The Connection Between Asthma and Sleep Disorders

Medical research finds that people with three health issues often have poor sleep health. This includes people with allergic rhinitis, atopic dermatitis, and asthma. Studies dating back to the 1980s link sleep disorders and asthma. In one study, researchers found that boys with asthma slept approximately 16 minutes less than boys without asthma. 

What is the connection between asthma and poor sleep? Symptoms play a part, but there’s more to it.

What You Need to Know About Asthma and Sleep Disorders

Asthma is a chronic condition where the bronchial tubes within the lungs swell. This restricts airflow and causes coughing, chest tightness, shortness of breath, and wheezing. Asthma categories include:

• Intermittent Asthma: Occurs less than twice a week
• Mild Persistent Asthma: Occurs more than twice a week but not every day
• Moderate Persistent Asthma: Occurs daily and interferes with daily life
• Severe Persistent Asthma: Hard to control, even with medications
• Allergic Asthma: Caused by an allergen like dust mites or pollen
• Aspirin-Induced Asthma: Occurs after taking aspirin
• Asthma-COPD Overlap Syndrome: Symptoms of both asthma and COPD combine
• Cough-Variant Asthma: Persistent cough
• Exercise-Induced Asthma: Caused by physical activity
• Nighttime Asthma: Worse at night, which makes it harder to sleep
• Occupational Asthma: Caused by exposure to chemicals or fumes
• Seasonal Asthma: Appears seasonally, like seasonal allergies

Sleep disorders are conditions where sleep is interrupted for some reason. Three of the most common sleep disorders tied to asthma are:

• Chronic Insomnia: A condition where a person has difficulty falling or staying asleep.
• Gastro Reflux Disease (GERD): A digestive issue where stomach acid and partially digested food leak back into the esophagus, causing coughing, heartburn, and throat spasms.
• Obstructive Sleep Apnea: An intermittent condition where the airway closes due to enlarged adenoids or tonsils, genetics, obesity, or underlying health issues. This prevents the flow of oxygen.

Points Where Asthma and Sleep Disorders Align

There are two main considerations when it comes to the intersection of asthma and sleep disorders. 

1. Asthma Symptoms Impact Sleep Quality

Your circadian rhythm plays an important role in sleep quality. When you enter deep, restorative sleep, it helps lower cortisol (stress hormone) levels. Your histamine-producing neurons become inactive while you sleep, which helps restore your body to low histamine levels.

Serotonin levels also decline as you sleep. This helps you sleep well and wake feeling refreshed.

Asthma’s coughing, chest tightness, wheezing, shortness of breath, and even asthma attacks make it hard to fall asleep and stay asleep. When asthma flares up, you wake frequently. Your body is never able to enter into deep sleep for more than a few minutes at a time.

If you control asthma with medications, some of them have side effects like insomnia. Albuterol stimulates your nervous system, which makes it hard to fall asleep. Corticosteroids increase cortisol levels, which impact your sleep-wake cycle and increase the risk of insomnia.

Other asthma medications also have side effects like feeling jittery, a faster heart rate, and a headache. It’s hard to sleep if your head is pounding.

2. A Poor Night’s Sleep Increases the Risk of Asthma

Because poor sleep quality also boosts the stress hormones within your body, it can trigger constriction of the bronchial airways. It also impedes your immune system, making it harder for people with allergies and respiratory infections, which also trigger asthma in certain people.

If your sleep quality is directly caused by conditions like GERD, insomnia, or sleep apnea, you struggle to get a good night’s sleep. Deep sleep helps ease inflammatory markers, which puts you at a higher risk of inflammation. That connection increases the chances of an asthma flare-up. 

It becomes a problematic circle of asthma, making it hard to sleep, and insomnia kicks in because of your asthma symptoms. Until your asthma and any underlying sleep disorders are controlled, you may struggle with both.

How Asthma and Sleep Disorders Are Diagnosed

How does a doctor tell if you have asthma, a sleep disorder, or both? There are several tests used to determine what’s going on with your health.

Asthma:

Spirometry is used to diagnose asthma in a medical office. It’s a test that measures how quickly you inhale and exhale and how much air you’re able to move in the process.

If tests are inconclusive, bronchoprovocation tests use common triggers to see if you have a reaction. You might be exposed to cold air to see if your lung function changes. Exercise is the other common trigger. 

A methacholine challenge test uses a drug to gradually constrict the airways in people with asthma. Air flow is tested before and after the trigger. The test results help determine asthma in cases where asthma is still suspected after a negative spirometer test.

Sleep:

Tests to determine sleep disorders depend on the suspected condition. The first route is often the Epworth Sleepiness Scale, which tracks your sleep, sleep disruptions, and how drowsy you feel during the day.

 If a doctor suspects obstructive sleep apnea, polysomnography is used to monitor oxygen levels, brain waves, your pulse, breathing rates, and movements of the eyes and legs while sleeping. 

If GERD interrupts your sleep, the use of a specific medication is tested to see if it eases your heartburn and other symptoms. If it does, it’s indicative of GERD. If it is inconclusive, an upper endoscopy is performed to look at your esophagus for damage.

Negative tests lead doctors to look at other issues. Is medication triggering insomnia? Are you overly stressed at work and having a hard time settling down? Could an outside noise, such as a neighbor coming home and slamming doors, wake you up?

Lifestyle Changes Are Only Part of the Solution

Sometimes, lifestyle changes help you manage your asthma and get a restful night’s sleep. If you’re overweight, talk to your primary care physician about medically supervised weight loss plans. Dietary changes and increasing physical activity may be enough to get you started. 

Avoid asthma triggers. If you know pollen is a trigger, avoid being outside when pollen counts are high. If you must go outside, wear a mask. Always carry your inhaler, just in case. 

Timing when you take asthma medications also helps. If you find you feel jittery for two hours after taking your medication, time your doses so that you’re awake and not heading to bed soon.

Integrated care is essential. You do need to work with an allergist to determine your asthma triggers and solutions that help you avoid asthma attacks. You also need to work with sleep specialists who determine what sleep disorder impacts your health. 

With a cohesive care plan for both your sleep quality and your asthma, the best treatment plans keep you healthy. Premium Allergy & Respiratory Center helps you uncover your asthma triggers and determine how severe it is. 

Once you have this information, your allergist works with your primary care physician and sleep specialists to build a comprehensive treatment plan. Schedule your appointment online and start getting the relief you deserve.