The results are in: good sleep practices are a non-negotiable to support your overall health — physically, mentally, emotionally, academically and relationally.
But what if your child is making their best effort, but continues to wake during the night from breathing-related issues? Is their asthma well-managed? Perhaps they still need to be diagnosed.
“Asthma is inflammation inside the lungs that affects a person’s ability to breathe well,” said Giuliana Gayoso, MD, pediatric pulmonologist with Avera Pediatric Specialists Sioux Falls.
In children, asthma symptoms include: recurrent episodes of wheezing, coughing, breathlessness (often shown as activity limitation) and nocturnal symptoms or awakenings. These symptoms are commonly triggered by viral infections, exercise, allergens, changes in weather, laugher, crying or irritants. Symptoms often worsen at night and can increase significantly during an actual asthma attack.
Asthma Symptoms Can Affect Your Child’s Sleep
Children with poorly controlled asthma experience higher rates of insomnia, difficulty falling asleep, sleep disruptions and nighttime awakenings compared to healthy children. It’s frustrating and painful.
“Even if you don’t have asthma, think of those times when you’re sick,” related Gayoso. “Nighttime coughing and congestion make it impossible to rest — imagine going through this a couple nights a week.”
Poor sleep quality in children with asthma correlates with worse asthma control and reduced quality of life, including school performance and daily functioning.
How Sickness Affects Asthma and Sleep
Kids and people with asthma need to be especially careful with illnesses. Viral respiratory infections are a major trigger for asthma exacerbations in children. When symptoms occur after a viral upper respiratory infection, children with asthma often take longer than usual to recover from an illness.
Also, lots of sleep is important to healing, so closely follow the directions of a family medicine doctor, pediatrician or pulmonologist. Managing asthma well upfront can help reduce breathing issues when recovering from an illness.
Goals of asthma management in kids include achieving the best possible control of symptoms, maintaining normal activity levels and minimizing the risk of asthma attacks or flare-ups.
Learn more: Support Lung Health by Getting Flu and COVID-19 Shots
How to Tell If Asthma Is Affecting Your Child’s Sleep
Asthma reactions can intensify during the night. Mucus gravitates into the throat, contributing to congestion and coughing. Also, the circadian rhythm can boost histamine production at night.
An accumulation of irritants in a bedroom, like pet dander or dust, combined with the physical aspects, can contribute to a strong immune reaction. The result is shallow, disturbed sleep.
Not properly treating asthma affects kids’ overall quality of life. During the day, your child might have difficulty paying attention in school, struggle with school performance, or react more negatively in situations — simply because they’re tired.
So what are the signs that asthma isn’t under control? Gayoso asks parents to pay attention to asthma symptoms. If your child experiences frequent nighttime awakenings from coughing or wheezing, symptoms more than twice a week, or has had a severe episode requiring urgent medical care, consult with a pediatrician or pulmonologist.
“When the basic act of breathing is hindering life, it’s time to see a doctor,” said Gayoso. “We conduct breathing tests for patients that have raised concerns about asthma.”
Manage Asthma for a Better Night’s Sleep
To make sure asthma doesn’t interrupt your child’s rest, the answer is simple. “The first thing we have to do is get your child’s asthma under control,” said Gayoso. “If your child is waking at night, it’s not under control.”
That means keeping inflammation and abnormal reactivity inside the lungs to a minimum by using medications.
Medications are typically delivered through an inhaler, but sometimes by mouth through a pill, syrup, food mix-in or nebulizer.
Treatment can look like:
- Fast-acting medications, like albuterol given through an inhaler, tame an asthma attack already in motion. Keep an inhaler on their nightstand just in case.
- Oral steroid tablets are fast-acting and can reduce worsened inflammation, like when your child is ill. Establish an asthma protocol with your doctor when your child is sick and follow it closely.
- Long-lasting medications, such as fluticasone and budesonide also given through an inhaler, keep the lungs less inflamed and stable to better prevent an asthma attack.
- Granule medicines, like montelukast, are appropriate for babies experiencing asthma symptoms. These packets are mixed with food.
- Nebulizers are medicines in the form of a liquid mist. It’s delivered through a mask held to the face.
Medications also help reduce your child’s sensitivity to triggers, such as an illness or dust or dander in their bedroom.
Treatment response should be reviewed after two to three months before deciding whether to continue therapy. Inhaled corticosteroids are the preferred treatment for persistent asthma in children and have shown to improve nocturnal symptoms and lung function.
Parents should also be aware that good sleep hygiene practices are important, as poor sleep hygiene can worsen the relationship between poor asthma control and sleep problems.
If you’re concerned about asthma in your child, schedule an appointment with your family medicine doctor or a pediatric pulmonologist. You don’t need a referral for a specialist.
