How Asthma and COPD Can Affect Your Sleep
And What You Can Do about It
by Jay Balachandran, MD, and Mihaela Teodorescu, MD
Good quality sleep is important for everyone. However, people with asthma or chronic obstructive pulmonary disease may have sleep issues that can lead to nighttime awakenings and daytime sleepiness. This can worsen their symptoms of asthma or COPD. Fortunately, there are a number of steps people with asthma or COPD can take to improve their sleep.
What kind of night disturbances might I experience with asthma or COPD?
Waking up at night, also called nighttime arousal or nighttime awakening, can happen if you have asthma or COPD. These arousals interrupt your sleep and may cause you to feel groggy in the morning or tired during the day. Symptoms of COPD and asthma that may cause you to wake up at night include coughing, wheezing, chest tightness, and breathlessness. People with COPD or asthma may also be at increased risk for sleep apnea and may awaken from symptoms of this sleep problem.
What is sleep apnea? Why can I experience sleep apnea with asthma or COPD?
Sleep apnea is a condition that causes you to have periods when you stop breathing during sleep. These pauses in breathing usually last 10 seconds or longer. It is not clear why sleep apnea may occur more often in people with asthma or COPD, but you are more at risk if you have severe asthma, are overweight, have nasal congestion, experience acid reflux, or use high doses of inhaled corticosteroids.
The first step to sleeping better is to make sure that your asthma or COPD is under good control.
How do sleep problems affect my asthma or COPD?
People with asthma or COPD who have a frequent problem waking up at night often have worse respiratory disease. They are also at risk for complications from their asthma or COPD. Sleep apnea can worsen asthma symptoms throughout the day, increase your need for rescue inhalers, and worsen your quality of life. If you have COPD, the pauses in your breathing and low oxygen levels with sleep apnea can make your COPD worse and can be life threatening. Moreover, sleep apnea can be a serious condition by itself. People with moderate to severe sleep apnea who do not get treatment have an increased risk for hypertension, heart disease, and stroke.
If you have asthma or COPD, you may be at increased risk for sleep apnea if ...
♦ You have more frequent asthma or COPD symptoms, are overweight, smoke, experience
nasal problems or heartburn,
or use higher doses of inhaled corticosteroids
♦ You are sleepy during the day, even after you have slept all night
♦ You snore or make choking noises while you sleep
♦ You have been heard having breathing pauses during sleep
♦ You wake up in the morning with headaches
What can I do to help myself sleep better?
The first step is to make sure that your asthma or COPD is under good control. Your healthcare provider can evaluate your condition to ensure that you are getting the right medical treatment and then develop a series of steps you can take to control your asthma or COPD and guide you through an episode of sudden breathlessness. He or she will also instruct you on when to use your rescue inhaler or pursed-lip breathing technique and give you a set of questions to ask yourself about your condition should you experience any sudden breathlessness.
Also, be sure to tell your healthcare provider if you have nasal congestion or experience heartburn so you can learn how to get them under better control. If you smoke, quitting smoking will not only help your asthma or COPD control, but the quality of your sleep will also improve. Sleep apnea is treatable, so tell your healthcare provider if you think you may have this condition so you can be evaluated.
Dr. Jay Balachandran is assistant professor of medicine and associate director of the Sleep Medicine Fellowship Program at the University of Chicago Medicine in Chicago, IL. He specializes in pulmonary, critical care, and sleep medicine. Dr. Mihaela Teodorescu is an associate professor of medicine who specializes in pulmonary, critical care, and sleep medicine at the University of Wisconsin School of Medicine and Public Health in Madison, WI.
Reprinted by permission of the American Thoracic Society from the American Journal of Respiratory and Critical Care Medicine, copyright © 2014 American Thoracic Society, thoracic.org.
This article was originally published in Coping® with Allergies & Asthma magazine, Spring/Summer 2014.