young woman coughing
The reasons why your asthma may get worse at night could be due to sleep position, hormones, allergies or temperature.

Why Is Asthma Worse at Night?

If you have asthma, you may notice that your symptoms are worse during certain times of the day. For example, some people have worse asthma symptoms during the spring or experience asthma exacerbations when it's cold outside.

But for some, asthma symptoms may be especially bothersome at night. An increase in coughing, wheezing, and shortness of breath can develop just as you try to get some sleep.

An increase in asthma symptoms at night can make it difficult to get proper rest, leaving you fatigued the next day. If asthma symptoms often flareup at night, you may end up with sleep deprivation, which can affect work or school, as well as your overall health.

Understanding why asthma may become worse at night and what you can do may help you get the sleep you need.

Why Asthma Gets Worse at Night

Whether asthma symptoms prevent you from falling asleep or wake you up in the middle of the night, it can be frustrating. The exact reason why asthma may be worse for some people at night is not completely understood. However, there are certain factors that appear to play a role.

Asthma might be worse at night for several reasons including the following:

Sleep Position

When you sleep and are in a reclining position, mucus from your sinuses can drip down your throat. This can trigger coughing, which makes it more difficult to breathe. The gravity from lying flat when you sleep also puts added pressure on your lungs and chest, which might increase shortness of breath in people with asthma.


Hormones affect most functions in your body, including your sleep cycle. Various hormones can change when you sleep.

For example, epinephrine helps widen and relax the airways. Your levels of epinephrine naturally decline when you sleep. The lower levels of the hormone may cause airways to narrow slightly. Histamine may also increase overnight, which causes airway restriction.


Allergens often trigger asthma symptoms. Common allergens may include dust mites and pet dander, which may be lurking in your bedroom.


Depending on the temperature in your bedroom, it may be making asthma symptoms worse. People with asthma have sensitive airways. If you sleep with the air too warm or too cold, you may be reacting to the temperature change.

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Improving Asthma at Night

Although you cannot control certain factors, such as your hormone levels, there are several things you can do to improve your asthma symptoms at night. Consider the tips below for suppressing flareups.

Reduce Allergens

Certain things in your bedroom might be triggering an increase in asthma symptoms. Make your bedroom as allergen-free as possible. By decreasing allergens, you may reduce nighttime symptoms.

Keep your bedroom free of dust and clean your bedroom often. Use a vacuum with a HEPA filter, which works well to trap dust. Get rid of items that easily collect dust, such as books or knickknacks.

You should also wash your bedding in hot water about once a week to get rid of dust mites. Consider using hypoallergenic pillowcases and sheets, which can help decrease allergens as well.

If pet dander is an issue, don’t let your four-legged friends sleep in your room. Pet danger can become trapped in the carpet, which can lead to an increase in symptoms.

Sleep with Your Head Elevated

An increase in mucus from your sinuses may trigger asthma symptoms, such as coughing. Acid reflux, which is very common, can also trigger coughing and other asthma symptoms.

If postnasal drip, increased mucus, or acid reflux is an issue, consider sleeping with the head of your bed elevated. Place a wedge pillow under your head or use a few pillows while you sleep.

Medication and/or Treatment Changes

If your asthma symptoms are worse at night, your medication and treatment schedule may not be working as well as it should. It’s important to talk to your doctor and determine if your treatment schedule may need to be tweaked.

For example, you may need to take a fast-acting bronchodilator before bedtime to relax the muscles in your airway. It’s also possible your long-term bronchodilator or maintenance medication is wearing off.

In some cases, it may help to use an airway clearance device, such as an Aerobika, to help clear the mucus from your lungs. Getting the mucus out before you go to bed may help prevent coughing while you are trying to sleep. Even minimal changes to your treatment schedule may help decrease asthma symptoms at night.


Sleep is vital for your health. If asthma symptoms are worse at night, especially if they are waking you up from your sleep, it’s essential to talk to your doctor. It may be a sign that your asthma is getting worse.

Fortunately, you don’t have to just live with an increase in asthma at night. Sometimes even small changes can make a big difference in controlling symptoms and helping you achieve a good night of rest.