If your child’s sleep is disturbed by symptoms such as coughing or wheezing at night, it can be tiring and upsetting for them, and you. Find out how you can lower the risk of night-time symptoms so everyone can get some rest.
Why are asthma symptoms often worse at night?
What do asthma symptoms at night mean?
How to lower the risk of night-time symptoms
Your night-time toolkit
Getting your child’s sleep pattern back on track
How you can cope with lack of sleep
Asthma symptoms are often worse at night because:
- lying down can trigger a cough, especially if your child also has a blocked nose or sinuses, or post-nasal drip (mucus that drips from the back of your nose down your throat) due to hay fever, allergic rhinitis or a cold.
- the way your child’s body controls inflammation (including in their airways) tends to switch off while they’re asleep.
- your child may be exposed to allergens at night such as dust mites in bedding or pets sleeping in their bedroom.
- If your child is still a baby or toddler and hasn’t yet been diagnosed with asthma one of the things the GP will be looking for is waking at night with a cough and/or wheeze. These are typical symptoms that could suggest they have asthma.
- If your child has already been diagnosed with asthma then coughing and/or wheezing at night is a sign their asthma is not well managed. Ask yourself: has their medicine routine slipped a bit? When was their last asthma review? Are you confident you know how to help your child use their inhalers in the best way?
- Coughing and wheezing can be symptoms of other things too. For example, if your child has a cold it is very common for them to cough more during the night.
Video: What to do if asthma affects your child's sleep at nightShakeela explains how she helps her son to cope with asthma symptoms at night.
Transcript for ‘Helping a child deal with asthma symptoms at night’
0:04 When it's cold at night, Salis' asthma tends to get quite bad.
0:09 He coughs and coughs quite a lot so that gets me up, it gets him up.
0:14 I tend to give him his blue reliever inhaler to help with his symptoms,
0:19 but at the same time, I have to prop him up with a few pillows and
0:22 that actually helps him breathe a lot better.
0:25 As soon as he lays down flat he starts breathing, has difficulty in
0:31 breathing and just coughs and coughs again.
0:33 I have to make sure that the bedroom temperature is quite constant
0:37 when Salis is coughing throughout the night,
0:39 because if it's too hot, he can't breathe and if it's too cold,
0:43 he's struggling, so I've just got to make sure it’s at that right
0:46 temperature where he is actually comfortable.
Fewer night-time symptoms will mean a better night’s sleep for your child and could mean better mood, behaviour and concentration during the day.
MANAGE THEIR ASTHMA WELL
If your child takes their prescribed medicine, even if they're well, they’re less likely to cough and wheeze, and/or find it hard to breathe at night. It’s important to quickly recognise when your child’s asthma is getting worse. Using an up-to- date written asthma action plan can help you do this.
KNOW THEIR TRIGGERS
Do what you can about any possible triggers such as pets or pollen. Don’t allow pets in the bedroom as that could be making things worse at night. If your child has hay fever watch out for bedding that’s been drying outside on high pollen count days. Make sure your baby or child is not exposed to cigarette smoke at all – this will make their asthma worse, and make them cough more at night.
KEEP THEIR BEDROOM AT THE RIGHT TEMPERATURE
Breathing colder air at night or sleeping in an air-conditioned room, such as a hotel room, can trigger asthma symptoms. Where possible, switch air conditioning off and keep the temperature in their bedroom steady so that it’s not too cold or too warm.
TRY PROPPING THEM UP
Some parents find their child coughs less and sleeps better if they sleep propped up with pillows, which helps to keep their airways open.
“l try to get him to sleep more upright, either in a chair or his pram, or with plenty of pillows in bed as this seems to help.” - Karen Blakey, mum to Riley, aged 2
“In my experience, it’s harder to deal with asthma symptoms during the night – I think because you’re tired you’re less able to think clearly. Somehow you feel far more vulnerable. I’d say to anyone who has a child with asthma, don’t hesitate to call 999 – especially if it’s the middle of the night. They’d rather see you than for you to wait until it’s too late.” - Anna Bonnett, mum to Gabriel, 10, and Beau, 5
1. Written asthma action plan
It can be hard to think straight when you’re tired. And if your child’s symptoms get worse it’s not always easy to know what to do. Your child’s written asthma action plan can help you decide what medicine to give them, and what to do if they have an asthma attack. Keep a copy of their latest written asthma action plan on your phone or by your bed so you don’t struggle to find it in the middle of the night.
