Help for asthma cough

Sleep and asthma

What to do when asthma stops you sleeping

Simple tips to stop asthma waking you at night

Why asthma can wake you up at night

Tips from other people with asthma

Who can I speak to if my sleep problems continue?

It’s quite common for people with asthma to find that asthma symptoms wake them up at night – but you shouldn’t have to put up with them.

If you’re coughing, wheezing, breathless, or have a tight chest at night, it’s a sign that your asthma is not well controlled and you might be at risk of an asthma attack.

Early morning asthma symptoms may also be a sign that your asthma has been difficult through the night, even if you weren’t aware of it.

Here are some simple steps you can take to stop asthma getting in the way of a good night’s sleep.

What to do when asthma stops you sleeping

  • If you have asthma symptoms, sit up and take your reliever inhaler (usually blue) as prescribed.
  • Always make sure your inhaler is beside your bed before you go to sleep, so you don’t have to search for it 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. “This is better than falling asleep straight away only to wake up soon after with asthma symptoms because your reliever didn’t help enough.”
  • Some people find propping themselves up with extra pillows helps as it keeps the airways open.

Video: Asthma and your sleep

Dr. 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.

Simple tips to stop asthma waking you at night in the long-term

You don’t have to just accept your night-time asthma symptoms as normal.

  • 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.
  • If you’re having asthma symptoms at night or noticing asthma symptoms when you first wake up, you should make a same day appointment to see your GP or asthma nurse. Symptoms that keep you awake at night are one of the signs you might be at risk of an asthma attack.

It’s also 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.

Why asthma can wake you up at night

If your asthma isn’t under control, you might get more symptoms at night.

There are several reasons why this might happen:

  • At night, your body produces fewer natural steroid hormones, which can affect your symptoms and more of the cells that cause inflammation in your airways.
  • When you lie flat on your back, gravity places extra pressure on your chest and lungs, making it harder to breathe. This position can also trigger a cough, as mucus in your nose could drip down to the back of your throat.
  • Your bedroom might contain triggers that can make your asthma worse, such as dust mites in your mattress, pillows and blankets.
  • Pet hair is a common asthma trigger, so avoid letting your pet sleep on your bed, and ideally keep them out of your bedroom.
  • Mould is another common asthma trigger, so check your bedroom for damp patches on walls and mould growing around windows.
  • Lots of people find pollen triggers their asthma symptoms. When pollen is high, try using a fan to keep your bedroom cool rather than opening a window.
  • Some people are triggered by cold air at night, or by sleeping in a cold room. If this is you, keep windows closed and keep the heating on low in the bedroom if you can.

If your GP has prescribed steroid pills for your asthma, you’ll probably be advised to take them in the morning after food, as they might cause difficulty sleeping if you take them at night, but always take them exactly as prescribed.

Don’t be tempted to stop taking the tablets early. It’s important to finish the course to bring your asthma back under control, otherwise your symptoms might come back and keep you awake anyway.

Tips from other people with asthma

If your asthma is keeping you awake at night, you’re not alone.

In our recent sleep survey, 45% of people told us they have difficulty sleeping because of their asthma at least once a week, and nearly 50% said they’d had an asthma attack at night.

Here are some of the things that people tell us help them get a good night’s sleep, which our nurses agree might be helpful:

  • Ease a dry throat with a glass of water
  • Try a nasal saline rinse or use decongestants to unblock a stuffy nose (but test this out during the day first: some people find products like Olbas Oil or Vicks trigger their asthma symptoms)
  • Take regular exercise
  • Relax in the evening using mindfulness, meditation, breathing exercises or yoga
  • Avoid caffeine in the afternoon and evening.

If you find reading about other people’s experiences useful, or have some advice to share, join the conversations on our HealthUnlocked forum.

Is your child disturbed by symptoms at night? Read our advice on asthma and your child’s sleep.

Who can I speak to if my sleep problems continue?

Need some more advice? Speak to your GP or asthma nurse.

You can also call our Helpline on 0300 222 5800 and talk to an expert asthma nurse (Monday-Friday, 9am-5pm), or message them on WhatsApp.

Last updated: September 2019

Next review due: September 2022

Asthma – symptoms, diagnosis, treatment

Getting a seasonal influenza vaccination (“flu jab”) will reduce the risk of influenza, which in turn will reduce the risk of serious asthma. People who are on regular preventive therapy for asthma (as well as people with various other medical conditions) can see their doctor about a free influenza vaccination each autumn.

