Herbie Murray
Asthma can significantly impact sleep quality, with nocturnal asthma affecting up to three-quarters of asthmatics in the UK. The condition can cause frequent awakenings, leading to daytime sleepiness, poor concentration, and heightened fatigue. To improve sleep with asthma, several strategies can be employed, including the use of inhalers, optimised sleeping positions, and a well-maintained bedroom environment. Inhalers, both reliever and preventer, can help manage asthma symptoms during sleep, while sleeping on one's left side or back with elevation can improve breathing and reduce acid reflux. Additionally, keeping the bedroom clean, allergen-free, and well-ventilated is crucial to minimising asthma triggers. These interventions aim to reduce the impact of asthma on sleep, improving overall quality of life.
| Characteristics | Values |
|---|---|
| Sleeping position | Sleeping on the left side with a pillow between the legs |
| Sleeping on the back with the head slightly elevated and a pillow under the knees | |
| Avoid sleeping on the right side or on the stomach | |
| Inhaler | Take the preventer inhaler daily as prescribed |
| Keep the reliever inhaler (usually blue) near the bed | |
| Sit up before using the inhaler | |
| Bedroom environment | Maintain clean bedding |
| Avoid strong scents | |
| Regulate bedroom temperature | |
| Keep windows closed | |
| Avoid air conditioning | |
| Invest in an air purifier | |
| Avoid pet hair, mould, pollen, dust mites, etc. | |
| Other | Treat underlying conditions such as GERD, allergic rhinitis, or obstructive sleep apnea |
| Avoid smoking | |
| Try breathing exercises before bed | |
| Use a nasal decongestant spray before bed |
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What You'll Learn
- Sleeping positions: Elevate your head and sleep on your left side or back
- Clean bedding: Wash bedding and minimise dust to reduce exposure to triggers
- Avoid scents: Opt for unscented products to promote a restful night
- Regulate temperature: Keep your room warm and avoid cold air
- Inhaler techniques: Take your preventer inhaler daily and keep your reliever inhaler nearby
Sleeping positions: Elevate your head and sleep on your left side or back
Sleeping comfortably when you have asthma can be challenging, but finding the right position can help you sleep better. If you're a side sleeper, sleeping on your left side can help keep your airways open. This position is also helpful for those who experience heartburn, as it reduces acid reflux by taking advantage of gravity, the shape of the stomach, and the angle of the connection between the oesophagus and the stomach. Adding a pillow between your legs can also help stabilise your spine and improve your sleep posture, making it easier to breathe.
If you prefer sleeping on your back, you can do so with your head slightly elevated and a pillow under your knees. This position improves circulation and keeps your body stable, making it easier to breathe and sleep. Sleeping with your head elevated also helps with sinus drainage. However, sleeping flat on your back without elevation is not recommended as it may worsen symptoms by putting pressure on your chest and causing mucus to drip down your throat.
Sleeping on your right side, also known as the right lateral decubitus position, should be avoided as it has been shown to increase resistance in the airways within the lungs. Sleeping on your stomach is also not recommended as it restricts airflow and lung expansion.
Experimenting with different sleeping positions and noting their effects on your asthma symptoms and sleep quality can help you find the best position for you.
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Clean bedding: Wash bedding and minimise dust to reduce exposure to triggers
Dust mites are a common trigger for asthma attacks and allergies. They tend to gather in bedding, feeding on the dead skin cells that your body naturally sheds. Given the many hours you spend sleeping, your bed is an ideal environment for dust mites to thrive.
To reduce exposure to dust mites, it is recommended to wash your bedding (sheets, blankets, pillowcases, and comforters) regularly in hot water, ideally once a week, at a minimum temperature of 120 degrees Fahrenheit. Opt for bedding that can withstand regular hot water washing. Use dust mite covers to protect your pillows and mattresses. They should completely cover the mattress or pillow and have a zip closure. Vacuum the bedroom floor regularly, using a vacuum cleaner equipped with a HEPA (high-efficiency particulate air) filter that prevents dust from being released back into the air.
When dusting, use a damp washcloth or microfiber cloth to trap and lock dust and reduce the amount stirred up during cleaning. Avoid fans at night, as these circulate dust and allergens that can trigger asthma flare-ups.
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Avoid scents: Opt for unscented products to promote a restful night
Scents can be a significant trigger for asthma, so opting for unscented products is a good idea if you want to promote a restful night.
The American College of Allergy, Asthma and Immunology (ACAAI) suggests that asthmatics avoid air fresheners, scented candles, and pinecones. These items pose a risk to people with asthma, similar to that of air fresheners. The strong smell of pine is also a known trigger, so if you're planning to have a Christmas tree, opt for an artificial one, and make sure to clean it thoroughly before bringing it inside.
Artificial trees are not the only decorations that can cause asthma flare-ups. Other decorations stored in cardboard boxes can gather mold and pests, which can trigger asthma. It's best to store decorations in plastic or steel bins to avoid this.
