Find out why asthma symptoms might happen at night, what you should do about them, and when to see your GP or asthma nurse.
On this page:
- Why is my asthma keeping me awake?
- What should I do when my asthma wakes me up?
- How to prevent asthma symptoms at night
- When to see your GP or asthma nurse
- Tips from other people with asthma
It’s common for asthma symptoms to come on at night, but you shouldn’t have to put up with them. Night-time asthma symptoms are a sign that your asthma isn’t well controlled, and you may be at risk of an asthma attack.
If your symptoms come on early in the morning, it could be a sign your asthma has been difficult through the night, even if you weren’t aware of it.
Here are some reasons why your symptoms may come on at night:
- How you sleep - lying on your back puts extra pressure on your chest and lungs. This makes it harder to breathe. It can also trigger a cough because mucus in your nose can drip to the back of your throat. If you get acid reflux lying flat might make it worse, and the acid can irritate your airways. Propping yourself up with pillows can help to keep your airways open.
- Side effects - some asthma medicines give you night-time side effects. Medicines like montelukast can cause sleep issues (in up to 1 in 100 people). Steroid tablets may also cause difficulty sleeping, so you may be advised to take them after food in the morning.
- Triggers - you may find asthma triggers in the bedroom. For example, dust mites in your mattress, pillows and blankets, and pet hair and mould. If you are affected by hay fever, you may find pollen affects you at night because pollen levels are highest in the early morning and early evening.
- Hot or cold air – breathing in hot air can cause the airways to narrow, so if your room is hot at night, try using a fan to keep cool. Cold air might also be triggering your symptoms. Try keeping windows closed and keep heating on low in the bedroom if you need to.
There is also evidence to suggest that a lack of sleep can make your asthma symptoms worse. If you’re struggling with sleep and it’s affecting your asthma, speak to your GP or asthma nurse.
Sit up and take your reliever inhaler (usually blue) as prescribed. It’s a good idea to keep your inhaler and spacer (if you use one) beside your bed before you go to sleep, so you don’t have to search for them in the middle of the night.
“Give yourself a bit of time to check your reliever medicine has dealt with your symptoms before you go back to sleep,” says Dr Andy Whittamore, Asthma UK's in-house GP. “This is better than falling asleep straight away only to wake up soon after with asthma symptoms because your reliever didn’t help enough.”
Video: Asthma and your sleepDr. Andy Whittamore explains why you should book an appointment with your GP if your asthma is keeping you awake at night.
Transcript for Asthma and your sleep
0:04 We hear from a lot of people on our
0:07 helpline and on social media that asthma does
0:10 interrupt their sleep on a
0:11 regular basis. As a health care
0:13 professional I know that unfortunately,
0:14 this means that your asthma is not quite
0:16 as well controlled as it can be. And it's
0:18 worth making appointment with your GP or
0:20 your practice nurse to see what we can
0:21 do to help relieve those symptoms and
0:24 actually improve your quality of sleep.
Using your preventer inhaler every day, as prescribed, will build up protection in your airways and keep your asthma symptoms under control, so they’re less likely to wake you at night.
It’s very important to:
- use your written asthma action plan to help you understand how to manage your symptoms and what to do if they get worse.
- go for regular asthma reviews with your GP or asthma nurse. They can check you’re using your inhalers correctly. It’s also a chance to talk about any triggers that might be affecting your sleep.
Does your child wake up at night from asthma symptoms? Read our advice on asthma and your child’s sleep.
Visit your GP or asthma nurse
Book a next-day appointment with your GP or asthma nurse if you are experiencing asthma symptoms at night or when you first wake up.
If your asthma is keeping you awake at night, you’re not alone. Here are some of the things that people with asthma tell us help them get a good night’s sleep:
- Try a nasal spray or decongestants to unblock a stuffy nose (but test this out during the day first - some people find decongestant products containing eucalyptus trigger their asthma symptoms).
- Keep as active as you can in the day to increase your lung strength and boost your immune system. Ask your GP or asthma nurse if you need support with exercise.
- Try using anti-allergy bedding covers and keep pets away from the bedroom.
- Try using an air purifier to help with allergy symptoms that trigger your asthma.
- Avoid any food or drink asthma triggers close to bedtime, such as caffeine and alcohol.
- Relax and de-stress before bed using breathing exercises and yoga.
Obstructive sleep apnoea is a breathing problem that happens when you sleep. If you’re looking for advice on OSA, our sister charity the British Lung Foundation has more information.
You can get advice and support about asthma and sleep by calling a respiratory nurse specialist on our Helpline, 0300 222 5800 (9am-5pm; Monday-Friday). Or you can WhatsApp them on 07378 606 728.
Last updated: August 2021
Next review due: August 2024