Why asthmatic patients should not sleep in the right lateral decubitus position

The topographical points affecting nasal resistance include the shoulders, upper thorax and buttocks, and we have demonstrated that vagal tone increases with right-sided pressure and decreases with left. We would therefore strongly recommend that asthmatic patients should avoid sleeping in the right lateral decubitus position. It would be interesting to speculate on a number of ramifications ensuing from the presence of increased vagal tone in asthmatic patients. If present, atrophic rhinitis, nasal polyps, and septal deviation may possibly affect incidence of asthma depending upon its presentation in the left or right nasal turbinate. We suggest that there should be increased incidence of right septal deviation and increased incidence of right turbinate nasal polyps in patients presenting with asthma. Patients with asthma may possibly have certain nasal cycle patterns that could easily be measured using Podoshin plates. Finally, our animal model of forced unilateral nostril breathing may explain certain facets of asthma.