of nocturnal asthma is not well understood. Still, several factors are believed to contribute to the condition, such as changes in hormone levels, increased airway inflammation, and decreased lung function while sleeping.

People with nocturnal asthma may experience coughing, wheezing, chest tightness, and shortness of breath at night. Proper management of the condition is crucial to minimize symptoms and prevent exacerbations.

What’s it Like Living with Nocturnal Asthma?

Living with nocturnal asthma can be challenging and disruptive to daily life. People with this condition may experience a variety of symptoms that can make it hard to get a good night’s sleep. This can lead to daytime fatigue, difficulty concentrating, and reduced quality of life.

Individuals with nocturnal asthma may wake up coughing, wheezing, and struggling to breathe at night. This can be an overwhelming experience, and it may take hours to recuperate and go back to sleep fully. Unfortunately, the lack of sleep can worsen asthma symptoms and lead to a vicious cycle of exacerbations.

In addition to the physical symptoms, people with nocturnal asthma may also experience emotional and psychological stress. The fear of having an asthma attack at night can cause anxiety and depression, worsening asthma symptoms. 

It’s essential to seek support from friends, family, and healthcare professionals to manage the condition and improve overall well-being.

Causes of Asthma Attacks at Night

Young man using nebulizer for asthma and respiratory diseases at home

Asthma attacks at night, known as nocturnal asthma, can be caused by various factors. Understanding these triggers is essential to prevent asthma attacks and minimize their impact on your quality of life. 

In this section, we’ll explore some of the most common causes of asthma attacks at night.

Sleeping position

The position in which you sleep can trigger your asthma symptoms at night. Lying flat on your back can make it more challenging for your lungs to expand and breathe, leading to increased symptoms.

On the other hand, sleeping on your side can help reduce symptoms by opening up your airways. Elevating your head with a pillow may also be beneficial in reducing asthma symptoms at night.

Breathing in cold air

Breathing in cold air can trigger asthma symptoms at any time, but it’s especially common at night. Cold air can constrict the airway, making it harder to breathe and leading to asthma symptoms.

Wearing a scarf or face mask while sleeping can help warm the air you breathe and reduce the likelihood of symptoms.

Exposure to allergens at night

Allergens such as dust mites, pet dander, and mold can trigger asthma symptoms at night. These allergens can be found in your bedroom bedding, carpets, and other soft surfaces.

Regularly washing bedding in hot water, vacuuming carpets and curtains, and using allergen-proof covers on pillows and mattresses can help reduce exposure to allergens.

Exposure to allergens during the evening

Exposure to allergens during the evening can also trigger asthma symptoms at night. 

For example, spending time outdoors during pollen season or cooking with strong-smelling ingredients can increase exposure to allergens. It’s essential to be mindful of potential allergen exposure and minimize exposure during the evening.

Poorly controlled daytime asthma

Poorly controlled daytime asthma can also lead to asthma attacks at night. When asthma symptoms are not well managed during the day, they can worsen at night, making it difficult to sleep.

Working with a healthcare professional to develop a treatment plan that effectively manages asthma symptoms during the day and night is essential

Lung function changes

Lung function naturally changes throughout the day and night, and this can impact asthma symptoms. At night, lung function typically decreases, making breathing harder and leading to asthma symptoms.

Monitoring lung function with a peak flow meter and adjusting medication as needed can help manage symptoms and prevent exacerbations.

Hormonal changes

Hormonal changes, such as during menstruation or pregnancy, can also trigger asthma symptoms at night. These changes can cause inflammation in the airways, leading to increased symptoms.

It’s essential to be aware of hormonal changes and work with a healthcare professional to adjust treatment to manage symptoms.

What Are the Symptoms of Nocturnal Asthma?

It’s important to note that there are a variety of symptoms that can occur during an asthma attack at night.

The symptoms may vary in severity and frequency among individuals with nocturnal asthma.

  • Coughing
  • Wheezing
  • Shortness of breath
  • Chest tightness
  • Rapid breathing
  • Difficulty sleeping
  • Night sweats
  • Fatigue
  • Anxiety or depression
  • Reduced ability to exercise or perform daily activities

If you experience any of these symptoms, you must call the nearest emergency room to develop a treatment plan that effectively controls your symptoms and improves your overall quality of life.

Nocturnal Asthma Risk Factors

Nocturnal asthma can affect anyone, but certain risk factors can increase your likelihood of experiencing asthma symptoms at night

Excess weight around the chest and abdomen

Excess weight around the chest and abdomen can make breathing more difficult, increasing the risk of asthma symptoms at night. In addition, extra weight can put pressure on the chest and diaphragm, making it harder to expand the lungs. Weight loss through diet and physical activity can help reduce the risk of nocturnal asthma.


man smoking a cigarette. Cigarette smoke spread.

Smoking and exposure to secondhand smoke can irritate the airways and increase the risk of asthma symptoms at night. Smoking can also reduce lung function and worsen asthma symptoms. Quitting smoking and avoiding exposure to secondhand smoke is essential in managing nocturnal asthma.

Allergic rhinitis

Allergic rhinitis, or hay fever, can increase the risk of nocturnal asthma. This is because allergic rhinitis causes inflammation in the nasal passages, which can trigger asthma symptoms at night. 


Sinusitis, or inflammation of the sinuses, can increase the risk of asthma symptoms at night. This is because sinusitis can cause postnasal drip, irritating the airways and triggering asthma symptoms.

Obstructive sleep apnoea (OSA)

Obstructive sleep apnoea (OSA) is a condition in which the airway becomes blocked during sleep, leading to pauses in breathing. OSA can increase the risk of asthma symptoms at night by causing inflammation in the airways.

