Many patients tell me that their symptoms are worse during the night or first thing in the morning.  Some even say that it takes them hours every morning to get their breathing  right. Symptoms  such as a blocked nose, excessive mucus,  tiredness,   chest   tightness,   wheezing  and   breathlessness   are common.  These  problems  are  usually caused  by incorrect breathing  while sleeping,  and  it is for this  reason that  we need to pay particular attention to how we breathe when we are asleep.

The  risk of an asthma  attack is greatest  during  sleep. Statistics show that most attacks occur between the hours of 3.00 and  5.00 a.m.  Professor  Buteyko’s theory  is that  the natural position for humans  is upright  because when we lie down, our breathing  increases  automatically  in comparison with  the  needs  of  our  metabolism.   For  someone   who  is already overbreathing,  this further increase in breathing  will lead to a further depletion  of carbon dioxide levels, and this can in turn lead to an attack.

transOversleeping is not good either. A good rule of thumb is to sleep only when  you feel tired. This is when  your body is telling you that sleep is necessary and generally seven to eight hours per night is enough. If you feel the need to sleep during  the day, take a nap for twenty minutes while sitting upright.  Correct  breathing  will increase  your  energy  level and reduce fatigue so additional  sleep should not be necessary. As your CP increases, the  number  of hours  sleep you need  each  night  should  gradually  decrease  – probably  to somewhere  between five or six.

Reduced breathing  during  the  day will help to reduce overbreathing at night, but we have very little control of our breathing  in  the  depths of our  slumbers.  Because of this, there  are a number  of recommendations that  may be fol- lowed to help ensure correct breathing  at night.


Sleeping positions

Sleeping  on  your  back is generally  the  worst  position  for someone   with  asthma.  Your  lower  jaw drops  and  mouth breathing  is almost inevitable. In this position, there  is very little  restriction   to  breathing   and  so  breathing   becomes deeper. Snoring, which is also caused by overbreathing and breathing  through  the  mouth,  is worse  while sleeping  on your back.

Increased  blood pressure  and bad health  are just some of the side effects of snoring, not to mention  the strain it can put on even the most harmonious of marriages.  (I was in a youth hostel one night many years ago where a severe snorer was in danger  of suffering grievous  bodily harm  from  the adjoining  bunk  – and  the  general  consensus  was that  he would  have  deserved  it!) Another  condition which  affects children  especially is bed wetting.  For years Buteyko advocated that bed wetting was caused by hyperventilation.  Now new research, published  in New Scientist, confirms  his view:

‘Breathing problems are to blame for many cases of bedwetting  in  children,  and  perhaps  in  some  adults  too.  And a simple treatment might solve the problem within weeks.’

Changing  from  sleeping  on  your  back to  sleeping  on your side may take some  time. It may be helpful to place a number  of pillows behind  you while you sleep on your side. Another suggestion would be to wear a rucksack on your back filled  with  clothes  or a football, and  then there  is the  old wives’ tale of sewing a tennis or golf ball into the back of your nightwear.  All of these options  may sound  a little eccentric,



but they will reduce  the likelihood of you rolling onto  your back and you should, over time, switch to sleeping  on your side or tummy.

After years of research, Professor Buteyko came to the conclusion  that  people  who sleep on their  left side, in the foetal position, tend  to breathe  less deeply. The reason  for this  is thought  to  be  variation  in  lung  capacity: the  lung which is closest to the bed performs  most of the work and, as the left lung is smaller than  the right, the volume of air brought  through  the lungs is reduced. Some people address the problem  by sleeping with four or five pillows under  the head. This has the effect of raising the head and chest above the level of the rest of the body, and a little nearer to a verti- cal position. A hard  mattress,  which restricts  frontal  move- ment  of the body, can also help to reduce  breathing.  A soft mattress, particularly something like a water bed, is not good for correct breathing  because it offers too little resistance.




Never eat before sleep

Eating a meal or drinking  a protein-rich drink such as milk or hot chocolate two or even three hours before going to bed will result in increased breathing. Then you will have both an increase  in breathing  due to lying in a horizontal  position, and an increase in breathing  due to eating or drinking. Then overbreathing is guaranteed, resulting in a poor night’s sleep. Eating  a  meal  late  at  night  can  also  result  in having  no appetite for breakfast.

Eating late at night on a regular basis is inherently unhealthy  for anyone  – asthmatic  or not.  It contributes  to increased  weight  gain  and lethargy, and  it can disrupt  the appetite  the  following day. My grandfather was a man  of much  wisdom and he had a saying that you should ‘always wake up with an appetite’. I’m sure he was right.

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