Why uncontrolled asthma can cause sleep problems in children

Sleep is a time to rest and replenish. Unfortunately, sleep is often considered a luxury these days, as there are so many activities that disrupt our sleep: that new TV show, one last peek at Facebook, a cool picture on Pinterest … wait, is that a video of a cat playing piano?

But some children often have health issues that disrupt their sleep. The Centers for Disease Control and Prevention estimates that about 1 in every 10 children has asthma. Children with asthma that is not well controlled often have symptoms when they’re trying to sleep — coughing, wheezing, shortness of breath.

Doctors believe there is a physiologic reason why asthma symptoms get worse at night. Our airways seem to get smaller at night (there’s more resistance to airflow). For a person without asthma, that may not mean much, but for children with asthma, that can make it much harder for them to breathe. In addition, our body’s natural immune system is less active at night, causing allergens (e.g., dust mites) to be more of a problem.

What parents need to know

Children with asthma can have poorer quality of sleep. The intermittent coughing causes arousals and awakenings throughout the night so that the child does not feel refreshed and well rested in the morning. Studies have shown that children with nighttime asthma have more difficulties in school.

The National Heart, Lung, and Blood Institute has created guidelines to help determine if a child’s asthma is well-controlled or not. Children with well-controlled asthma have nighttime symptoms less than twice per month. Children with not well-controlled asthma have symptoms up to three times per week, and children with very poorly controlled asthma have nightly symptoms.

Talk to your child’s doctor if you are worried your child is having asthma symptoms at night. Sometimes, simple changes in medications, decreasing allergen exposure, or improvement of other health issues like acid reflux can significantly improve your child’s breathing during sleep.

Oh, and that last update on Facebook? It can wait for tomorrow morning.

Lynn D’Andrea, MD Medical Director Pulmonary Services

The Pulmonary Medicine Program at Children's Wisconsin is recognized as one of the nation's best by U.S. News & World Report and includes Wisconsin's only pediatric sleep center accredited by the American Academy of Sleep Medicine. The pulmonary clinics at Children's Wisconsin welcome children with a wide range of breathing and sleep problems, ranging from asthma to extremely complicated conditions.