Doctor John Floyer wrote a treatise on Asthma in 1698 that was the first-ever major research done on fatal diseases. In his research, he clearly mentioned that people having anxiety issues or who remain sad or angry have a larger chance of getting asthma attacks. The reason behind this statement he gave was actually to intimidate people living with asthma that being sad or angry put a stopper on your humor motions. He recommended gentle vomiting for people having anger issues while they have asthma. But why does my asthma get worse at night?
He also raised the awareness of this most asked query way back in his work. In an asthma attack, the airways in a person’s lungs start getting close, which makes it eventually hard for him to breathe. When this happens, the person experiences tightness in the chest, which causes coughing and wheezing while breathing. Floyer enlightened another symptom. As he was also an asthma patient, his asthma became worse at night, which kept him up till the morning.
Centuries passed, and now scientists are backing up his theories. In 2005 a study revealed that 75% of asthma patients experience the worst attacks at night time. A survey in the 1970s showed that nighttime and early cold morning attacks could be fatal if not treated timely.

According to the director of the Oregon Institute of Occupational Health Sciences at Oregon Science and Health University, no one is sure medically about what causes asthma to get worse at night;
“Most people sleep at night, so maybe it’s the sleep that causes your asthma to get worse at night,” he says. Or it may be caused by body position or mites or allergens in the bedding. Or, Shea adds, “maybe it’s the internal body clock.”
Here are some factors that contribute to triggering asthma, especially at night;
Internal Body clock – Circadian rhythm of a human system causes the hormonal levels to come down at night. The hormonal imbalance becomes the reason for narrowing down your airways which exacerbates the asthmatic symptoms.
Dust mites – The bedsheet, pillow, and blanket can be heaven to live for many microscopic insects and pet wastes. If someone is allergic to dust, these dust mites can trigger and worsen asthma conditions at night.
Gravity – When an asthmatic person lies down, naturally, the chest and the lungs feel pressure. A person with weak lungs has to put extra pressure to breathe normally, which triggers asthma.
Trouble sleeping due to asthma should be discussed with doctors. According to Cr. Bose,
“It’s important to share your nighttime symptoms with your doctor because it’s one of the ways he or she can determine how well your asthma is controlled,” she says. “People with asthma tend to underreport their nighttime symptoms, which can be a sign that you need more of your medication or a change in treatment.” Your doctor may need to make adjustments to your asthma treatment plan so you feel better, day and night, Bose says.
Sleeping better with asthma

To treat your asthma, along with the proper and timely medications, try following these seven tips to sleep better with asthma and reduce the chances of nighttime asthma attacks.
- Keep your bedroom clean – To keep your bedroom clean, use a HEPA – High-efficiency particulate air filter vacuum to clean the bed and blankets to remain safe from mites and dirt. You can buy it from any allergy equipment supplying company in case HEPA filtered vacuum.
- Wash your bedding weekly in hot water – Make sure the water remains at least 130 Fahrenheit, so it helps in killing mites and removing dust particles.
- Get a dust-proof pillow and mattress protectors – The dust-protecting mattress and pillow covers are handwoven to protect the bedding from mites and dirt the patients especially. They are available at homeware and bedding stores.
- Get a humidifier – When you live in old areas, the lack of humidity can trigger asthma as the colder air is usually dry. Depending on where you reside, it is best to invest in a humidifier that helps you add moisture to your bedroom in colder weather. Dust and mites survive in low humid atmospheres. Adding artificial humidity can keep them away from bugging you while you work.
- Keep your pets away while sleeping – “If you have pets, keep them out of the bedroom so their dander doesn’t collect or stick to the carpeting and bedding,” Bose says. Also, you need to keep your pets out of your bedroom, especially if they like to cuddle. Keep the danger away as much as possible.
- Keep your head up – It is likely dangerous for people with acid reflux or asthma problems to keep a flat pillow when they go to bed. When you have a sinus infection or cold that disturbs you, then you should keep your head slightly elevated.
- Make a diagnosis of sleep apnea – American Thoracic Society says people with asthma are at a higher risk of sleep apnea compared to any other individual. In sleep apnea, a person experiences intervals of breathing while they sleep. When people with asthma can’t breathe having sleep apnea symptoms, the results can be severe. To prevent a sleep apnea attack, talk to your doctor and start a diagnosis.
Categories of Asthmatic conditions

Asthmatic conditions vary from person to person. Based on the severity of the disease, asthma can be categorized into four classifications. However, all of them can trigger the condition severely at nighttime, this is why you need to know about them beforehand.
Mild intermittent asthmatic symptoms- According to Mayo Clinic, mild intermittent asthma symptoms remain minor for up to two to three nights for a month.
Mild persistent asthma takes a person to a high level from a mild intermittent asthmatic condition that affects a person twice or thrice a week, especially at nighttime. Mild persistent asthma attacks at night time usually, no matter whether the symptoms are intermittent or persistent, hardly occur during daytime.
Moderate Asthma – The symptoms of moderate asthma appear once a day but can be seen more than once in the nighttime.
Severe persistent asthma – in this condition, a person can show symptoms of acute asthma throughout the day and frequently in one single night.
End Notes
No matter at what level or in which category you find yourself, it is sure that you might have felt stronger asthma attacks at nighttime or the time when the sun starts to set till dawn. The symptoms seem to get worse at night. Although, there might be some reasons behind these conditions.
These conditions include the ones we mentioned above, like dust and mites, allergens, pet waste, lack of humidity due to cold weather, etc.
Dr. Thomas presents another theory that is linked with nighttime asthma triggers. He says people with asthma produce a higher number of white blood cells linked to asthma. This is the hormonal change that a person suffers while they sleep and feel chronic symptoms of Asthma. He added that this function seems to be linked with the decline of lung function.
Lastly, if you have asthma and irregular breathing conditions that affect your sleep, like sleep apnea, both can interplay in elevating the state of nighttime wakeups. In general, sleep apnea contributes to worsening asthmatic symptoms by creating inflammation in the airways.
The same happens with people with GERD (Gastroesophageal reflux disease), which worsens asthma. GERD is a condition where the stomach reverses the acid into our throat. Like sleep apnea, if you have GERD, it can affect your sleep and trigger asthma, especially at nighttime.