Sleep Apnea and Night-time Asthma: Knowing the Difference

If you or your partner has suffered from mild sleep apnea, you may have pursued a remedy at home. You might have investigated  at increased exercise, stricter diets, oral appliances, and upright sleeping positions that help relieve the apnea. It’s possible, however, that these steps have done you no good. You or your partner may continue to suffer from frequent awakenings, daytime sleepiness, or the mood-swings that indicate a disrupted sleep cycle. You may even notice difficulty breathing at night, one of the most common calling cards of sleep apnea. But if addressing the apnea isn’t working, what could it be?

One possibility is night-time asthma. While it might sound strange to somebody who doesn’t suffer from asthmatic symptoms during the day, there many factors related to sleep that can increase the incidence of asthmatic symptoms. One particularly common factor is acid-reflux disease, or GERD. In addition to changes in the airway that result directly from sleep, GERD can cause inflammation of the airways that lead to coughing, wheezing, and difficulty breathing at night. Often, this is interpreted as a subset of snoring, which accompanies sleep apnea, but night-time asthma is a very different problem.

One way to distinguish the two is to make certain that there are no – or very few – apneic events, or times when the sleeper stops breathing entirely. These two disorders are not mutually exclusive – you can have both! – but night-time asthma is marked by more wheezing, coughing, or difficulties experienced during inhalation and exhalation. It is not usually marked by total stops.

Though night-time asthma carries many of the same risks as most sleep disorders (obesity, heart disease, neurological disease), its treatment pattern is very different. Instead of relying on a CPAP machine, sufferers are likely to receive courses of night-time medicines to help ease the inflammation of the airways and support restorative sleep. This means that if you or your partner haven’t found any relief in the form of addressing sleep apnea, setting up a sleep evaluation to test for sleep asthma could be the first step to improving your long-term health!