5 possible triggers of nocturnal asthma

Asthma and Allergy Foundation of America

LearnLungsA guide to managing asthma as an adult5 possible triggers of nocturnal asthma
Asthma and Allergy Foundation of America

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  • Allergies
  • Reflux
  • Cold Air
  • Hormonal Changes
  • Sleep Apnea

If you battle your worst asthma symptoms at night, you could have nocturnal asthma, also called nighttime asthma. As the name implies, this is when asthma strikes at night, interrupting sleep. These symptoms can negatively impact a person’s quality of life in a number of ways, from hindering performance at work and school, to needing to visit a healthcare provider more frequently, to increased irritability, anxiety and numerous health risks associated with getting too little sleep.

There's usually not one specific trigger that causes nocturnal asthma. If you're struggling with symptoms of a sleep disorder or nocturnal asthma, it is important to work with your healthcare provider to identify the specific causes and determine how best to address your symptoms so you can get the rest you need.

In the meantime, here are some potential causes of nocturnal asthma and what you can do about them.

Allergies

Allergy triggers that exist in your bedroom can lead to a nighttime asthma attack. These include dust mites, mold, pet dander and seasonal allergens that become trapped in your clothing, bedding and hair. Studies also show that if you're exposed to an allergen before bed, there's a good chance that you could experience a delayed second response at night. So do what you can to allergy-proof your home and avoid triggers throughout the day.

Reflux

Gastroesophageal reflux disease (GERD) is twice as common among asthma patients, though the exact relationship between the two conditions is still unclear. However, there is also a known association between GERD and sleep disturbances. If you’ve been diagnosed with GERD, or are experiencing acid-reflux (better known as heartburn), you should discuss these symptoms with your healthcare provider.

Cold Air

While air-conditioning is often recommended to asthma patients as a way to regulate temps and reduce airborne allergens, cold, dry air is known to aggravate asthma symptoms, and air-conditioning has been reported as a trigger for asthma attacks. If your bedroom room is very cold in the winter or air-conditioned in the summer, the cold air could aggravate your airways and make asthma symptoms worse. Make adjustments to the air temperature as needed to head off any breathing issues.

Hormonal Changes

Hormonal changes that commonly occur while you sleep can increase your risk of experiencing nocturnal asthma. Epinephrine keeps your airways open and prevents airway spasms and excessive mucus reproduction. So, if this hormone drops at night, you could be more vulnerable to having an attack. You may be instructed to take your asthma medications before bedtime to help prevent this effect.

Sleep Apnea

Obstructive sleep apnea is a serious condition that causes a brief lapse in breathing and sometimes occurs in conjunction with asthma. If your healthcare provider suspects you have this problem, it's important to undergo testing to confirm the diagnosis so you can get proper treatment.

Written by Lisa D. Ellis.
Medically reviewed by Ann Wendling, MD, MPH.August, 2025
Updated onOctober, 2026
Asthma and Allergy Foundation of America

Partner resources

Patient and Caregiver SupportDrug and Financial Assistance ProgramsAsthma and Allergy Podcast
Written by Lisa D. Ellis.
Medically reviewed by Ann Wendling, MD, MPH.August, 2025
Updated onOctober, 2026
  • Allergies
  • Reflux
  • Cold Air
  • Hormonal Changes
  • Sleep Apnea

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