People with asthma may find their symptoms worsen when they sleep. Certain sleep positions may help reduce asthma symptoms and improve sleep quality in those with this condition.

Doctors refer to asthma attacks that occur while sleeping as nocturnal asthma. Nocturnal asthma can cause coughing and make people wake up, disrupting their sleep. However, resting, trying certain sleep positions, and reducing the allergens in the bedroom can help lower the frequency of nocturnal asthma attacks.

This article will review the sleeping positions that may benefit those with nocturnal asthma. It will also discuss some tips that may reduce the risk of asthma attacks and when someone should consult a doctor.

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Nocturnal asthma is common. Between 44% and 61% of people with asthma experience nocturnal symptoms at least once a week. Symptoms such as coughing can make sleeping difficult.

Different sleep positions may improve nocturnal asthma symptoms and improve sleep quality. Some positions to try include the following.

Sleep on the left side with a pillow between the legs

Sleeping on the left side may reduce the symptoms of gastroesophageal reflux, a common trigger of nocturnal asthma. Due to gravity and the shape of the connection between the stomach and the esophagus, sleeping on the left side may help relieve acid reflux. The esophagus refers to the food pipe.

Placing a pillow between the legs can also provide more comfort and stability to the spine.

While no medical evidence suggests that sleeping on one side is better, some people may wish to try it.

Read more about which side to sleep on.

Sleep on the back with the shoulders and neck elevated

Elevating the neck and shoulders with pillows while resting on the back can help open the airways during sleep and reduce the risk of nocturnal asthma attacks.

Sleeping in this position can also help prevent postnasal drip — where mucus buildups in the back of the throat — and coughing. This is likely because gravity helps keep the airways clean and makes breathing easier.

Sleep on the back with the head elevated and a pillow under the knees

Propping the head and shoulders when resting on the back can help open the airways. Adding a pillow under the knees can make it more comfortable and help someone stay in that position. This helps prevent their body from slowly sliding down from the elevated position during sleep.

Alongside trying a different sleeping position, people can take several steps that may help:

  • reduce the risk of nocturnal asthma attacks
  • relieve asthma symptoms
  • improve sleep quality

People can try the following measures.

Remove allergens from the bedroom

Dust, dust mites, and other allergens can sit in the bedroom. Taking measures, such as dusting and vacuuming the bedroom frequently, can help reduce exposure and risk of asthma attacks at night.

People should also wash their bedding at least once a week to remove allergens and kill bacteria that may live on them, preventing infections and allergic reactions.

Use dust-proof mattress covers and pillows

This can prevent dust mites from living and breeding inside pillows and mattress covers. Having fewer dust mites in bedding can help prevent them from entering a person’s airways during sleep.

Read more about dust mite allergies.

Remove damp and mold

Damp and mold can irritate the airways. Removing these allergens from the bedroom can reduce the risk of nocturnal asthma.

Read more about getting rid of mold in the home.

Use a humidifier and an air purifier

Allergens and dry air can irritate the airways and trigger an asthma attack. Air purifiers can reduce the number of allergens in the air, while humidifiers keep the air from getting too dry. This can prevent airway irritation and lower the risk of nocturnal asthma.

Read more about air purifiers for asthma.

Keep windows closed throughout the night

Opening the windows may allow allergens — such as pollen and dust — into the bedroom. This may increase the risk of triggering asthma during the night. Keeping windows closed can help reduce exposure to asthma-causing allergens.

Keep pets out of the bedroom

Pet dander can trigger asthma and irritate the airways. Keeping pets away from the bedroom can significantly reduce the quantity of this allergen in someone’s bedroom, reducing the risk of irritation that may otherwise occur overnight.

Read more about the link between cats and asthma.

If someone experiences nocturnal asthma more than once a week, they need to consult a doctor.

Frequent nocturnal asthma episodes may indicate that someone’s condition is becoming more serious or progressing to a more advanced stage. Doctors can perform relevant exams to diagnose the severity of the asthma and recommend the most appropriate treatment.

Here are answers to common questions about sleeping with asthma:

How can someone calm an asthma cough at night?

Doing breathing exercises, sipping water, and using an inhaler may help calm asthma cough at night.

Why is asthma worse at night and in the morning?

During the night, people may breathe cold, dry air, which can irritate the airways and trigger asthma.

Certain allergens in the bedroom or having other health conditions, such as gastroesophageal reflux, may also worsen asthma at night.

What is the best position to sleep in with breathing problems?

Sleeping on the back with the head and shoulders raised with pillows is the best position for those with breathing problems. This is because it promotes the opening of the airways.

Several sleep positions may help people improve nocturnal asthma. However, changing sleep positions may not treat asthma symptoms completely. Keeping the bedroom clean and free from allergens can also significantly help reduce the risk of airway irritation and asthma attacks.