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Nocturnal Asthma
Chalaywan Pinyochotiwong1, Naricha Chirakalwasan1,2, Nancy Collop3,4
1Excellence Center of Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Asian Pacific Journal of Allergy and Immunology
|June 27, 2021
Summary
Nocturnal asthma affects over half of asthma patients, causing poor sleep and daytime impairment. Managing comorbid conditions like sleep apnea and GERD is key to improving nighttime asthma symptoms.
Area of Science:
- Pulmonology
- Sleep Medicine
- Allergy and Immunology
Background:
- Nocturnal asthma significantly impacts patient quality of life and daytime function.
- Prevalence ranges from 44-61%, indicating a substantial unmet clinical need.
- Current asthma treatments do not always adequately control nighttime symptoms.
Purpose of the Study:
- To review the unique pathophysiology of nocturnal asthma.
- To explore the role of comorbid conditions in nocturnal asthma.
- To discuss management strategies for nocturnal asthma.
Main Methods:
- Literature review of studies on nocturnal asthma.
- Analysis of pathophysiological mechanisms including circadian rhythms and environmental factors.
- Examination of the impact of comorbidities like obstructive sleep apnea and GERD.
Main Results:
- Circadian variations in inflammation, genetic factors (beta 2-adrenergic receptor polymorphism), and pollution contribute to nocturnal asthma.
- Obstructive sleep apnea and gastroesophageal reflux disease are significant comorbidities.
- Continuous positive airway pressure (CPAP) improves nocturnal symptoms in OSA patients; proton-pump inhibitors may benefit GERD patients.
Conclusions:
- Nocturnal asthma requires specific attention due to its prevalence and impact.
- Management should include addressing comorbid conditions alongside standard asthma therapy.
- Targeting comorbidities like OSA and GERD offers a promising therapeutic avenue for nocturnal asthma control.
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