Overview
Asthma is the most common chronic illness in children  worldwide. It occurs when the airways become inflamed, causing the  muscles around the bronchial tubes to tighten and contract, and  producing excessive amounts of mucus. At night, the airways become more  hyper-responsive, resulting in more severe and frequent symptoms,  according to a review published in the January 2009 issue of "McGill  Journal of Medicine" by Dr. Darrell Ginsberg.
Severity
In a  sleeping child, asthma signs and symptoms become more exaggerated.  According to Dr. Ginsberg, wheezing, cough and breathing may become  worse during sleep. Wheezing or whistling sounds may become louder and  more pronounced. Breathing may become more difficult and cause the skin  around the ribs or neck to pull in. Cough also becomes worse late at  night, according to the American College of Allergy, Asthma and  Immunology. The airways also become more responsive and easily react to  the environment when the child is asleep.
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Cause
According  to Dr. Ginsberg, the airways become more inflamed and hyper-reactive  following a circadian rhythm at 4 a.m. Sleep can also make the lung  functions worse and tend to make asthma symptoms more severe because the  sleeping child may not compensate for the lack of oxygen. A sleeping  child also may not be able to increase his capacity to take in more air  during an attack, compared to when he is awake.
Diagnosis
The  gold standards for diagnosing asthma include a medical exam, clinical  history and a test for the amount of airflow. However, testing for  accurate airflow is not possible while a child is asleep, notes Dr.  Ginsberg. Hence, a better alternative is diagnosing nocturnal wheeze  using a computerized monitoring device.
Effects on Sleep
Worsening  signs of asthma at night may result in poor sleep quality for the  child, relates Dr. Ginsberg. Children may wake up more frequently at  night because of their symptoms. Intermittent wheezing also makes  falling back to sleep more difficult for the child. Children may also  become sleepier during the day. Parents of children with asthma also  tend to become more moody and feel hassled as they themselves lack  sleep, comments Dr. Ginsberg.
Effects on Life
According  to Dr. Ginsberg, nocturnal asthma may also result in behavior problems  related to lack of sleep. Children may also develop emotional problems,  learning disabilities, miss school more, and poorer performance in  school, notes a study in the September 2000 issue of "Archives of  Pediatrics and Adolescent Medicine." Parents of children suffering from  nocturnal asthma also tend to miss more workdays.







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