Other control methods include breathing techniques such as the Buteyko Method. Staying physically fit and avoiding smoking can also minimise asthma symptoms and attacks. Desensitisation and allergen avoidance may also be useful. Alternative therapies such as acupuncture, homeopathy and massage prove effective for some people in managing their asthma.

Be alert for signs of worsening asthma: night waking, breathlessness or difficulty speaking on exertion, loss of response to your reliever.

Further support

For more information about asthma talk to your doctor or contact support and resource groups such as:

Asthma and Respiratory Foundation NZ
PO Box 1459
Wellington 6140 Phone: (04) 499 4592
E-mail: [email protected] Website: www.asthmafoundation.co.nz Asthma New Zealand – The Lung Association Phone: (09) 623 0236 Email: [email protected] Website: www.asthma.org.nz O’Toole, M.T. (Ed.) (2013). Asthma. Mosby’s Dictionary of Medicine, Nursing & Health Professions (9th ed.). St Louis, MI: Elsevier Mosby.
Advocacy & Education Committee of the Asthma Foundation (2013). What is asthma? (Booklet PDF). Wellington: Asthma and Respiratory Foundation of New Zealand. https://s3-ap-southeast-2.amazonaws.com/assets.asthmafoundation.org.nz/documents/What-is-Asthma-Resource.pdf
Asthma and Respiratory Foundation of New Zealand (2014). Key statistics: Respiratory disease in New Zealand (Web Page). Wellington: Asthma and Respiratory Foundation of New Zealand. https://www.asthmafoundation.org.nz/research/key-statistics
Advocacy & Education Committee of the Asthma and Respiratory Foundation (2013). Triggers in asthma (Booklet PDF). Wellington: Asthma and Respiratory Foundation of New Zealand. https://s3-ap-southeast-2.amazonaws.com/assets.asthmafoundation.org.nz/documents/Triggers-in-Asthma-Resource.pdf
Ministry of Health (2014). Asthma (Web Page). Wellington: Ministry of Health. http://www.health.govt.nz/your-health/conditions-and-treatments/diseases-and-illnesses/asthma

Last Reviewed – April 2017

Key points

Smoking and asthma is a dangerous combination. People with asthma and those around them shouldn’t smoke.

Healthy eating may help with your asthma. Aim for plenty of fruit, vegetables and fish, choose lean meats and reduced-fat dairy foods, and limit foods high in saturated fat (e.g. fast foods).

Don’t let your asthma stop you being physically active. Consider getting involved in structured exercise training, as people with asthma who participate in this sort of training feel better. If being physically active causes asthma symptoms, tell your doctor so you can get effective treatment.

Being overweight may make asthma harder to manage. Losing just 5 or 10 kilograms could really improve your asthma.

People with asthma should keep their flu shots up to date.

Your mental health can affect your asthma, and asthma may affect your mental health. Talk to your doctor if you have been feeling down, anxious, or aren’t enjoying those things you normally do enjoy.

It is especially important to manage your asthma carefully during pregnancy, because you are breathing for two. Keep taking your asthma medicines as usual, and talk to your doctor as early as possible about your asthma care during pregnancy.

Healthy habits can help you manage your asthma

This brochure provides information about how healthy habits and lifestyle choices can help with your asthma.

Taking care of your asthma also involves:

  • taking your preventer medicine regularly if your doctor has prescribed it
  • knowing how to use your inhaler (puffer) properly – this could include using a spacer
  • following your written asthma action plan
  • avoiding things that make your asthma worse (e.g. tobacco smoke, other fumes, or animals that you are allergic to)
  • seeing your doctor regularly for asthma checkups
  • asking your doctor or pharmacist for information and advice about asthma.
  • Everyone with asthma should have their own written asthma action plan and follow it. If you don’t have one, ask your doctor.

Go smoke-free

Smoking stops your asthma puffers working

Smoking and asthma is a dangerous combination.

Smoking or breathing other people’s smoke:

  • damages your lungs
  • makes asthma harder to manage
  • stops asthma medicines working properly
  • increases your risk of asthma attacks or flare-ups
  • damages children’s lungs and worsens wheezing and asthma.

Tobacco smoke that clings in your hair and clothing is still poisonous. Smoking home-grown or illegally produced loose tobacco (‘chop-chop’) is as harmful as smoking branded cigarettes. Any type of smoke damages your lungs. People with asthma who quit smoking have healthier lungs within just 6 weeks.