Acid reflux

Acid reflux, or gastroesophageal reflux disease (GERD), can increase the risk of nocturnal asthma. This is because acid reflux can irritate the airways, triggering asthma symptoms.


Stress can increase the risk of nocturnal asthma by triggering an inflammatory response in the airways. Stress can also lead to poor sleep quality, worsening asthma symptoms at night. 

Managing stress through relaxation methods such as deep breathing, meditation, or yoga can help reduce the risk of nocturnal asthma.

How is Nocturnal Asthma Diagnosed?

Diagnosing nocturnal asthma typically involves a combination of medical background, physical examination, and diagnostic tests such as spirometry, peak flow measurements, and overnight oximetry.

Your healthcare professional may also recommend a referral to an asthma specialist or an allergist to perform additional testing, such as allergy or bronchial challenge tests.

How is Nocturnal Asthma Treated?

Panoramic shot of asthmatic man using inhaler with spacer. Fat man using asthma inhaler while sitting at home due to allergy. Asia man using spray asthma

The treatment for nocturnal asthma is similar to daytime asthma and involves a combination of medications, lifestyle modifications, and avoidance of triggers

Medications to treat nocturnal asthma may include inhaled bronchodilators, corticosteroids, or leukotriene modifiers.

Lifestyle modifications such as maintaining a healthy weight, avoiding smoking and secondhand smoke, and minimizing exposure to allergens can also help manage nocturnal asthma symptoms.

Working closely with your healthcare professional to develop an individualized treatment plan that meets your needs and effectively manages your nocturnal asthma is essential.

How to Prevent Nighttime Asthma

Nocturnal asthma attack can be prevented by lifestyle changes and taking specific precautions. 

Here are some tips to help avoid nocturnal asthma attacks:

Maintain a Clean and Allergen-free Bedroom Environment

Dust, pet dander, and other allergens can trigger nocturnal asthma attacks. Keep your bedroom clean, vacuum regularly, and avoid keeping any furry pets in your bedroom.

Regulate Nighttime Bedroom Temperature

Changes in temperature and humidity levels can cause airway irritation and trigger asthma symptoms. Keep your bedroom cool and well-ventilated by using a fan or air conditioner.

Address Underlying Conditions 

Untreated allergies, acid reflux, or sleep apnea can worsen asthma symptoms, including those at night. Treating these underlying conditions can help alleviate nocturnal asthma attacks.

Keep a Reliever Inhaler Accessible

Always keep your reliever inhaler within reach, ideally on your bedside table, if you experience any asthma symptoms at night.

Stay Hydrated by Keeping Water Within Reach

Drinking water or having a glass of water by your bed can help alleviate dryness and irritation in the airways, which can worsen nocturnal asthma symptoms.

Practice Breathing Exercises

Exercising diaphragmatic and pursed-lip breathing exercises can help reduce stress, improve lung function, and decrease the risk of nocturnal asthma attacks.

Schedule Regular Asthma Reviews with GP or Practice Nurse

Regular asthma reviews can help you monitor your symptoms, adjust your medications if necessary, and identify any potential triggers causing your nocturnal asthma attacks.

Adhere to an Asthma Treatment Plan

Working with your healthcare team to develop an individualized asthma treatment plan can help you manage your symptoms and reduce the risk of nocturnal asthma attacks.

Manage Weight for Better Asthma Control

Excess weight can worsen asthma symptoms and increase the risk of nocturnal asthma attacks. 

A healthy weight maintained with regular exercise and a balanced diet help alleviate asthma symptoms and improve overall health.

Quit Smoking 

Smoking and exposure to secondhand smoke can trigger asthma symptoms, including at night. 

Quitting smoking and avoiding secondhand smoke help control asthma and reduce the risk of nocturnal asthma attacks

What is the Best Position to Sleep with Asthma?

Finding the proper sleeping position can help people with asthma breathe more easily at night. 

People with asthma can alleviate their risk of asthma attacks while sleeping by choosing a position that opens up the airways and reduces pressure on the chest.

Lie on your back with your shoulders and neck slightly raised

Sleeping on your back with your shoulders and neck slightly elevated can help open the airways and reduce pressure on the chest. Use a pillow to prop up your upper body at a 30- to 45-degree angle to achieve this. This position can help prevent acid reflux, which can trigger asthma symptoms at night.

Place a pillow between your legs and lie on your left side.

Sleeping on your left side decreases pressure on the lungs and allows air to flow more easily. A pillow between your legs can help keep your spine neutral and reduce strain on the lower back. This position can also help prevent acid reflux.

Lie on your back with your head elevated and your knees bent with a pillow under your knees

This position helps open up the airways and reduce pressure on the chest. Raise your upper body with a pillow or wedge, and place a pillow under your knees to keep your spine neutral. Doing this position can help prevent acid reflux and reduce strain on the lower back.

What to Do During Asthma Attack Without Inhaler?

If you’re experiencing an asthma attack at night without an inhaler, you should try to remain calm and take slow, deep breaths.

A breathing technique like pursed-lip breathing can help control your breathing. Sitting or standing straight is also important to help open your airways.
If your symptoms continue, seek medical attention urgently by calling emergency services or going to the nearest hospital.

Know When to Go to an Emergency Room in Pearland, TX, During an Asthma Attack

Identifying the signs of an asthma attack and when to seek emergency care is essential to avoid possible complications. Don’t hesitate to call 911 or head to the nearest emergency room if your condition shows severe symptoms or they are not improving with your usual asthma medications. 

If you’re in Pearland, TX, and require emergency care for an asthma attack, we recommend visiting Aether Health – SilverLake ER. Their team of experienced medical professionals is dedicated to providing quality emergency care 24/7.

Don’t wait until it’s too late–seek medical attention immediately. Visit Aether Health – SilverLake ER for all your emergency medical needs in Pearland, TX.