![]() The consequences of lack of sleep are signficant-especially for children with asthma. 4 For persons with asthma, this period then becomes a sort of “double whammy,” with compounded airflow restriction that can compromise the quality of sleep. During REM periods, respiratory function is normally subdued (tidal volume and functional residual capacity both decline). The other part of the equation is that REM sleep is heaviest during early morning. ![]() Cortisol and corticotropin levels are peaking simultaneously-a response that is most pronounced in persons with nocturnal asthma (compared with both asthmatics and non-asthmatics). The amount of nitric oxide exhaled in the morning is lower in persons who do have asthma than in those who do not. The net result of this is increased bronchoconstriction and airway resistance, occurring in airways that are already inflamed. Flow rates are lower and there is more variation in respiratory function. In asthmatic persons, this pattern is similar but exaggerated. 2 What mechanisms cause sleep disturbance in persons with asthma? In persons who do not have asthma, PEFR and FEV 1 are greatest at night and lowest in the morning. These researchers are not alone: recent data from the Room to Breathe Survey (a global initiative underway in Canada, Greece, Hungary, The Netherlands, the United Kingdom, and South Africa) shows that 59% of 943 children and adolescents who had asthma and were interviewed reported nocturnal awakening. Teodorescu and colleagues, 1 have published numerous studies on sleep disorders in persons with asthma, finding it to be a common issue. Some patients, however, experience disturbing snoring, choking, coughing, and/or breathlessness during sleep. ![]() Patients may notice that they have trouble falling or staying asleep or that they are sleepy during the day. While daytime attacks are obvious, those that occur at night may be more subtle. ![]()
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