If you are planning a pregnancy, you and your partner should stop smoking before the pregnancy to protect your unborn baby.

Protect kids’ growing lungs by making sure your home and car are smoke-free.

Tips for quitting

Talk to your doctor, pharmacist or asthma and respiratory educator.

Phone Quitline on 13 78 48 (13 QUIT), visit the Commonwealth Government’s anti smoking campaign website: quitnow.gov.au, or visit the Cancer Institute NSW “I can quit” website: icanquit.com.au

Using medicines to help you quit (for example, using nicotine replacement patches or gum) could double your chance of success.

Don’t give in and have ‘just one puff’ — it could set back all your hard work. Learn to manage stress while quitting – Quitline can help you.

Enjoy healthy eating

Healthy eating might help your asthma.

Fresh fruit and vegetables are full of antioxidants, which may improve your lung health and help avoid asthma attacks. Aim for 5 servings of vegetables and 2 servings of fruit every day. Eating fish often may help with your asthma too.

Eating too much saturated fat may prevent your asthma medicines working properly. Limit the amount of convenience foods high in saturated fat, and choose lean meats, skinless chicken and reduced-fat dairy foods.

Milk and other dairy foods don’t cause or worsen asthma symptoms.

Enjoy a physically active lifestyle

Getting more active can make you feel better.

Don’t let your asthma stop you being physically active. Choose an activity you enjoy, as this can help motivate you, and aim for at least 30 minutes of moderately intense physical activity every day or most days. Moderately intense physical activity means any activity that makes you breathe noticeably faster and deeper than usual, but does not make you puff and pant.

Asthma symptoms after physical activity are common but treatable, so don’t let this put you off being active. If being physically active causes asthma symptoms, tell your doctor so you can find the treatment that works best for you. This could be as simple as taking extra puffs of your reliever before you warm up.

Asthma symptoms should not stop you from participating in sports or physical activity, whether just for fun or more competitively. Many of our Olympic athletes have asthma.

Consider getting involved in structured exercise training, as people with asthma who participate in this sort of training may feel better.

If you have asthma symptoms when you are physically active or exercise, then there are some things you can do:

  • Get as fit as possible. The fitter you are, the more you can exercise before asthma symptoms start.
  • Exercise in a place that is warm and humid – avoid cold, dry air if possible.
  • Avoid exercising where there are high levels of pollens, dusts, fumes or pollution.
  • Try to breathe through your nose (not your mouth) when you exercise. This makes the air warm and moist when it reaches your lungs – cold dry air can make symptoms worse.

Make sure you do a proper warm-up before exercising. If you have asthma symptoms after your warm-up but taking your reliever helps settle them, then you may be able to carry on without getting symptoms again during your session, even if you exercise hard.

After you exercise, do cooling down exercises while breathing through your nose and covering your mouth (especially if the air is cold and dry).

If you participate in competitive sports, make sure you check which asthma medicines you are allowed to take by contacting the Australian Sports Anti-Doping Authority (asada.gov.au) and the World Anti-Doping Authority (wada-ama.org).

Lighten the load on your lungs

Losing just a bit of weight could make you feel better and breathe more easily

Being overweight may make asthma harder to manage, as carrying extra weight puts extra strain on your lungs, and might also worsen asthma.

If you are overweight, losing just 5–10% of your current weight (e.g. 5 or 10 kilograms for a person who weighs 100 kilograms) can really improve your asthma, so you get fewer asthma symptoms and need less medicine.

Breathing problems during sleep are also common among people who are overweight, and can make asthma harder to manage. If you snore or don’t feel refreshed after a night’s sleep, talk to your doctor.

Gastro-oesophageal reflux disease is common in overweight people so see your doctor if you have reflux, heartburn or indigestion.

Avoid the flu

Keep up your flu shots.

People with asthma should keep their flu shots up to date. Ask your doctor which vaccinations are recommended for your age group and health conditions.

Take care of your mental health

If your asthma is getting you down or if you feel anxious, tell your doctor.

Asthma can be harder to manage or cope with if you have depression or another mental health condition. Asthma can also affect your mental health.

Talk to your doctor if you have been feeling down or anxious, or if you haven’t been able to feel interested in things you normally enjoy. You can also contact beyondblue for more information on depression and anxiety, and where to get help (see Further information).

