Not only can severe asthma make it difficult for you to fall asleep, but it can also wake you up in the middle of the night. One survey reported that 45 percent of participants with asthma had difficulty sleeping at least once a week.

Symptoms you may experience at night with severe asthma include coughing, wheezing, and breathlessness. You may also have nocturnal asthma, meaning your symptoms worsen at night.

Other reasons your asthma may get worse at night include:

  • reduced airflow when you lie down
  • mucus may pool in your throat when you lie down
  • your body’s anti-inflammatory defenses decrease when you sleep, resulting in swelling in your lungs and the narrowing of airways
  • allergens in your bedroom
  • other health conditions that worsen your asthma symptoms, including allergic rhinitis, obesity, gastrointestinal reflux, or obstructive sleep apnea

Adjusting your nighttime routine can help you get a better night’s sleep with severe asthma. But the most important factor is to manage your asthma and related health conditions daily.

Here are some tips for sleeping soundly when you live with severe asthma.

Managing your asthma is key to a good night’s sleep. You’re more likely to have sleep disturbances if your asthma isn’t properly managed.

Always follow the treatment plan that your doctor recommends to control your symptoms during the day and night. Your plan may include using a preventer inhaler, avoiding asthma triggers, and taking any other medications. If you use a rescue inhaler more than twice a week, your treatment plan may need adjusting.

It’s important to use an inhaler or other medications at the time of day your doctor recommends. For example, if you use a steroid medication for asthma symptoms, your doctor may recommend taking it earlier in the day to avoid difficulty falling asleep at night.

An uptick in nighttime asthma symptoms may be a sign that your medication isn’t working as it should. Discuss your treatment plan with your doctor. Together, you can determine if your medication is effective over the course of the night and during the day.

Track your treatment plan and record any unexpected symptoms that occur throughout the day or night. Share this information with your doctor if needed.

Ask your doctor about other possible health conditions that may be interfering with your sleep.

For example, you may have obstructive sleep apnea (OSA) if you have asthma. In one study, researchers found that people living with asthma are at a higher risk of developing OSA.

Conditions like OSA can interfere with your sleep. Your doctor can recommend a treatment plan to reduce symptoms related to other health conditions.

Your bedroom could be full of allergens. The following may trigger your asthma symptoms:

  • Your pillows, mattresses, and carpet or rug may contain dust mites.
  • You may have a pet who likes to spend time in your room, and their dander can trigger asthma.
  • Your room could be moist and breeding mold. You may be more at risk for this if you have a bathroom attached to your bedroom. A bathroom is a common area for mold.
  • You use a body care product or fragrance in your bedroom that can trigger your asthma.

To avoid these allergens in your bedroom:

  • Clean it regularly.
  • Keep pets out.
  • Vacuum your carpet or rugs as well as your mattress.
  • Cover your mattress and pillows in dust mite covers.
  • Wash bedding in warm or hot water to kill dust mites.
  • Clean damp areas regularly and open windows if your room is overly humid.
  • Consider replacing any fixtures, items, and even walls if they’re moldy.
  • Avoid using body care products, candles, and household cleaners with fragrances.
  • Clean or replace the filters in your heating and cooling devices, vacuum cleaner, and any other appliances that have a filter.

Make sure you’re ready for a good night’s sleep by practicing good sleep habits.

This may include a nightly routine where you:

  • Power down screen devices well before bedtime.
  • Go to bed at the same time every night.
  • Engage in relaxing activities, like reading, before turning your lights off.

You may be able to avoid reduced airflow during sleep by using another pillow or two. Extra pillows will put the top half of your body at an incline, making it easier to breathe.

Make sure your room is a comfortable, steady temperature for sleep. A room that’s too hot may cause restlessness, and an overly air-conditioned or cold room could trigger your asthma. Your optimal sleeping temperature may be between 60 and 67°F (16 and 19°C).

Moving your body throughout the day can help you get a better night’s sleep. Participate in workouts that don’t trigger your asthma symptoms, though. Try exercises that are low-impact, like yoga, swimming, or cycling.

It’ll be difficult to sleep if you feel stressed and have tons of thoughts racing through your head at night. Try participating in stress-reducing activities like yoga or meditation during the day. Also, avoid going to bed angry or upset.

Make sure your room is dark enough for sleep. You may need blackout shades or curtains to keep light from coming through your windows. Avoid using night-lights or other devices that emit unnecessary light.

Drinking water prior to falling asleep may ease symptoms like a dry throat, which can lead to coughing. Avoid drinking too much before bedtime, so you don’t have to get up and use the bathroom in the middle of the night.

Managing your severe asthma can be the key to a better night’s sleep. If you’re having trouble controlling your asthma, speak with your doctor about making adjustments to your treatment plan.

If you seem to be doing everything right and still have difficulty falling or staying asleep, there are many things you can try. Remove allergens, follow good sleep habits, and adjust your pillows to sleep better with severe asthma.