How to sleep with Asthma: Positions

Introduction

If you are suffering from asthma, you will realise that your symptoms are usually worse at night. Therefore, you might dread going to sleep at night in fear of being woken up several times with tightness in the chest, wheezing, or shortness of breath; and consequently having to use your inhaler for relief.  

The main purpose of this article is to share with you tips and remedies that can reduce the symptoms of night-time asthma. This can be as simple as changing your sleeping position.  Following these advise will have a significant impact on your sleep and quality of life. However, always seek medical advice if you suffer from other conditions, such as back and hip pain.

Three main takeaways :

1. Night-time asthma affects many people with asthma
2. Lying on your back and propping yourself up with extra pillows can alleviate night-time asthma
3. Sleeping on your side with a pillow between your legs can help if you have breathing problems

About Asthma

Asthma is a chronic lung condition that causes your airways (bronchial tubes) to narrow, swell, and produce extra mucus. The common signs of asthma are coughing, chest tightness, wheezing, and breathlessness. 

Asthma can affect people of all ages. However, asthma symptoms do not appear all the time. Some asthma patients may not have symptoms over long periods of time. Nevertheless, you should treat your asthma daily to reduce common asthma symptoms.   

Asthma usually begins during childhood, but one can also develop asthma at any time during adulthood. The exact causes of asthma are still not known but there are a variety of common asthma triggers, including:¹

• Colds or flus
• Allergic reactions to dust mites, animal fur, or pollen
• Changes in weather
• Certain medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
• Damp or mould
• Physical activity during cold and dry weather
• Acid reflux or gastroesophageal reflux diseases that causes stomach acid to come back up your throat
• Smoke, pollution, or fumes
• Going through periods of  stress 

Asthma has different levels of severity, thus, your your asthma symptoms may change over time as the severity of your asthma changes. Therefore, it is important to have regular checks with your GP or asthma nurse. If you do not monitor your asthma regularly, you run the risk of an asthma attack. A severe asthma attack could even result in death. 

Nocturnal Asthma 

Nocturnal asthma, or night-time asthma, symptoms are signs that your asthma is not under control. Therefore, you may be at risk of an asthma attack. It is believed that up to 75% of people with asthma in the UK suffer from this.² 

Below are some of the reasons that your night-time asthma may come while you are sleeping.³

Sleeping Position

Lying on your back (supine position) puts more pressure on your chest and lungs. As a result, it makes it harder for you to breathe. Moreover, if you get acid reflux at night, this sleeping position will make it worse as the acid can irritate your airways.

Triggers

There might be asthma triggers lurking in your bedroom. Dust mites in your mattress, pillows, and blankets are the usual suspects. Other triggers could be mould on the walls, ceiling, or tiles of your room. Pollens and pet hair are also known triggers for people with asthma.

Hot or Cold Air

If your room is hot at night, the hot air can cause your airways to narrow, resulting in coughing, chest tightness, breathlessness and/or wheezing. Similarly, cold air might also trigger your asthma symptoms.

Side Effects

Asthma medication can give you night-time side effects. Montelukast, a type of asthma medication, can cause sleep issues, such as insomnia. In the same way, steroid tablets may also cause sleeping difficulties.

Best Sleeping Positions for People with Asthma

So, what are the best sleeping positions for someone with asthma? Read on to find out.^4,5

Position 1: Lie on your back whilst elevating your shoulders and neck⁶

Sleeping in the supine position can cause respiratory difficulties for people with asthma. This is because it makes it harder for you to breathe as your tongue may fall down your throat and block the airways. 

Therefore, the best position is to prop yourself up with one or two extra pillows. This will raise your shoulders and neck keeping your airways open and reducing night-time asthma symptoms.

Position 2: Lie on your left side with a pillow between your legs

Sleeping on the side is the most popular position with around 75% of people sleeping this way. This sleeping position makes breathing easier and your tongue is less likely to move down your throat. 

Sleeping on the side also supports your respiratory tract, allowing you to breathe easily. 

If you sleep on your left side, you can avoid the problems of supine sleep (such as respiratory difficulties). This sleeping position is a better choice for limiting the effects of night-time asthma.

Placing a firm pillow between your knees and bending your legs to support your lower back keeps your spine aligned.⁷ Hence, your airways are more stable and this position will less likely to restrict breathing. Furthermore, it will help those with breathing abnormalities, such as sleep apnoea.

Caution

If you are pregnant or suffering from existing shoulder, lower back, or hip pain, it is best to seek medical advice before adopting any of the two sleeping positions.

Sleeping Positions to Avoid

You should avoid lying on your stomach (prone position). In this position, the face is turned to the side, with the arms and hands at your side and the legs are held straight.

This sleeping position makes it harder for you to breathe as the body’s weight is pressing down on the lungs, thus, limiting the movement of the rib cage and diaphragm. You are also more likely to get a stiff neck as this position places some strain on your shoulder and upper back muscles.

Sleeping on your stomach can also lead to lower back and neck pain. Moreover, you are likely to change your body positions several times to try to get comfortable during the night.

Alternative Tips for Sleeping with Asthma

If your asthma keeps you awake at night, below are some tips that you can do to get a good night’s sleep:³

• Try using a nasal spray to unblock a stuffy nose
• Being active during the day can increase your overall lung strength and capacity, and boost your immune system
• Try using an air purifier in your rooms to remove allergens, such as pollen, pollution and dust
• Use an anti-allergy bedding cover and keep your pets away from your bed or bedroom
• Avoid any food or drink that might trigger asthma close to bedtime
• Use breathing techniques, like Pranayama, Buteyko and Papworth, to help with your asthma
• Yoga might help you deal with stress and anxiety, hence improving the quality of your sleep
• Get treatment if you have obstructive sleep apnoea 

When should I contact my doctor?

If you continue to struggle with your sleep and suffer from nocturnal asthma, speak to your health professional (GP or asthma nurse) at your next appointment.

Summary

Many people with asthma lose quality sleep every night because asthma symptoms flare up at night. This is known as nocturnal asthma or night-time asthma. We have given you some tips to help alleviate the symptoms and allow you to have a good night’s sleep. You can start by changing your sleeping position. Lying on your back while elevating your shoulder and neck or sleeping on your left side with a pillow between your legs are the best sleeping positions for people with night-time asthma.

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