If problems with your asthma are getting you down, talk to your doctor. Your local Asthma Foundation can also provide support, education and information to help you manage your asthma (see Further information).

Learning how to manage your asthma and having regular asthma check-ups with your doctor can make you feel better, especially if you are experiencing depression and anxiety.

Regular exercise can also help reduce symptoms of anxiety and depression in people with asthma.

Plan a healthy pregnancy with asthma

If you can’t breathe, neither can your baby.

If you are pregnant or planning a pregnancy, you need to know some asthma facts:

  • It is especially important to manage your asthma carefully during pregnancy. Untreated asthma, poorly controlled asthma or serious flare-ups during pregnancy put mothers and babies at risk.
  • You should not stop taking your asthma medicines. Talk to your doctor as soon as possible to plan your asthma care during pregnancy.
  • Asthma can change during pregnancy. Your doctor may advise you to have asthma check-ups more often while you are pregnant.
  • Both parents should stop smoking before the woman becomes pregnant to protect the unborn baby.

Women with asthma who are planning a pregnancy should see their doctor to update their written asthma action plan before the pregnancy.

Before becoming pregnant is also a good time to talk to your doctor or pharmacist about all the medicines you are taking for asthma and any other condition (including any non-prescription medicines and complementary medicines). Ask about which medicines you should keep taking during pregnancy, and whether there are any safer options.

If you are pregnant and have asthma, or have had asthma at any time in your life, make sure your obstetrician and midwife know you have asthma.

If you have asthma symptoms while pregnant, act immediately: take your reliever puffer straight away and contact your doctor if symptoms return. If you can’t breathe normally within a few minutes of taking your reliever puffer during an asthma attack, ask someone to call 000 for an ambulance (nationalasthma.org.au/emergency).

Further information

Healthy living resources

  • Commonwealth Government’s anti-smoking campaign site: quitnow.gov.au
  • Quitline: 13 78 48
  • Dietitians Association of Australia: daa.asn.au
  • Heart Foundation: heartfoundation.org.au
  • beyondblue info line 1300 224 636 and website beyondblue.org.au

Additional information

  • Talk to your doctor or pharmacist
  • Visit the National Asthma Council Australia website at: nationalasthma.org.au
  • Contact your local Asthma Foundation1800 645 130 asthmaaustralia.org.au

For Health Professionals

Visit the National Asthma Council Australia website to:

  • order printed copies of this brochure
  • access the related information paper for health professionals

Acknowledgments

Developed by the National Asthma Council Australia in consultation with an expert panel of clinicians. Supported through funding from the Australian Government Department of Health.

Recommended Citation

National Asthma Council Australia. Asthma & Healthy Living: A guide to healthy habits and lifestyle choices for people with asthma. Melbourne. National Asthma Council Australia, 2013.

Disclaimer

Although all care has been taken, this brochure is only a general guide; it is not a substitute for individual medical advice/treatment. The National Asthma Council Australia expressly disclaims all responsibility (including negligence) for any loss, damage or personal injury resulting from reliance on the information contained.

© 2013

Asthma symptoms getting worse

Transcript for ‘Signs that your asthma is getting worse’

0:00 Asthma attacks rarely happen out of the blue.

0:03 They often take a few days to build up.

0:07 Asthma is different for everybody.

0:10 By learning how to recognise when your asthma symptoms are getting worse,

0:14 it’ll help you to stay in control.

0:18 So, signs that your asthma is getting worse are variable.

0:23 The most common sort of signs are you may feel some wheezing,

0:26 you may have a cough, you may find a tightness in your chest.

0:32 If you keep a peak flow diary, you may find that your peak flow scores are reducing a bit.

0:38 You may also find that you’re using your blue reliever inhaler more frequently than you usually would.

0:45 If your symptoms continue to be worse and you’re using your blue inhaler a lot,

0:52 then please do call us on the helpline or contact us by email,

0:56 especially if you’re not sure what to do next.

0:59 We can discuss what’s been going on with you

1:01 and make a plan for a way forward.

1:05 If you are using your preventer inhaler as prescribed,

1:09 every day, even when you’re well and using really good inhaler technique,

1:14 and despite this, your asthma symptoms are getting worse,

1:18 it’s a good idea to see your GP.

Related resources

Adult action plan

Using an asthma action plan will help you to stay well. Download and fill in with your GP.

Download (163 KB)

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