Night time coughing & asthma: are they related?

New Delhi, May 5 (IANS) Asthma is a condition in which there is a narrowing of airways due to swelling of mucosa and also there is increase production of mucus in the airways.
On Asthma Day, Dr Vikas Maurya, Director & Head of Dept. of Pulmonology & Sleep Disorders, Fortis Hospital, Shalimar Bagh talks about night time coughing and if it’s related to asthma.
Asthma causes symptoms such as wheezing (whistling sound from chest), shortness of breath, chest tightness and cough that vary over time in occurrence, frequency and intensity and may be more severe at night.
Night time (nocturnal) cough is seen commonly in asthma but is not limited to asthma only. It can be seen in many other illnesses.

These are:

*Acid reflux, also known as heartburn. It happens when some of the acidic stomach contents go back up into the esophagus and causes cough when it irritates the wind pipe. Common in asthma.
*Post viral (URI) cough, usually seen after common cold or URI, causes severe cough with nighttime symptoms and is due to hypersensitivity of the airways
*Post nasal drip, commonly seen with cold. Mucus secretions from nose drips down behind the nose into throat and irritates the wind pipe and causes cough which is more in lying down position ie sleep
*Smoking, can also cause irritable dry cough along with breathing issues which can be sometime very irritating in the night

The cause of nighttime cough in asthma can be due to following reasons :

*Patient not taking regular medications or it may occur during exacerbations. So it may be a sign of noncompliance with medications or impending asthma attacks.
*Asthma per se can be worse during sleep though exact reasons not known but there are explanations that include increased exposure to allergens, cooling of the airways, being in a reclining position, and hormone secretions that follow a circadian pattern. Sleep itself may even cause changes in bronchial function.
*Cough variant asthma – a type of asthma characterized only by dry cough. Cough can occur both in day and night, but may be severe during night time.
*Acid reflux – also common in asthmatics.
*Allergens in room or on beddings, triggers cough by irritating hypersensitive airway.

Other problems with Nighttime cough:

*Not only results in disturbed sleep but also the following day get disturbed as well.
*Person can’t do the work properly, can’t concentrate and feels irritated throughout the day and the whole quality of life is disturbed.

Important ways to relief from this nocturnal cough are:

Proper treatment of asthma or cough variant asthma
*Sleeping in an propped up position. Post nasal drips and mucus backs up in the throat during the day and irritates windpipe during night and causes cough. Sleeping in this position prevents this to some extent.
*Treating acid reflux. By avoiding food that causes increase acidity, eating few hours before sleep and taking medications if required
*Drinking tea with honey. This soothes the throat, relieves of some congestion on the throat and loosens the mucus and gives symptomatic relief from cough
Humidification of room – 50% humidity with the help of humidifier can result in control of irritable cough by soothing the airways.
*Decrease allergens – by cleaning and getting rid of the dust from the bedroom decreases nighttime cough
Cough suppressants and expectorants can also help in symptomatic relief of cough.
*Use a saline nasal spray – clears nasal passages of the allergens and irritants and of the mucus. This may also decrease post nasal drip. All this helps in decreasing cough.
Dr. Maurya emphasises it is important not to ignore nigh time cough. It is necessary to get it properly diagnosed and treated as asthma is one such disease in which night time symptoms are common. It can be a symptom of worsening of asthma or cough variant asthma or many other illnesses as told earlier. Adequate treatment not only relieves of the condition but also improve the quality of life.

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