Advertisement

Sleep and Asthma

  • M. F. Fitzpatrick
  • C. M. Shapiro
  • N. J. Douglas
Conference paper

Abstract

At least 70% of asthmatic patients are woken from time to time by coughing, wheezing and breathlessness at night [1, 2]. The presence of nocturnal symptoms in patients with asthma denotes poor asthma control, and the concomitant overnight fall in peak flow correlates well with asthma severity [3]. It is important to enquire specifically about nocturnal symptoms in patients with asthma as many patients overlook these symptoms [4]. Epidemiological surveys suggest that the prevalence of nocturnal symptoms is as common in asthmatic patients attending general practitioners in the community as those attending hospital clinics [1, 4].

Keywords

Continuous Positive Airway Pressure Asthmatic Patient Peak Expiratory Flow Rate Ipratropium Bromide Mucociliary Clearance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Turner-Warwick M (1984) The definition and recognition of nocturnal asthma. In: Barnes PJ, Levy J (eds) Nocturnal asthma (Symposium 73 ). Royal Society of Medicine, London, pp 3–5Google Scholar
  2. 2.
    Connolly CK (1979) Diurnal rhythms in airway obstruction. Br J Dis Chest 73: 357–366PubMedCrossRefGoogle Scholar
  3. 3.
    Bellia V (1988) Validation of morning dip as indication of astma severity. Chest 94 (1):108— 110CrossRefGoogle Scholar
  4. 4.
    Turner-Warwick M (1988) Epidemiology of nocturnal asthma. Am J Med 85 (Suppl lB): 6–8PubMedCrossRefGoogle Scholar
  5. 5.
    Lewinsohn HC, Capel LH, Smart J (1960) Changes in forced expiratory volume throughout the day. Br Med J 1: 462–464PubMedCrossRefGoogle Scholar
  6. 6.
    Hetzel MR, Clark TJH (1980) Comparison of normal and asthmatic circadian rhythms in peak expiratory flow rate. Thorax 35: 732–738PubMedCrossRefGoogle Scholar
  7. 7.
    Kerr HD (1973) Diurnal variation of respiratory function independent of air quality. Arch Environ Health 26: 144–153PubMedGoogle Scholar
  8. 8.
    Ryan G, Latimer KM, Dolovich J, Hargreave FE (1982) Bronchial responsiveness to histamine: relationship to diurnal variation of peak flow rate, improvement after bronchodilator, and airway calibre. Thorax 37: 423–429PubMedCrossRefGoogle Scholar
  9. 9.
    Davies RJ, Green M, Schofield NM (1976) Recurrent nocturnal asthma after exposure to grain dust. Am Rev Respir Dis 114: 1011–1019PubMedGoogle Scholar
  10. 10.
    Platts-Mills TAE, Mitchell EB, Nock P, Tovey ER, Noszoro H, Wilkins SR (1982) Reduction of bronchial hyperreactivity during prolonged allergen avoidance. Lancet 11: 675–677CrossRefGoogle Scholar
  11. 11.
    Reinberg A, Ghata J, Sidi E (1963) Nocturnal asthma attacks: their relationship to the circadian adrenal cycle. J Allergy 34: 323–330PubMedCrossRefGoogle Scholar
  12. 12.
    Soutar CA, Carruthers M, Pickering CAC (1975) Nocturnal and morning asthma. Thorax 30: 436–440PubMedCrossRefGoogle Scholar
  13. 13.
    Clark TJH, Hetzel MR (1977) Diurnal variation of asthma. Br J Dis Chest 71: 87–92PubMedCrossRefGoogle Scholar
  14. 14.
    Soutar CA, Carruthers M, Pickering CAC (1977) Nocturnal asthma and urinary adrenaline and noradrenaline excretion. Thorax 32: 677–683PubMedCrossRefGoogle Scholar
  15. 15.
    Morice A, Sever P, Ind P (1986) Adrenaline, bronchoconstriction and asthma. Br Med J 293: 539–540CrossRefGoogle Scholar
  16. 16.
    Fairfax AJ (1984) The role of beta-adrenoreceptor agonists in the treatment of nocturnal asthma. In: Barnes PJ, Levy J (eds) Nocturnal asthma (Symposium 73 ). Royal Society of Medicine, London, pp 89–100Google Scholar
  17. 17.
    Fairfax AJ, McNabb WR, Davies HJ et al. (1980) Slow-release oral salbutamol and aminophylline in nocturnal asthma: relation of overnight changes in lung function and plasma drug levels. Thorax 35: 526–530PubMedCrossRefGoogle Scholar