2. Your child’s reliever medicines
If your child needs their reliever in the middle of the night save time by keeping it in a safe place in your bedroom, so you know where it is and can find it quickly, even when you’re tired, or its dark. If it’s a spare inhaler, check it from time to time to make sure it’s not empty and that it's still in date.
3. Your child’s hospital bag
Having a bag packed and ready for an emergency avoids the stress of chasing around in the middle of the night gathering things together.
“It really helps to have James’ bag of tricks packed and ready. It’s got all his medicines in it: his EpiPen, his latest hospital letters and appointments. It goes everywhere with us.” - Kelly, mum to James, 5
4. Handy reminders
Writing a list of reminders during the day can be a great help. If it's the middle of the night and you’re half asleep and not thinking straight, at least you can trust a list you wrote during the day when you were wide awake.
For example, you could make a note of:
- any signs or symptoms your child usually has just before and during an asthma attack
- how much reliever inhaler your child usually needs to settle their symptoms
- what other things have helped before, such as propping them up with pillows
- important telephone numbers such as your out of hours GP, or friends or neighbours you can call on to look after any other children
- things you need to take with you to A&E, for example your child’s written asthma action plan, all their medicines, including their own spacer
- when to call 999 – this will be on your child’s written asthma action plan, but you might want to discuss it with your partner and both come to an agreement about the signs and symptoms that will make calling 999 the best option.
If your child’s asthma is affecting their sleep, it’s likely they will feel tired and lacking in energy, and unable to play or concentrate at school. These tips can help get your child’s sleep pattern back on track if it’s been disrupted due to asthma symptoms. And hopefully they’ll also help the rest of the family get some much-needed sleep too.
A bedtime routine
Having a set time to go to bed each night and get up every morning may help your child establish a good sleep pattern. This may also help them get into a good routine with the rest of their day, including taking their asthma medicines. Babies and young children respond well to good routines such as having a bath, reading a book and then going to bed.
Keeping screens out of the bedroom
Turning off the TV and their iPad will help your child’s mind switch off and get them in the mood for sleep. Studies show that it’s harder for children to get to sleep and sleep well if they’ve been looking at phones, computers or other screens in bed.
Don’t send them to bed hungry
Some foods can help your child sleep better, for example, milk, bananas and cereals or pasta. So, think about what your child is having for dinner, and what time they’re eating. Could they have a snack before bed so that hunger doesn’t keep them awake, or wake them up in the night?
Keep the bedroom dark
Light can interfere with how well your child sleeps. If they’re afraid of the dark, leave a light on outside their room, or open the curtains a bit.
Poor sleep will not only affect your child’s day-to-day life, it can have a knock-on effect on you, too. You may feel unable to drop off to sleep when you know your child is uncomfortable during the night, and be anxious about your child's symptoms getting worse. It’s common for parents to feel exhausted, confused and frightened when their child isn’t sleeping due to asthma symptoms.
Try these tips:
- Have your child’s written asthma action plan and your emergency list nearby to remind yourself how to act quickly and confidently if your child’s asthma symptoms are getting worse.
- Jot down concerns about your child’s asthma symptoms and how you will deal with them – for example, making an appointment with your GP or asthma nurse. This will help clear your mind and help you feel more able to sleep.
- Don’t lie there worrying – get up and do something monotonous, such as the ironing, to help your mind switch off and relax you into sleep mode again.
- Catch up on your rest whenever possible. “In the past, when George was poorly, I would check on him throughout the night. It was a difficult time but I used to try to get George to have some rest throughout the day and I would rest too.” - Jayne Bettles, mum to George, 14.
- Limit caffeine – it can be tempting to rely on countless cups of coffee and tea or energy drinks to get you through the day but caffeine can keep you awake, particularly when you drink it in the afternoon. Try a soothing herbal tea instead. “Camomile tea calms me down if I haven’t had enough sleep and I’m feeling agitated.” - Shakeela Riaz, mum to Sami, 6, and Salis, 12.
- Share your concerns with other parents on our asthma forum or read parents' stories to find out how others coped.
- Speak to one of our asthma nurse specialists on our Helpline on 0300 222 5800 (9am - 5pm; Mon - Fri) for specific advice on coping with your child’s asthma symptoms at night.
Last updated August 2017