Children who suffer from asthma sometimes find symptoms are particularly bad at night.
Wheezing and coughing at night are common among children and teens with asthma. But nighttime symptoms can indicate severe asthma and increase risk of complications if they’re not brought under control.
The problem can rob children of sleep and cause daytime fatigue, affecting academic performance and leading to more school absenteeism.
It’s not entirely known why nighttime symptoms – also known as nocturnal asthma – occur. But doctors believe hormonal changes associated with circadian rhythms play a role, Dr. Karas said.
“Lung function itself follows a circadian rhythm,” said Dr. Karas. “Lung function is best around 4 p.m. and worst at about 4 a.m. The difference is not significant for most people, but the changes can be extreme for those with asthma.”
Factors that can also exacerbate asthma symptoms at night include reclining, exposure to allergens such as pet dander, and acid reflux.
The key to curbing symptoms is diagnosis and treatment, said Dr. Karas. Make sure your child’s asthma is well under control, and that will take care of nighttime symptoms, he said. Inhaled steroids are usually sufficient to treat mild to moderate asthma.
“Almost all kids with asthma can be adequately managed to the point where it doesn’t interfere with daily life,” he said. “But the medication only works if you take it. Often we see a child does better with medication, and then parents stop giving the medication and symptoms return.
“Compliance with medication is a big challenge. We just need to keep educating families on the need to give controller medication every day, even if their children are no longer having symptoms.”