Losing Sleep Over Asthma or COPD?

Losing Sleep Over Asthma or COPD?

Good quality sleep is important for everyone. People with asthma or those who have chronic obstructive pulmonary disease (COPD) may have sleep issues that can lead to nighttime awakenings and daytime sleepiness. This may worsen their symptoms of asthma or COPD. However, there are several steps people with asthma or with COPD can take to improve their sleep. Keep reading for answers to your questions about how asthma and COPD can affect your sleep and what you can do about it.

What kind of night disturbances can I get with asthma or COPD?

Waking up at night, also called nighttime arousals or nighttime awakenings, can happen if you have asthma or COPD. These arousals interrupt your sleep and may result in feeling groggy in the morning, tired during the day, or even both. Symptoms of COPD and asthma that may cause you to wake up at night include coughing, wheezing, breathlessness, nasal congestion, and heartburn. People with COPD or asthma may also be at increased risk for obstructive sleep apnea and may awaken from symptoms of this sleep problem.

People with asthma or COPD who have a frequent problem with waking up at night often have worse respiratory disease.

What is sleep apnea and why can I get sleep apnea with both asthma and COPD?

Sleep apnea is a condition that causes you to snore and 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 and those with 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.

How do sleep problems affect my asthma or my COPD?

People with asthma or COPD who have a frequent problem with 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, increase your risk for exacerbations, and reduce your survival. Sleep apnea can be a serious condition by itself. People who have moderate to severe sleep apnea that is not treated are at higher risk for hypertension, heart disease, and stroke. 


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. Talk to your healthcare provider to review your disease control, see that you are getting the right medical treatment, and make a plan of things you can do to control your asthma or COPD. Your healthcare provider will instruct you on when to use your rescue inhaler and how to use breathing techniques, like pursed lip breathing, should you experience any sudden breathlessness. Also, talk to your healthcare provider if you have problems with regular nasal congestion or heartburn, to get them under better control. If you smoke, quitting smoking will not only help your asthma or COPD control, but also improve the quality of your sleep. Tell your healthcare provider if you think you may have sleep apnea so that you can be evaluated. Sleep apnea is a treatable condition.

Take Action!

If you have asthma and/or COPD, you may be at increased risk for sleep problems. 

Talk to your healthcare provider if you

  • Have more frequent asthma or COPD symptoms and are not sleeping well
  • Have conditions that can make sleeping and disease control worse, such as being overweight, nasal congestion, or regular heartburn
  • Are sleepy during the day, even after you have slept all night
  • Snore, make choking noises, or have breathing pauses during sleep, as you may have obstructive sleep apnea
  • Wake up in the morning with headaches
  1. If you smoke, quit.
  2. Follow good sleep practices.
  3. Work with your healthcare team to keep your lung disease in good control.

Reprinted with permission from the ATS Patient Information Series handout “Sleep Problems in Asthma and COPD,” © American Thoracic Society, thoracic.org

This article was published in Coping© with Allergies & Asthma magazine, Fall/Winter 2019-2020.