Travel can also mean encountering triggers, such as pets or smoke, in other people's homes. It's important to communicate your needs to your hosts and prepare by packing your inhaler and spacer in an easily accessible place.
In your daily life, you may want to avoid wearing fragrances and opt for unscented laundry detergents and cleaning products. Fragrances in detergents and cleaning products can escape through vents and cause issues for asthmatics.
In addition to avoiding scents, there are other strategies to improve sleep with asthma. These include finding a comfortable sleeping position, keeping your reliever inhaler nearby, and setting your bedroom thermostat slightly higher in the evenings to prevent asthma triggers due to cold temperatures.
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Regulate temperature: Keep your room warm and avoid cold air
Keeping your room warm and avoiding cold air is an important factor in reducing asthma symptoms at night. Cold air is a common trigger for asthma, so it is important to regulate the temperature in your room.
The ideal room temperature for people with asthma is a mild temperature, between 68°F and 71°F (20°C and 21.6°C), with low humidity between 30% and 50%. This mild temperature won't irritate the airways, and the humidity will make the air more comfortable to breathe. You can use a humidifier to achieve this, especially in dry environments or during winter when indoor heat is typically higher.
In contrast, very cold temperatures can worsen asthma and affect lung function. The effects of extreme cold can last for almost three days, so it is important to maintain a stable, mild temperature in your room. Avoid fans in temperatures below 90°F, as they can increase body temperature and circulate dust and allergens that can trigger asthma flare-ups.
Additionally, consider other factors that can impact the temperature and humidity in your room, such as using exhaust fans or opening windows after showering to maintain low humidity and prevent the growth of dust mites and mold, common allergens for people with asthma.
By regulating the temperature and humidity in your room, you can create an environment that supports better sleep and reduces asthma symptoms.
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Inhaler techniques: Take your preventer inhaler daily and keep your reliever inhaler nearby
If you have asthma, you may find that your symptoms worsen at night. This can be due to various factors, including your sleeping position, bedroom temperature, and bedtime habits. To improve your sleep quality, it is important to manage your asthma effectively, and this includes using inhaler techniques properly. Here are some detailed instructions on inhaler techniques to help you sleep better when having asthma:
Take your preventer inhaler daily
Preventer inhalers are designed to be taken daily to prevent or manage asthma symptoms. They contain medications such as inhaled corticosteroids (ICS), which reduce inflammation in your lungs and help prevent asthma attacks. It is important to follow your doctor's instructions on how often and when to take your preventer inhaler. Make sure to include it in your daily routine, even if you feel like your asthma is under control.
Keep your reliever inhaler nearby
Reliever inhalers, also known as rescue inhalers, are fast-acting and provide quick relief during an asthma attack or when your breathing becomes difficult. They are typically prescribed to be used as needed to lessen asthma symptoms. Keep your reliever inhaler close by, especially at bedtime, so you can access it quickly if needed. If you experience asthma symptoms during sleep or upon waking up, it is important to use your reliever inhaler as prescribed and consult your healthcare provider to ensure proper asthma management.
Proper inhaler technique
To ensure the effective use of your inhaler, follow these steps:
- Remove the cap and check that the mouthpiece is clear.
- Shake the inhaler vigorously 10 to 15 times before each use.
- Breathe out completely, pushing out as much air as possible.
- Hold the inhaler with the mouthpiece down and form a tight seal by placing your lips around it.
- Start to breathe in slowly through your mouth while simultaneously pressing down on the inhaler once.
- Take the inhaler out of your mouth and hold your breath for a slow count of 10 if possible, allowing the medicine to reach your lungs.
- Breathe out slowly through your mouth, puckering your lips slightly.
- If using a quick-relief medicine (beta-agonists), wait 1 to 2 minutes before taking another puff if needed.
- Replace the cap firmly on the mouthpiece.
- Rinse your mouth with water, gargle, and spit afterward to reduce potential side effects.
- Clean your inhaler if you notice powder in or around the mouthpiece.
By following these inhaler techniques and working with your healthcare provider to manage your asthma effectively, you can improve your sleep quality and overall health.
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Frequently asked questions
Sleeping on your left side can help keep your airways open and reduce acid reflux. If you prefer to sleep on your back, use pillows to prop yourself up to help open your airways and take the pressure off your chest. Sleeping on your right side is not recommended as it increases resistance in the airways within the lungs.
Keep your bedroom clean and free of allergens. Wash your bedding regularly with hot water to remove dust mites and allergens. Avoid using duvets and pillows with feathers. Keep your windows closed and invest in an air purifier to improve the air quality in your bedroom.
Keep your reliever inhaler near your bed and sit up before using it to help the medication get into your throat and lungs more easily. If you are experiencing flare-ups at night, consult a doctor to review your treatment. You can also try breathing exercises before bed to help with anxiety and breathing.
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