Have you ever found yourself reaching for your inhaler more often at night? For many people living with asthma, nights can be unexpectedly rough, even when the day feels fine. With World Asthma Day 2025 highlighting improved care and awareness, it's the ideal moment to discuss this often overlooked issue. It is observed on the first Tuesday of May and aims to increase awareness and enhance care for asthma patients globally.
We spoke to Dr Sulaiman Ladhani, Pulmonologist, Wockhardt Hospitals, Mumbai Central, who explained why asthma often worsens at night.
What Is Nocturnal Asthma?
"Many asthmatic sufferers experience more pronounced symptoms during the night, including coughing, wheezing, and shortness of breath. This condition, known as 'nocturnal asthma,' can significantly impair sleep and quality of life," explained Dr Ladhani.
According to a 2005 study, nighttime symptoms and nocturnal declines in lung function are commonly seen among patients with asthma. Up to 75% of people who have asthma can have nighttime symptoms that wake them up at least once per week, and about 40% experience these symptoms every night.
Also Read: Can You Develop Asthma Later In Life? Know What May Put You At Risk
Causes of Nocturnal Asthma
Circadian Rhythm
The natural body rhythm, circadian rhythm, is responsible for worsening asthma symptoms. At night, our body makes less cortisol, a hormone that naturally balances inflammation. Having lower cortisol levels may allow inflammation in the airways to rise, causing the muscles that are around the airways (bronchial muscles) to constrict, making breathing more difficult.
Melatonin Levels
Melatonin, the hormone responsible for sleep, may also indirectly contribute to airway constriction in some people. "Moreover, our body temperature drops at night and low temperatures can irritate airways in people with asthma, especially if the environment is poorly ventilated or exposed to cold air," added Dr Ladhani.
Lying Down Isn’t Helping
Posture matters more than we realise. When you lie down, especially flat on your back, gravity isn't helping mucus drain as effectively from your lungs. As a result, you experience congestion, restricted airflow, and nighttime coughing. People who also experience acid reflux, another common asthma trigger, may find that lying down allows stomach acid to creep into the oesophagus, irritating the airways and triggering asthma symptoms.
Hidden Triggers in the Bedroom
"Your bedroom might be making your asthma worse without you realising it. Bedrooms may harbour dust mites, pet dander, or mould, which can aggravate asthma symptoms," said Dr Ladhani. If you sleep with pets in your bed or haven’t washed your pillows and blankets in a while, it could add fuel to the fire.
Also Read: How To Distinguish And Manage Nocturnal Asthma And Sleep Apnoea
How To Manage Nocturnal Asthma?
"To control nocturnal asthma, you should first control your asthma during the day. Physicians advise taking medication as prescribed, using air purifiers, washing bedding once a week in hot water, and staying away from allergens," said Dr Ladhani.
If symptoms continue, it is necessary to evaluate and treat underlying conditions, including obstructive sleep apnoea or cardiac abnormalities that may cause or worsen asthma symptoms at night.
Bottomline
Dr Ladhani concluded, "On this World Asthma Day, let's not overlook nighttime symptoms. Identifying and treating nocturnal asthma and its causes can lead to better sleep, better lung function, and a healthier life overall. If your asthma worsens at night, it's not just an annoyance; it's a wake-up call for immediate medical attention."
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your professional if you are dealing with any health issue to avoid complications.]