  18. 18.
    Milledge JS, Morris J (1979) A comparison of slow-release salbutamol with slow-release aminophylline in nocturnal asthma. J Int Med Res 7 (Suppl 1): 106–110PubMedGoogle Scholar
  19. 19.
    Baust W, Bohnert B (1969) The regulation of heart rate during sleep. Exp Brain Res 7: 169–180PubMedCrossRefGoogle Scholar
  20. 20.
    Morrison JFJ, Pearson SB, Dean HG (1988) Parasympathetic nervous system in nocturnal asthma. Br Med J 296: 1427–1429CrossRefGoogle Scholar
  21. 21.
    Gelder CM, Hubble D, Hetzel MR (1988) Parasympathetic nervous system in nocturnal asthma (letter). Br Med J 297: 424CrossRefGoogle Scholar
  22. 22.
    Catterall JR, Rhind GB, Whyte KF, Shapiro CM, Douglas NJ (1988) Is nocturnal asthma caused by changes in airway cholinergic activity? Thorax 43: 720–724PubMedCrossRefGoogle Scholar
  23. 23.
    Barnes PJ (1989) Muscarinic receptor subtypes: implications for lung disease. Thorax 44 (3): 161 — 167PubMedCrossRefGoogle Scholar
  24. 24.
    Sertl K, Meryn S, Graninger W, Laggner A, Schlick W, Rameis H (1986) Acute effects of pirenzipine on bronchospasm. Int J Clin Pharmacol Ther Toxicol 24 (12): 655–657PubMedGoogle Scholar
  25. 25.
    Cazzola M, Russo S, De Santis D, Principe P, Marmo E (1987) Respiratory responses to pirenzipine in healthy subjects. Int J Clin Pharmacol Ther Toxicol 25 (2): 105–109PubMedGoogle Scholar
  26. 26.
    Morrison JFJ, Hathaway TJ, Clelland CA, Scott JP, Wallwork J, Higgenbottam TW (1989) Diurnal variation in FEV1 following heart-lung transplantation ( Abstr ). Thorax 44: 323Google Scholar
  27. 27.
    Jonsson E, Mossberg B (1984) Impairment of ventilatory function by supine posture in asthma. Eur J Respir Dis 65: 496–503PubMedGoogle Scholar
  28. 28.
    Whyte KF, Douglas NJ (1989) Posture and nocturnal asthma. Thorax 44: 579–581PubMedCrossRefGoogle Scholar
  29. 29.
    Wilson NM, Charette L, Thomson AH, Silverman M (1985) Gastro-oesophageal reflux and childhood asthma: the acid test. Thorax 40: 592–597PubMedCrossRefGoogle Scholar
  30. 30.
    Davis RS, Larsen GL, Grunstein MM (1983) Respiratory response to intraesophageal acid infusion in asthmatic children during sleep. J Allergy Clin Immunol 72: 393–398PubMedCrossRefGoogle Scholar
  31. 31.
    Nagel RA, Brown P, Perks WH, Wilson RSE, Kerr JD (1988) Ambulatory pH monitoring of gastroesophageal reflux in “morning dipper” asthmatics. Br Med J 297: 1371–1373CrossRefGoogle Scholar
  32. 32.
    Hughes DM, Spier S, Rivlin J, Legvinson J (1983) Gastroesophageal reflux during sleep in asthmatic patients. J Paediatr 102: 666–672CrossRefGoogle Scholar
  33. 33.
    Goodall RJR, Earis JE, Cooper DN, Bernstein A, Temple JG (1981) Relationship between asthma and gastroesophageal reflux. Thorax 36: 116–121PubMedCrossRefGoogle Scholar
  34. 34.
    Ekstrom T, Lindgren BR, Tibbling L (1989) Effects of ranitidine treatment on patients with asthma and a history of gastroesophageal reflux: a double-blind crossover study. Thorax 44 (1): 19–23PubMedCrossRefGoogle Scholar
  35. 35.
    Deal EC, McFadden ER, Ingram RH, Strauss RH, Jaeger JJ (1979) Sole of respiratory heat exchange in production of exercise-induced asthma. J Appl Physiol 46: 467–475PubMedGoogle Scholar
  36. 36.
    Chen WY, Chai H (1982) Airway cooling and nocturnal asthma. Chest 81: 675–680PubMedCrossRefGoogle Scholar
  37. 37.
    Catterall JR, Rhind GB, Stewart IC, Whyte KF, Shapiro CM, Douglas NJ (1986) Effect of sleep deprivation on overnight bronchoconstriction in nocturnal asthma. Thorax 41: 676–680PubMedCrossRefGoogle Scholar
  38. 38.
