How to Sleep with Asthma: Positions and Tips

If you have asthma, you may have noticed that your symptoms are often worse in the evening. Your sleeping position, bedroom temperature, and other bedtime factors can be triggers for asthma.

Nocturnal asthma is common, and up to 75 percent of people with asthma say their symptoms wake them up at least once a week.

The good news is that there are a few steps you can take to sleep safely and comfortably, even if you have asthma. Here are the best sleeping positions for people with asthma, as well as some other strategies to help you sleep soundly.

1. Lie on your back with your shoulders and neck elevated.

Elevating your neck and shoulders with two, three, or more pillows can open your airways while you sleep. If your sinuses drain more during the night, sleeping with pillows under your shoulders gives the drainage a gravity boost, allowing you to breathe easily while you sleep.

2. Lie on your left side with a pillow between your legs.

If you’re a side sleeper with asthma, lying on your left side can help—especially if you suffer from gastroesophageal reflux, also known as heartburn, which can trigger asthma, especially at night. Sleeping on the left side takes advantage of gravity, the shape of the stomach, and the angle of the connection between it and the esophagus.which can reduce reflux. Lying on your left side with your head elevated can be enough to get you through the night comfortably, but if it’s not, experiment by placing a pillow between your legs.

Adding the pillow can keep your spine stable throughout the night and improve your sleeping posture, which can help you breathe easier.

3. Lie on your back with your head elevated and knees bent with a pillow under your knees.

For some people, sleeping on your side is just too much of a change. If you prefer to sleep on your back with pillows supporting your head and shoulders, you can place another pillow under your knees.

This extra pillow can improve blood circulation and keep your body stable throughout the night, preventing you from slipping out of your elevated position while you sleep.

As important as finding a sleeping position that works for you is also important to rule out sleeping positions that could make your asthma symptoms worse.

Sleeping on the right side, also known as the right lateral position, can make asthma symptoms worse. 1990 researchers closed that sleeping on your right side increases resistance in the airways of your lungs as you breathe in and out during the night. This was based on the theory that sleeping on the right side can increase vagal tone, which activates the parasympathetic nervous system, resulting in narrowing of the airways. However, it doesn’t apply to everyone, so asthmatics should experiment to see what works for them.

You may also want to avoid sleeping on your stomach. While some people find stomach sleeping comforting, this position doesn’t allow free flow of air into your lungs while you sleep.

Sleeping flat on your back without the pillows raising behind your neck and shoulders can also make your symptoms worse.

Other ways to reduce asthma symptoms at night include:

  • Reduce allergens in your bedroom. Consider using an air purifier next to your bed and keep your room air circulating throughout the night.
  • Wash your linens in hot water every 1-2 weeks to get rid of dust mites and other irritants that may be on your sheets.
  • Depending on your allergies, consider switching to natural cotton bedding instead of synthetic polyester.
  • Keep pets away from your bed, especially when you are in it.
  • Keep asthma medication on your bedside table or another easily accessible place and take it as directed by your doctor.
  • Set the thermostat in your bedroom a little higher in the evening. Sleeping in a cold environment can be an asthma trigger.

Nocturnal asthma can be common, but there are times when you should discuss the symptoms with a doctor.

If you wake up at night with asthma symptoms more than once a week, you should talk to a doctor, despite treatment. They may need to change your treatment plan.

A doctor may also have other advice on creating a healthy sleep schedule, managing GERD, and minimizing stress to improve sleep quality and minimize nocturnal asthma symptoms.

Changing your sleeping position may not completely eliminate your asthma symptoms. But if you rethink how you sleep—as well as other factors in your sleep environment—you might find a way to significantly reduce the time you spend waking up at night.

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