Why is my asthma worse at night? breathing hard at night lying down

Hi, @mcdc1959 - I wanted to check in and see how your September pulmonary appointment and your CT scan went? Did you end up making a cardio appointment, as well?

I have had asthma for a very, very long time. There are certain triggers that set it off, like pollen, my number one allergy. But I do not have any chest heaviness when I lie down. I do have a pulmonologist and suggest you have that discussion in that office. Good luck and let us know how you’re doing!

Have you been evaluated for allergies especially for dust and dust mites? Those are often thriving in bedrooms and would make things worse when lying down. This can be treated by allergy shots, encasing bedding, and allergy nose sprays and medications.

Also perhaps ask about being evaluated for gastric reflux, particularly silent reflux. This is a common issue for folks with lung conditions—so much so that National Jewish evaluates all their patients for reflux. When reflux is treated, it can help breathing (and when untreated can make breathing worse).

@hicopd - I had more asthma symptoms (coughing, especially, but I think also some inaudible wheezing) lying down at night previously. I think it related to my dust/dust mite allergies, as you mentioned. I already took some regular inhalers, allergy medications and nose sprays. I've tried allergy shots before, but they only seemed to really impact my cat allergy. I took some benzonatate, which helped a bit, and grabbed my Albuterol inhaler from my nightstand if I coughed in bed. At least temporarily, this helped a bit.

What really made a difference in my particular situation was finally getting approved and taking mepolizumab shots monthly. At first, I did not think these shots were doing anything. Then, later, when speaking to my allergist at an appointment, I realized I was coughing less at night and during the day. I no longer got into such a bad asthma situation that I had to take a round of prednisone.

Are you allergic to dust/dust mites, hicopd? If so, what do you do to manage them?

Yes, I’m allergic to dust and dust mites. I bought encasings for all our bedding and wash bedding in very hot water and use hot dryer. Also have hardwood floors plus sheet vinyl, no carpet.
I also took allergy shots for 7 years. All of these measures plus taking 3 nasal sprays every morning and evening and 3 inhalers as well seem to help.
I will be starting dupixent at the end of the month , since I have high eosinophils and frequent COPD exacerbations in addition to asthma. It’s a biologic injected every 2 months.

Correction—injected every 2 weeks!

I have had asthma for 50 years, and about 15 years ago I started having problems sleeping with asthma. My doctor prescribed Spiriva Resprimat Inhaler. I have had no more problems sleeping. The medication works for 24 hrs, so it works for you throughout the entire day. It’s pricey but if you have insurance the price is manageable.

Try going GLUTEN FREE!

1. Bread 🍞 GF
2. Pasta 🍝 GF
3. Cereal 🥣 GF
4. Snacks/Chips/Pretzels GF
5. Biscuits GF
6. Cake 🍰 GF
7. Rice 🍚 GF

This has really improved my lung 🫁 function. You will experience better breathing 😮‍💨… I promise… if you continue with your regular diet routine you will continue to suffer 😔

Going Gluten-free may help asthma if one is sensitive to gluten or allergic to wheat, barley or rye. But it is not a cure for everyone, nor does it necessarily result in better breathing.

I have been asthmatic for most of my life, and intentionally gluten-free for over 15 years. But it did not improve my breathing - only my digestive and allergy symptoms.

Every person is different, I am glad it worked for you. Do you also look for the "hidden" gluten in packaged foods?

Are you sleeping flat? I sleep upright in a chair. It took getting used to but was a game changer. Also using nasal rinse before bed and clearing lungs with nebulizer and asthma meds every day and if at night I just do the sodium chloride. Breathing exercises and ACTS. Also have blood work checked for eosinophils.