    Pavia D (1984) Mucociliary clearance at night: effect of physical activity, posture, and circadian rhythm. In: Barnes PJ, Levy J (eds) Nocturnal asthma (Symposium 73 ). Royal College of Medicine, London, pp 29–38Google Scholar
  39. 39.
    Bateman JRM, Pavia D, Clarke SW (1978) The retention of lung secretions during the night in normal subjects. Clin Sci 55: 523–527Google Scholar
  40. 40.
    Reinberg A, Gervais P (1972) Circadian rhythms in respiratory functions, with special reference to human chronophysioiogy and chronopharmacology. Bull Physiopathol Respir 8: 663–675Google Scholar
  41. 41.
    Floyer J (1698) A treatise of the asthma. Wilkins, Innis, LondonGoogle Scholar
  42. 42.
    Reinberg A (ed) (1979) Chronobiological field studies of oil refinery shift workers. Chronobiologia 6 (Suppl 1): 1–119Google Scholar
  43. 43.
    Halberg F, Reinberg A (1979) Chronobiological serial section circadian rhythm adjustment following transmarian flight and life in novel environment. Waking Sleeping 1: 259–279Google Scholar
  44. 44.
    Kales A, Beall GN, Bajor GF, Jacobson A, Kales JD (1968) Sleep studies in asthmatic adults: relationship of attacks to sleep stage and time of night. J Allergy 41: 164–173PubMedCrossRefGoogle Scholar
  45. 45.
    Kales A, Kales JD, Sly RM, Scharf MB, Tan TL, Preaton TA (1970) Sleep patterns of asthmatic children: all night EEG studies. J Allergy 46: 300–308PubMedCrossRefGoogle Scholar
  46. 46.
    Montplaisir J, Walsh J, Malo JL (1982) Nocturnal asthma: features of attacks, sleep and breathing patterns. Am Rev Respir Dis 125: 18–22PubMedGoogle Scholar
  47. 47.
    Gugger M, Molloy J, Gould GA, Whyte KF, Raab GM, Shapiro CM, Douglas NJ (1989) Ventilatory and arousal responses to added inspiratory resistance during sleep. Am Rev Respir Dis 140: 1301–1307PubMedCrossRefGoogle Scholar
  48. 48.
    Shapiro CM, Catterall JR, Montgomery I, Raab GM, Douglas NJ (1986) Do asthmatics suffer bronchoconstriction during rapid eye movement sleep? Br Med J 292: 1161–1164CrossRefGoogle Scholar
  49. 49.
    Bellia V, Ferrara G, Insalaco G, Visconti A, Bonsignore G (1989) Nocturnal asthma is not related to specific stages of sleep ( Abstr ). Am Rev Respir Dis 140: 363–367PubMedCrossRefGoogle Scholar
  50. 50.
    Bellia V, Bonsignore G (1987) The significance and physiological mechanisms producing “morning dipping” in asthmatics. Bull Eur Physiopathol Respir 23 (5): 538–539PubMedGoogle Scholar
  51. 51.
    Morgan AD, Rhind GB, Connaughton JJ, Catterall JR, Shapiro CM, Douglas NJ (1987) Breathing patterns during sleep in patients with nocturnal asthma. Thorax 42: 600–603PubMedCrossRefGoogle Scholar
  52. 52.
    Baughman RP, Loudon RG (1988) The utility of a long-acting sympathomimetic agent, procaterol, for nocturnal asthma. Chest 93 (2): 285–288PubMedCrossRefGoogle Scholar
  53. 53.
    Hudgel DW, Hendricks C (1988) Palate and hypopharynx - sites of inspiratory narrowing of the upper airway during sleep. Am Rev Respir Dis 138: 1542 - 1547PubMedCrossRefGoogle Scholar
  54. 54.
    Chan CS, Woolcock AJ, Sullivan CE (1988) Nocturnal asthma: role of snoring and obstructive sleep apnoea. Am Rev Respir Dis 137: 1502–1504PubMedGoogle Scholar
  55. 55.
    Guilleminault C, Quera-Salva MA, Powell N, Reilly R, Romaker A, Partinen M, Baldwin R, Nino-Murcia G (1988) Nocturnal asthma: snoring, small pharynx and nasal CPAP. Eur Respir J 1: 902–907PubMedGoogle Scholar
  56. 56.
    Smolensky M, Halberg H, Sargent F (1972) chronobiology of the life sequence. In: Itoh S, Ogata K, Yoshimura H (eds) Advances in climatic physiology. Springer, Berlin Heidelberg New York, pp 281–318Google Scholar
  57. 57.
    Mitler MM, Hajdukovic RM, Shafor R, Hahn PM, Kripke DF (1987) When people die: cause of death versus time of death. Am J Med 82: 266–274PubMedCrossRefGoogle Scholar
  58. 58.
    Douglas NJ (1985) Asthma at night. Clin Chest Med 6: 663–674PubMedGoogle Scholar
  59. 59.
    Cochrane GM (1984) Asthma deaths at night. In: Barnes PJ, Levy J (eds) Nocturnal asthma (Symposium 73 ). Royal Soc Med, London, pp 11–15Google Scholar
  60. 60.
    Hetzel MR, Clark TJH, Braithwaite MA (1977) Asthma: analysis of sudden deaths and ventilatory arrests in hospital. Br Med J 1: 808–811PubMedCrossRefGoogle Scholar
  61. 61.
    Benatar SR, Ainslie GM (1986) Deaths from asthma in Capetown, 1980–1982. S Afr Med J 69: 669–671PubMedGoogle Scholar
  62. 62.
    Douglas NJ, White DP, Weil JV etal. (1982) Hypoxic ventilatory response decreases during sleep in normal man. Am Rev Respir Dis 125: 286–289PubMedGoogle Scholar
  63. 63.
    Douglas NJ, White DP, Weil JV etal. (1982) Hypercapnic ventilatory response in sleeping adults. Am Rev Respir Dis 126: 758–762PubMedGoogle Scholar
  64. 64.
    Catterall JR, Douglas NJ, Calverly PMA, Brash HM, Brezinova V, Shapiro CM, Flenley DC (1982) Irregular breathing and hypoxaemia during sleep in chronic stable asthma. Lancet 1: 301–304PubMedCrossRefGoogle Scholar
  65. 65.
    Dunleavy RA, Baade LE (1980) Neuropsychological correlates of severe asthma in children 9-14 years old. J Consult Clin Psychol 48 (2): 214–219PubMedCrossRefGoogle Scholar
  66. 66.
    Springer C, Goldenberg B, Ben Dov I, Godfrey S (1985) Clinical, physiologic, and psychologic comparison of treatment by cromolyn or theophylline in childhood asthma. J Allergy Clin Immunol 76: 64–69PubMedCrossRefGoogle Scholar
  67. 67.
    Rachelefsky GS, Wo J, Adelson J, Mickey MR, Spector SL, Katz RM, Siegel SC, Rohr AS (1986) Behaviour abnormalities and poor school performance due to oral theophylline use. Paediatrics 78: 1133–1138Google Scholar
  68. 68.
    Furukawa CT, Shapiro GG, Bierman W, Kraemer MJ, Ward DJ, Pierson WE (1984) A double blind study comparing the effectiveness of cromolyn sodium and sustained- release theophyline in childhood asthma. Paediatrics 74: 453–459Google Scholar
  69. 69.
    Hetzel MR, Clarke TJH, Gillem ST, Issac P, Perkins M (1985) Is sodium chromoglycate effective in nocturnal asthma? Thorax 40: 793–794PubMedCrossRefGoogle Scholar
  70. 70.
    Morgan AD, Connaughton JJ, Catterall JR, Shapiro CM, Douglas NJ, Flenley DC (1986) Sodium chromoglycate in nocturnal asthma. Thorax 41: 39–41PubMedCrossRefGoogle Scholar
  71. 71.
    Rhind GB, Connaughton JJ, McFie J, Douglas NJ, Flenley Dc (1985) Sustained release choline theophyllinate in nocturnal asthma. Br Med J 291: 1605–1607CrossRefGoogle Scholar
  72. 72.
    Stewart IC, Rhind GB, Power JT, Flenley DC, Douglas NJ (1987) Effects of sustained release terbutaline on symptoms and sleep quality in patients with noctural asthma. Thorax 42: 797–800PubMedCrossRefGoogle Scholar
  73. 73.
    Ullman A, Svedmyr N (1988) Salmeterol, a new long acting inhaled beta adrenoceptor agonist: comparison with salbutamol in adult asthmatic patients. Thorax 43: 674–678PubMedCrossRefGoogle Scholar
  74. 74.
    O’Driscoll BRC, Ruffles SP, Ayres JG, Cochrane GM (1988) Long-term treatment of severe asthma with subcutaneous terbutaline. Br J Dis Chest 82: 360–367PubMedCrossRefGoogle Scholar
  75. 75.
    Mullarkey MF, Blumenstein BA, Andrade WP, Bailey GA, Olason I, Wetzel CE (1988) Methotrexate in the treatment of corticosteroid dependent asthma: a double blind crossover study. N Engl J Med 318: 603–607PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • M. F. Fitzpatrick
  • C. M. Shapiro
  • N. J. Douglas
    • 1
  1. 1.Kennedy Tower,Royal Edinburg HospitalUniversity Departments of Pyschiatry and Respiratory MedicineEdinburghUK

Personalised recommendations